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Dose Error Reduction System

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https://www.readbyqxmd.com/read/28799408/assessment-of-apixaban-prescribing-patterns-for-nonvalvular-atrial-fibrillation-in-hospitalized-patients
#1
Caitlin M Gibson, Carmen B Smith, Sondra Davis, Michael J Scalese
BACKGROUND: Apixaban is a direct oral anticoagulant (DOAC) for the prevention of stroke and systemic embolism in patients with nonvalvular atrial fibrillation (NVAF). Other DOACs require renal dose adjustments based solely on creatinine clearance. Apixaban differs in that its dose adjustments are more complex, potentially leading to prescribing errors. OBJECTIVE: To determine if adherence to Food and Drug Administration (FDA)-approved dosing for apixaban is maintained in hospitalized patients with NVAF...
August 1, 2017: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/28755565/automatic-plume-episode-identification-and-cloud-shine-reconstruction-method-for-ambient-gamma-dose-rates-during-nuclear-accidents
#2
Xiaole Zhang, Wolfgang Raskob, Claudia Landman, Dmytro Trybushnyi, Christoph Haller, Hongyong Yuan
Ambient gamma dose rate (GDR) is the primary observation quantity for nuclear emergency management due to its high acquisition frequency and dense spatial deployment. However, ambient GDR is the sum of both cloud and ground shine, which hinders its effective utilization. In this study, an automatic method is proposed to identify the radioactive plume passage and to separate the cloud and ground shine in the total GDR. The new method is evaluated against a synthetic GDR dataset generated by JRODOS (Real Time On-line Decision Support) System and compared with another method (Hirayama, H...
July 26, 2017: Journal of Environmental Radioactivity
https://www.readbyqxmd.com/read/28755403/monitoring-deep-inspiration-breath-hold-for-left-sided-localized-breast-cancer-radiotherapy-with-an-in-house-developed-laser-distance-meter-system
#3
Christer A Jensen, Tatiana Abramova, Jomar Frengen, Jo-Åsmund Lund
Deep inspiration breath hold (DIBH) in left-sided breast cancer radiotherapy is a technique to reduce cardiac and pulmonary doses while maintaining target coverage. This study aims at evaluating an in-house developed DIBH system. Free-breathing (FB) and DIBH plans were generated for 22 left-sided localized breast cancer patients who had radiation therapy (RT) after breast-conserving surgery. All patients were treated utilizing an in-house laser distance measuring system. 50 Gy was prescribed, and parameters of interest were target coverage, left anterior descending coronary artery, (LAD) and heart doses...
July 29, 2017: Journal of Applied Clinical Medical Physics
https://www.readbyqxmd.com/read/28741892/dose-comparison-between-gafchromic-film-xio-and-monaco-treatment-planning-systems-in-a-novel-pelvic-phantom-that-contains-a-titanium-hip-prosthesis
#4
Nicholas Ade, F C P du Plessis
The presence of metallic prostheses during external beam radiotherapy of malignancies in the pelvic region has the potential to strongly influence the dose distribution to the target and to tissue surrounded by the prostheses. This study systematically investigates the perturbation effects of unilateral titanium prosthesis on 6 and 15 MV photon beam dose distributions using Gafchromic EBT2 film measurements in a novel pelvic phantom made out of a stack of nylon slices. Comparisons were also made between the film data and dose calculations made on XiO and Monaco treatment planning systems...
July 25, 2017: Journal of Applied Clinical Medical Physics
https://www.readbyqxmd.com/read/28732613/photorefractive-intrastromal-corneal-crosslinking-for-the-treatment-of-myopic-refractive-errors-six-month-interim-findings
#5
Matthias Elling, Inga Kersten-Gomez, H Burkhard Dick
PURPOSE: To evaluate the safety and efficacy of photorefractive intrastromal corneal crosslinking (CXL) in low myopia. SETTING: Ruhr University Eye Hospital, Bochum, Germany. DESIGN: Prospective case series. METHODS: Healthy eyes with myopia or myopic astigmatism had photorefractive intrastromal CXL using the Mosaic system to apply ultraviolet-A (UVA) 365 nm (30 mW/cm(2)) irradiance (total calculated UVA dose of 10 J/cm(2) or 15 J/cm(2)) with riboflavin 0...
