Muchos de los errores de tratamiento producidos en lasunidades de cuidados intensivos neonatales (UCIN) tienensu origen en la necesidad de efectuar secuencias de cálculospara determinar dosis y diluciones de fármacos.

Para ayudar en estas tareas se diseñó una hoja de cálculo(neodosis) que facilita los cálculos y estandariza las dilucionesde algunas de las terapias más usadas en reanimacióny UCIN. Para evaluar su utilidad se diseñó estetrabajo.

Se efectuó un estudio controlado, cruzado y aleatorizadomediante simulaciones clínicas en las que se evaluó el númerode errores y tiempo utilizado en su resolución, con ysin el programa. Fueron realizadas un total de 54 pruebasen las que intervinieron médicos (residentes de tercer ycuarto año y pediatras) y personal de enfermería.

El personal asistencial probado cometió un número noinsignificante de errores en pruebas de simulación sobrecálculos típicos de UCIN.Neodosis ayudó a médicos y enfermeras a reducir muysensiblemente estos errores y a emplear menos tiempoen su resolución.

Many treatment errors in neonatal intensive care unitsare caused by the need to carry out a sequence of calculationsto determine the dose and dilution of the drugs used

To help in this task, we designed a spreadsheet (Neodosis)that helps clinicians and nurses to calculate the dosesand standardize the dilutions of some of the drugs mostcommonly used in resuscitation and neonatal intensivecare units. The aim of this study was to verify the usefulnessand reliability of this software package

A randomized, cross-over, controlled trial was conductedthrough simulated clinical cases in which the numberof errors in the prescription data and the amount of timespent in making calculations, with and without the program,were evaluated. Fifty-four tests were performed by pediatricians, third- and fourth-year pediatric residents, and nurses

Without computer support, all three groups made errors(residents, pediatricians and nurses in descending order).When Neodosis was used, all the medical staff madesignificantly fewer errors. The greatest reduction wasfound in errors made by pediatric residents: minor errorsdecreased from 16% to 2% and major errors from 1.6 % tozero. When using the spreadsheet, the time spent by allgroups in making the calculations was reduced by betweenone-third and one-half.

The tests performed with simulated clinical cases revealedthat the number of errors made by the healthcarepersonnel who participated in this study was not inconsiderable.The use of Neodosis helped physicians andnurses to make markedly fewer errors and also savedthem time.