Abstract INTRODUCTION: Pseudomonas aeruginosa is one of the main pathogens causing infection in intensive care units (ICUs) and usually presents antimicrobial resistance. METHODS: Data were obtained from ICUs between 2010 and 2013. RESULTS: P. aeruginosa had a prevalence of 14.5% of which 48.7% were multidrug resistant. We observed increasing resistance to carbapenems and polymyxin B and growing consumption of aminoglycosides, meropenem, ceftazidime, and polymyxin B. The regression impact between resistance and consumption was significant with respect to amikacin, imipenem, meropenem, and polymyxin B. CONCLUSIONS: Monitoring antimicrobial consumption and resistant microorganisms should be reinforced to combat antimicrobial- and multi-drug resistance.

ABSTRACT BACKGROUND: Patient safety culture is part of the organizational profile of healthcare institutions and is associated with better quality of care. OBJECTIVE: To assess patient safety culture in a university hospital. DESIGN AND SETTING: Hospital-based cross-sectional study conducted in a public university hospital in São Paulo, Brazil, between September and December 2015. METHODS: We randomly selected 68 sectors of the hospital, to include up to 5 employees from each sector, regardless of length of experience. We used the validated Brazilian version of the Hospital Survey on Patient Safety Culture (HSOPS) via an electronic interface. We calculated the percentage of positive responses for each dimension of the HSOPS and explored the differences in age, experience, occupation and educational level of respondents using the chi-square test. RESULTS: Out of 324 invited respondents, 314 (97%) accepted the invitation and were surveyed. The sample presented predominance of women (72%), nursing staff (45%) and employees with less than six years’ experience at the hospital (60%). Nine out of the 12 dimensions showed percentages of positive responses below 50%. The worst results related to “nonpunitive response to errors” (16%). A better safety culture was observed among more experienced staff, nurses and employees with a lower educational level. In the previous year, no events were reported by 65% of the participants. CONCLUSIONS: The patient safety culture presented weaknesses and most of professionals had not reported any event in the previous year. A policy for improvement and cyclical assessment is needed to ensure safe care.

No Brasil, os idosos representavam 9,05% em 1999 e, em 2020, poderão totalizar 13% da população. Nessa faixa etária as doenças crônicas e degenerativas são comuns e freqüentemente se utiliza muitos medicamentos. A prescrição e o uso inadequado dos mesmos podem levar a resultados indesejados, acarretando internações hospitalares evitáveis e elevando os custos do sistema de saúde. O objetivo deste trabalho foi conhecer os estudos de intervenção do farmacêutico e sua influência no uso de medicamentos pelo paciente idoso, listados em cinco bases de dados, no período entre 1970 e 1999. Foram localizados 76 artigos, resultando em 15 trabalhos para análise e discussão. Os estudos sobre o tema são escassos e limitados aos países de economia avançada. De uma forma geral, as intervenções apresentaram resultado positivo. A maioria das intervenções limitou-se ao aconselhamento ao usuário e/ou ao prescritor, notando-se falta de ações que levem à adequação do medicamento ao usuário.

The total proportional geriatric population in Brazil is projected to increase from 9.05% in 1999 to approximately 13% in 2020. Non-communicable diseases are common in this age group, and medication is used frequently. Inadequate prescription and improper use of drugs can produce undesirable outcomes, leading to avoidable hospitalization and increasing health care costs. The objective of this paper was to conduct a literature review of pharmacists' interventions and their influence on use of medication by elderly patients, based on five databases from 1970 to 1999. The sample consisted of 76 studies, of which 15 were analyzed and discussed. Research on this subject is scarce, and limited to developed countries. In general, the interventions presented favorable outcomes. Most actions were limited to counseling patients and their physicians, and there was a lack of interventions to adjust the medication to the user.

No Brasil, os idosos representavam 9,05% em 1999 e, em 2020, poderão totalizar 13% da população. Nessa faixa etária as doenças crônicas e degenerativas são comuns e freqüentemente se utiliza muitos medicamentos. A prescrição e o uso inadequado dos mesmos podem levar a resultados indesejados, acarretando internações hospitalares evitáveis e elevando os custos do sistema de saúde. O objetivo deste trabalho foi conhecer os estudos de intervenção do farmacêutico e sua influência no uso de medicamentos pelo paciente idoso, listados em cinco bases de dados, no período entre 1970 e 1999. Foram localizados 76 artigos, resultando em 15 trabalhos para análise e discussão. Os estudos sobre o tema são escassos e limitados aos países de economia avançada. De uma forma geral, as intervenções apresentaram resultado positivo. A maioria das intervenções limitou-se ao aconselhamento ao usuário e/ou ao prescritor, notando-se falta de ações que levem à adequação do medicamento ao usuário.

The total proportional geriatric population in Brazil is projected to increase from 9.05% in 1999 to approximately 13% in 2020. Non-communicable diseases are common in this age group, and medication is used frequently. Inadequate prescription and improper use of drugs can produce undesirable outcomes, leading to avoidable hospitalization and increasing health care costs. The objective of this paper was to conduct a literature review of pharmacists' interventions and their influence on use of medication by elderly patients, based on five databases from 1970 to 1999. The sample consisted of 76 studies, of which 15 were analyzed and discussed. Research on this subject is scarce, and limited to developed countries. In general, the interventions presented favorable outcomes. Most actions were limited to counseling patients and their physicians, and there was a lack of interventions to adjust the medication to the user.