June 2017: Journal of Cataract and Refractive Surgery
https://www.readbyqxmd.com/read/28675553/a-combined-intervention-to-reduce-interruptions-during-medication-preparation-and-double-checking-a-pilot-study-evaluating-the-impact-of-staff-training-and-safety-vests
#6
Saskia Huckels-Baumgart, Milena Niederberger, Tanja Manser, Christoph R Meier, Carla Meyer-Massetti
AIM: The aim was to evaluate the impact of staff training and wearing safety vests as a combined intervention on interruptions during medication preparation and double-checking. BACKGROUND: Interruptions and errors during the medication process are common and an important issue for patient safety in the hospital setting. METHODS: We performed a pre- and post-intervention pilot-study using direct structured observation of 26 nurses preparing and double-checking 431 medication doses (225 pre-intervention and 206 post-intervention) for 36 patients (21 pre-intervention and 15 post-intervention)...
July 3, 2017: Journal of Nursing Management
https://www.readbyqxmd.com/read/28643030/hospital-electronic-prescribing-system-implementation-impact-on-discharge-information-communication-and-prescribing-errors-a-before-and-after-study
#7
Pamela Ruth Mills, Anita Elaine Weidmann, Derek Stewart
PURPOSE: The study aimed to test the hypothesis that hospital electronic prescribing and medicine administration system (HEPMA) implementation impacted patient discharge letter quality, nature and frequency of prescribing errors. METHOD: A quasi experimental before and after retrospective case note review was conducted in one United Kingdom district general hospital. The total sample size was 318 (random samples of 159 before and after implementation), calculated to achieve a 10% error reduction with a power of 80% and p < 0...
June 22, 2017: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28574959/intravenous-smart-pump-drug-library-compliance-a-descriptive-study-of-44-hospitals
#8
Karen K Giuliano, Wan-Ting Su, Daniel D Degnan, Kristy Fitzgerald, Richard J Zink, Poching DeLaurentis
BACKGROUND: Although intravenous (IV) smart pumps with built-in dose-error reduction systems (DERS) can reduce IV medication administration error, most serious adverse events still occur during IV medication administration. Sources of error include overriding DERS and manually bypassing drug libraries and the DERS. METHODS: Our purpose was to use the Regenstrief National Center for Medical Device Informatics data set to better understand IV smart pump drug library and DERS compliance...
June 1, 2017: Journal of Patient Safety
https://www.readbyqxmd.com/read/28538369/significant-reduction-of-fluoroscopy-repetition-with-lumbar-localization-system-in-minimally-invasive-spine-surgery-a-prospective-study
#9
Guoxin Fan, Hailong Zhang, Xin Gu, Chuanfeng Wang, Xiaofei Guan, Yunshan Fan, Shisheng He
The conventional location methods for minimally invasive spinal surgery (MISS) were mainly based on repeated fluoroscopy in a trial-and-error manner preoperatively and intraoperatively. Localization system mainly consisted of preoperative applied radiopaque frame and intraoperative guiding device, which has the potential to minimize fluoroscopy repetition in MISS. The study aimed to evaluate the efficacy of a novel lumbar localization system in reducing radiation exposure to patients.Included patients underwent minimally invasive transforaminal lumbar interbody fusion (MISTLIF) or percutaneous transforaminal endoscopic discectomy (PTED)...
May 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28535917/sensitivity-evaluation-of-two-commercial-dosimeters-in-detecting-helical-tomotherapy-treatment-delivery-errors
#10
Shrikant Deshpande, Mark Geurts, Philip Vial, Peter Metcalfe, Lois Holloway
PURPOSE: To assess the sensitivity of two commercial dosimetry systems in detecting Helical TomoTherapy (HT) delivery errors. METHOD: Two commercial dosimeters i) MatriXX(Evolution) and ii) ArcCHECK® were considered. Ten retrospective nasopharynx HT patients were analysed. For each patient, error plans were created by independently introducing systematic offsets in: a) Jaw width error ±1, ±1.5 and ±2mm, b) Couch speed error ±2%, ±2.5, ±3% and ±4%, and c) MLC Leaf Open Time (MLCLOT) errors (3 separate MLC errors: either leaf 32 open or leaf 42 remains open during delivery, and 4% random reductions in MLCLOT)...
