Protocolization of Analgesia and Sedation Through Smart Technology in Intensive Care: Improving Patient Safety.

Background: The risk of medication errors in intensive care units is high, primarily in the drug administration phase.

Local Problem: Management of high-alert medications within intensive care units in the study institution varied widely. The aim of this quality improvement project was to protocolize and centralize the management of high-alert medications in acute care settings and to implement smart intravenous infusion pump technology in intensive care units.

Real-world effectiveness and factors associated with increased mortality in non-critically ill patients with COVID-19 pneumonia receiving remdesivir.

Objectives: Evidence on the effectiveness of remdesivir when used in real-life clinical practice is controversial. This study aims to analyse its effectiveness and the factors associated with increased mortality in non-critically ill patients with COVID-19 pneumonia who require supplemental low-flow oxygen and received remdesivir.

Methods: A retrospective cohort study was conducted at Ramón y Cajal University Hospital (Madrid, Spain) which included all patients treated with remdesivir in our institution during the second pandemic breakout in Spain, from August to November 2020.

Cost-utility analysis of venetoclax in combination with obinutuzumab as first-line treatment of chronic lymphocytic leukaemia in Spain.

Objective: Venetoclax in combination with obinutuzumab has significantly improved efficacy versus immunochemotherapy (progression-free survival) in patients with chronic lymphocytic leukaemia who have not  received prior treatment. The objective of this study was to evaluate its efficiency in Spain using a cost-utility analysis.

Method: Using a partitioned-survival analysis model adapted to the Spanish  context and based on three health states (progression-free survival, survival  after progression, and death), a simulation of the evolution of patients who  were candidates for initiating first-line treatment was conducted for a lifetime  time horizon.

Healthcare failure mode and effect analysis in the chemotherapy preparation process.

Purpose: To conduct a Health Care Failure Mode and Effects Analysis (HFMEA) of the chemotherapy preparation process to identify the steps with the potential to cause errors, and to develop further strategies to improve the process and thus minimize the risk of errors.

Methods: An HFMEA was conducted to identify and reduce preparation errors during the chemotherapy preparation process. A multidisciplinary team mapped the preparation process, formally identified all the steps, and then conducted a brainstorming session to determine potential failure modes and their potential effects.

Evaluation of adherence and clinical outcomes in patients undergoing allogeneic haematopoietic stem cell transplantation.

Objective: To measure adherence to cyclosporine, tacrolimus and  sirolimus prophylaxis against secondary graft failure; cyclosporine,  tacrolimus, sirolimus and mycophenolate prophylaxis against graft- versus-host disease; and posaconazole, voriconazole, valganciclovir  prophylaxis against infection in patients undergo to transplantation of  haematopoietic stem cells; and to analise the incidence of acute  complications based on adherence.

Method: Retrospective observational study of patients who underwent  allogeneic haematopoietic stem cell transplantation between May 2017  and May 2018. Analyses were carried out between 0 and +100 days  post-engraftment.

Chemotherapy Near the End of Life in Onco-Hematological Adult Patients.

Objective: The use of chemotherapy near the end of life is not advisable. There are scarce data in Europe but shows signs of aggressiveness. We designed this study to analyze the proportion of onco-hematological patients receiving chemotherapy within their last 2 weeks of life as well as starting a new chemotherapy regimen in the 30 days prior to death.

Impact of the implementation of vasoactive drug protocols on costs in the treatment of critically ill patients.

Objective: To evaluate the efficiency of the protocolization and centralization of  the preparation of intravenous vasoactive drug mixtures in the treatment of  critically ill patients.

Method: A prospective interventional study (July 2012-December 2014) was  conducted to measure the impact of different vasoactive drug protocols on costs  in the treatment of critically ill patients. The economic impact was measured by  comparing the direct costs (fixed and variable) of the preparation of intravenous  vasoactive drug mixtures in the Pharmacy Department with their traditional  preparation in hospital care units.

[Adherence to entecavir for chronic hepatitis B and correlation with effectiveness].

Purpose: to evaluate adherence of patients with chronic hepatitis B initiated on entecavir as first-line treatment and to correlate adherence with effectiveness.

Methods: observational retrospective study performed between January 2007 and June 2013. Patients treated with entecavir for at least one year were included.

[Designing a software for drug management in special situations at a hospital's drug administration service].

Objective: to describe the features of a computer program for management of drugs in special situations (off-label and compassionate use) in a Department of Hospital Pharmacy (PD). To describe the methodology followed for its implementation in the Medical Services. To evaluate their use after 2 years of practice.