Indicadores para la calidad asistencial y la atención farmacéutica al paciente VIH

Objective: To identify and to promote improvements in the quality of the sanitary attention to the HIV+ patients in the Clinical Units of the hospitals in our country, there being included and reinforcing the perspective of Pharmaceutical Care. Methods: To carry out the project, during the period January- June 2012, the following phases were defined. First, a bibliographical review was realized and reading criticizes related to the pathology HIV and quality criteria. Later, a presencial qualitative investigation phase was carried out with the expert participants. The first one was carried out by means of two technologies: the nominal group and a variant of groups of discussion. The application of the technologies was supported by an technical support that allowed the codification and valuation organized. The last phase of the project consisted of a meeting presencial, where there were outlined the aims of the first meeting and put jointly all the work that the subgroups of work had elaborated to agree on the contents. Of the first selection of ideas, the equipment of investigation worked and prioritized those elements that describe and give response to the raised aims. Concretely, the correct definition of the safety and quality indicators in the area of the hospital pharmacist, there being elaborated a card that was describing every aspect to bear in mind for the later measurement of the indicator. Finally, a plan of actions was elaborated to improve the clinical practice synthesized according to his level of priority. Results: Across the methodology of the project, the experts identified the quality criterias in pharmaceutical care procedure. The principal barriers identified were: asistencial pressure, personnel management system’s, security and ignorance of the pharmacotherapy, lack of quality culture and difficulties of access to the information. Principals clinical risks identified were: mistakes in the guidelines with the changes of treatments, lack of information of the whole medication of the patient, lack in resources and time adapted to realize the processes, lack of communication between professionals, ignorance of interactions or adverse events. The principal results that were extracted from the analysis of situation were that the priority line of action had to happen for a link between patients, specialists and primary care. It should promote the clinical management of the units of HIV, the access to the information for all the professionals who realize pharmacoterapeutical follow-up to these patients and the major implication on the part of these. Finally, 29 quality indicators were defined in the pharmaceutical care to the HIV+ patient distributed in structure, processes and results and the plan of improvement for the attention and his level of priority considered. Discussion: This document gives response to the increasing demand for homogenizing the clinical practice and establishing common criteria of quality that result a benefit for the sanitary system and, in consequence, for the professionals and the patients.