May 2017: Physica Medica: PM
https://www.readbyqxmd.com/read/28530330/-the-sherlock-system-clinical-and-logistic-pharmaceutical-services
#11
Roni Leibowitz, Shahar Aflalo, Ornit Cohen, Ahuva Lustig
BACKGROUND: The drug inventory in the hospital consumes a large part of the hospital's budget. Classic drug management is based on weekly visits of the pharmacist in the departments, writing an order and dispensing it. This method is wasteful in terms of sending a bulk of drugs that will not necessarily be utilized, and it is also inefficient in terms of human resources. The unit-dose method, which is more advanced, is based on filling out individual prescriptions for each of the inpatients in the department...
August 2016: Harefuah
https://www.readbyqxmd.com/read/28498024/a-prospective-risk-assessment-of-informal-carers-medication-administration-errors-within-the-domiciliary-setting
#12
Anam Parand, Giuliana Faiella, Bryony Dean Franklin, Maximilian Johnston, Fabrizio Clemente, Neville A Stanton, Nick Sevdalis
Increasingly, medication is being administered at home by family and friends of the care-recipient. This study aims to identify and analyse risks associated with potential drug administration errors made by informal carers at home. We mapped medication administration at home with a multidisciplinary team that included carers, health care professionals and patients. Evidence-based risk-analysis methodologies were applied: Healthcare Failure Modes and Effect Analysis (HFMEA), Systematic Human Error Reduction and Prediction Analysis (SHERPA) and Systems-Theoretic Accident Model and Processes (STAMP)...
June 9, 2017: Ergonomics
https://www.readbyqxmd.com/read/28479741/effect-of-naringenin-a-naturally-occurring-flavanone-against-pilocarpine-induced-status-epilepticus-and-oxidative-stress-in-mice
#13
Sheeba Shakeel, Muneeb U Rehman, Nahida Tabassum, Umar Amin, Manzoor Ur Rahman Mir
BACKGROUND: Epilepsy is a disorder of the central nervous system characterized by recurrent seizures. It is a very common disease in which approximately 30% of patients do not respond favourably to treatment with anticonvulsants. Oxidative stress is associated with neuronal damage arising from epileptic seizures. The present study investigated the effects of naringenin in pilocarpine-induced epilepsy in mice. Naringenin, one of the most frequently occurring flavanone in citrus fruits, was evaluated for its shielding effect against the pilocarpine induced behavioural, oxidative and histopathological alterations in rodent model of epilepsy...
January 2017: Pharmacognosy Magazine
https://www.readbyqxmd.com/read/28479718/potential-lipid-lowering-effects-of-eleusine-indica-l-gaertn-extract-on-high-fat-diet-induced-hyperlipidemic-rats
#14
Siew Ling Ong, Koteswara Rao Nalamolu, How Yee Lai
BACKGROUND: To date, anti-obesity agents based on natural products are tested for their potential using lipase inhibition assay through the interference of hydrolysis of fat by lipase resulting in reduced fat absorption without altering the central mechanisms. Previous screening study had indicated strong anti-obesity potential in Eleusine indica (E. indica), but to date, no pharmacologic studies have been reported so far. OBJECTIVE: This study was performed to investigate the lipid-lowering effects of E...
January 2017: Pharmacognosy Magazine
https://www.readbyqxmd.com/read/28448851/accurate-3d-reconstruction-of-bony-surfaces-using-ultrasonic-synthetic-aperture-techniques-for-robotic-knee-arthroplasty
#15
William Kerr, Philip Rowe, Stephen Gareth Pierce
Robotically guided knee arthroplasty systems generally require an individualized, preoperative 3D model of the knee joint. This is typically measured using Computed Tomography (CT) which provides the required accuracy for preoperative surgical intervention planning. Ultrasound imaging presents an attractive alternative to CT, allowing for reductions in cost and the elimination of doses of ionizing radiation, whilst maintaining the accuracy of the 3D model reconstruction of the joint. Traditional phased array ultrasound imaging methods, however, are susceptible to poor resolution and signal to noise ratios (SNR)...
