Palabras clave
Errores de medicación
Fármacos cardiovasculares
Seguridad del paciente
Cuidados críticos
Cómo citar
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Resumen
Objetivo: Identificar estrategias de enfermería relacionadas con la seguridad en la preparación, administración, titulación y monitorización de fármacos vasoactivos en unidades de cuidados críticos, con base en evidencias científicas publicadas en los últimos cinco años. Métodos: Revisión integradora de la literatura, estructurada mediante la estrategia PICO y realizada en las bases MEDLINE/PubMed, CINAHL y LILACS, entre julio y octubre de 2025. Se incluyeron artículos completos, publicados entre 2020 y 2025, en portugués, inglés y español, que respondieran a la pregunta orientadora. La selección siguió las recomendaciones PRISMA, con eliminación de duplicados en Rayyan, cribado independiente por revisores y análisis de los textos completos elegibles. Resultados: La muestra final estuvo compuesta por seis estudios. Las evidencias señalaron que protocolos institucionales, capacitación continua, monitorización hemodinámica rigurosa, comunicación interprofesional, tecnologías asistenciales y juicio clínico cualificado constituyen estrategias relevantes para reducir la variabilidad asistencial y fortalecer la seguridad medicamentosa en el manejo de infusiones vasoactivas. Consideraciones finales: Las estrategias identificadas contribuyen a prácticas más seguras; sin embargo, el reducido número de estudios y el predominio de diseños observacionales exigen cautela al afirmar impacto directo en la reducción de errores de medicación.
Referencias
AGSUS. Manual de protocolos de metas de segurança do paciente. 2025. Disponível em: https://agenciasus.org.br/shared-files/16992/?MANUAL-DE-PROTOCOLOS-DE-METAS-DE-SEGURANCA-DO-PACIENTE.pdf. Acesso em: 5 nov. 2025.
AL GHARIBI KA, ARULAPPAN J. Repeated simulation experience on self-confidence, critical thinking, and competence of nurses and nursing students: an integrative review. SAGE Open Nursing, 2020; 6: 1-8.
AL-ZARU IM, et al. Effectiveness of an educational program regarding vasoactive drugs at the level of knowledge and practices among nurses working in critical care units. Jordan Journal of Nursing Research, 2022; 1(2): 4-15.
ANDALUZ-OJEDA D, et al. Fármacos vasoactivos en el tratamiento del shock séptico. Medicina Intensiva, 2022; 46(Supl. 1): 26-37.
ASSIS SF, et al. Eventos adversos em pacientes de terapia intensiva: estudo transversal. Revista da Escola de Enfermagem da USP, 2022; 56: e20210481.
BERGMAN L, et al. Registered nurses’ experiences of working in the intensive care unit during the COVID-19 pandemic. Nursing in Critical Care, 2021; 26: 467-475.
BOTELHO LL, et al. O método da revisão integrativa nos estudos organizacionais. Gest Soc, 2011; 5: 121-136.
BRASIL. Metas internacionais de segurança do paciente. 2021. Disponível em: https://www.gov.br/ebserh/pt-br/hospitais-universitarios/regiao-sudeste/hc-ufmg/saude/metas-internacionais-de-seguranca-do-paciente/metas-internacionais-de-seguranca-do-paciente. Acesso em: 3 jun. 2025.
COELHO F, et al. Predisposing factors to medication errors by nurses and prevention strategies: a scoping review of recent literature. Nursing Reports, 2024; 14: 1553-1569.
DUTRA SVO, et al. Instruction strategies for drug calculation skills: a systematic review of the literature. Nurse Education Today, 2022; 111: 105299.
EVANS L, et al. Surviving Sepsis Campaign: international guidelines for the management of sepsis and septic shock 2021. Critical Care Medicine, 2021; 49(11): 1974-1982.
FATHIZADEH H, et al. Prevalence of medication errors and its related factors in Iranian nurses: an updated systematic review and meta-analysis. BMC Nursing, 2024; 23: 175.
GERSHENGORN HB, et al. Association of premorbid blood pressure with vasopressor infusion duration in patients with shock. American Journal of Respiratory and Critical Care Medicine, 2020; 202(1): 91-99.
GRIFFIN E, et al. An economic analysis of critical care nurse resourcing following the uptake of ready-to-administer noradrenaline for hypotensive shock in adults in England. Advances in Therapy, 2022; 39: 727-737.
HUNTER S, et al. Intensive care patients receiving vasoactive medications: a retrospective cohort study. Australian Critical Care, 2022; 35: 499-505.
HUNTER S, et al. Nurse management of noradrenaline infusions in intensive care units: an observational study. Australian Critical Care, 2024; 37: 58-66.
HUNTER S, et al. The influence of intensive care unit culture and environment on nurse decision-making when managing vasoactive medications: a qualitative exploratory study. Journal of Clinical Nursing, 2023; 32:
-4091.
INTENSIVE CARE SOCIETY. Guidance for: the use of vasopressor agents by peripheral intravenous infusion in adult critical care patients. 2020. Disponível em: https://www.wyccn.org/uploads/6/5/1/9/65199375/peripheral_vasopressor_guide_fianl.pdf. Acesso em: 16 nov. 2025.
JBI. JOANNA BRIGGS INSTITUTE. JBI levels of evidence. Melbourne: The Joanna Briggs Institute, 2013.
JOINT COMMISSION. National patient safety goals: effective January 2026 for the critical access hospital program. 2025. Disponível em: https://www.jointcommission.org/en-us/standards/national-performance-goals. Acesso em: 20 nov. 2025.
KWAME A, PETRUCKA PM. A literature-based study of patient-centered care and communication in nurse-patient interactions: barriers, facilitators, and the way forward. BMC Nursing, 2021; 20: 158.
MORAIS AM, et al. Exercício como mobilização precoce em pacientes com uso de drogas vasoativas. Revista Brasileira de Fisiologia do Exercício, 2020; 19(4): 301-311.
MOTIEJUNAITE J, et al. Inotropes and vasopressors are associated with increased short-term mortality but not long-term survival in critically ill patients. Anaesthesia Critical Care & Pain Medicine, 2022; 41: 101012.
PAGE MJ, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ, 2021; 372: 71.
PUXTY K, et al. Understanding and mitigating medication errors associated with patient harm in adult intensive care units: a scoping review. Intensive Care Medicine, 2025; 51: 1098-1111.
REISDORFER AP, et al. Cuidados de enfermagem ao paciente no pós-operatório de cirurgia cardíaca, na unidade de terapia intensiva. Revista Brasileira de Enfermagem, 2021; 74(2): e20200163.
SANTOS CM, et al. The PICO strategy for the research question construction and evidence search. Rev Latino-Am Enfermagem, 2007; 15: 508-11.
SKRIFVARS MB, et al. Individualized blood pressure targets during postcardiac arrest intensive care. Current Opinion in Critical Care, 2020; 26(3): 259-266.
SMITH SE, et al. Exploration of norepinephrine dose-capping practices: report from an international, interprofessional survey of critical care clinicians. Journal of Pharmacy Practice, 2024; 37(5): 1132-1140.
SOUZA MT, et al. Integrative review: what is it? How to do it? Einstein (São Paulo), 2010; 8: 102-6.
TARRAHI MJ, et al. Medication safety climate from the perspectives of healthcare providers: a cross-sectional study. Journal of Education and Health Promotion, 2023; 12: 195.
TU HN, et al. Reducing medication errors by adopting automatic dispensing cabinets in critical care units. Journal of Medical Systems, 2023; 47: 52.
WATERVAL E, et al. Nurses’ decision-making and confidence with titration of vasoactive medication. American Journal of Critical Care, 2025; 34(4): e24-e31.
WORLD HEALTH ORGANIZATION. Global burden of preventable medication-related harm in health care: a systematic review. Geneva: World Health Organization, 2023a. Disponível em: https://iris.who.int/server/api/core/bitstreams/f208903d-b47d-4a8c-9fac-d8136c2bdbb6/content. Acesso em: 20 nov. 2025.
WORLD HEALTH ORGANIZATION. Global patient safety action plan 2021–2030: towards eliminating avoidable harm in health care. Geneva: World Health Organization, 2021. Disponível em: https://iris.who.int/server/api/core/bitstreams/a28c34c0-089c-4f5d-a0b1-5d9c35a3cd67/content. Acesso em: 23 nov. 2025.
WORLD HEALTH ORGANIZATION. Global patient safety report 2024. Geneva: World Health Organization, 2024. Disponível em: https://iris.who.int/server/api/core/bitstreams/ae1caeae-bc04-4a71-a6b0-ab478f9a8c79/content. Acesso em: 24 nov. 2025.
WORLD HEALTH ORGANIZATION. Medication without harm: policy brief. Geneva: World Health Organization, 2023b. Disponível em: https://iris.who.int/server/api/core/bitstreams/1eacccb6-838e-4787-bfd9-4bdeb4debfcf/content. Acesso em: 27 nov. 2025.
WORLD HEALTH ORGANIZATION. Patient safety. 2023c. Disponível em: https://www.who.int/news-room/fact-sheets/detail/patient-safety. Acesso em: 18 nov. 2025.