April 19, 2017: Computerized Medical Imaging and Graphics: the Official Journal of the Computerized Medical Imaging Society
https://www.readbyqxmd.com/read/28443354/optimization-of-intelligent-infusion-pump-technology-to-minimize-vasopressor-pump-programming-errors
#16
MULTICENTER STUDY
Nina Vadiei, Carrie A Shuman, Manasa S Murthy, Mitchell J Daley
BACKGROUND: There is a lack of data evaluating the impact of hard limit implementation into intelligent infusion pump technology (IIPT). The purpose of this study was to determine if incorporation of vasopressor upper hard limits (UHL) into IIPT increases efficacy of alerts by preventing pump programming errors. METHODS: Retrospective review from five hospitals within a single healthcare network between April 1, 2013 and May 31, 2014. A total of 65,680 vasopressor data entries were evaluated; 19,377 prior to hard limit implementation and 46,303 after hard limit implementation...
August 2017: Expert Opinion on Drug Safety
https://www.readbyqxmd.com/read/28398210/out-of-field-doses-from-pediatric-craniospinal-irradiations-using-3d-crt-imrt-helical-tomotherapy-and-electron-based-therapy
#17
Marijke De Saint-Hubert, Dirk Verellen, Kenneth Poels, Wouter Crijns, Federica Magliona, Tom Depuydt, Filip Vanhavere, Lara Struelens
Medulloblastoma treatment involves irradiation of the entire central nervous system, i.e. craniospinal irradiation (CSI). This is associated with the significant exposure of large volumes of healthy tissue and there is growing concern regarding treatment-associated side effects. The current study compares out-of-field organ doses in children receiving CSI through 3D-conformal radiotherapy (3D-CRT), intensity modulated radiotherapy (IMRT), helical tomotherapy (HT) and an electron-based technique, and includes radiation doses resulting from imaging performed during treatment...
July 7, 2017: Physics in Medicine and Biology
https://www.readbyqxmd.com/read/28368966/intravenous-administration-errors-intercepted-by-smart-infusion-technology-in-an-adult-intensive-care-unit
#18
Rebecca Ibarra-Pérez, Fabiola Puértolas-Balint, Elizabeth Lozano-Cruz, Sergio E Zamora-Gómez, Lucila I Castro-Pastrana
OBJECTIVES: The aim of the study was to investigate the efficacy of intravenous (IV) smart pumps with drug libraries and dose error reduction system (DERS) to intercept programming errors entailing high risk for patients in an adult intensive care unit (ICU). METHODS: A 2-year retrospective study was conducted in the adult ICU of the Hospital Juárez de México in Mexico City to evaluate the impact of IV smart pump/DERS (Hospira MedNet) technology implementation...
April 1, 2017: Journal of Patient Safety
https://www.readbyqxmd.com/read/28297338/epid-based-in-vivo-dosimetry-system-clinical-experience-and-results
#19
Sofia Celi, Emilie Costa, Claas Wessels, Alejandro Mazal, Alain Fourquet, Pascal Francois
Mandatory in several countries, in vivo dosimetry has been recognized as one of the next milestones in radiation oncology. Our department has implemented clinically an EPID based in vivo dosimetry system, EPIgray, by DOSISOFT S.A., since 2006. An analysis of the measurements per linac and energy over a two-year period was performed, which included a more detailed examination per technique and treatment site over a six-month period. A comparison of the treatment planning system doses and the doses estimated by EPIgray shows a mean of the differences of 1...
May 2016: Journal of Applied Clinical Medical Physics
https://www.readbyqxmd.com/read/28288091/utilizing-electronic-health-record-information-to-optimize-medication-infusion-devices-a-manual-data-integration-approach
#20
Amanda Chuk, Robert Maloney, Joyce Gawron, Colin Skinner
Health information technology is increasingly utilized within healthcare delivery systems today. Two examples of this type of technology include the capture of patient-specific information within an electronic health record and intravenous medication infusion devices equipped with dose error reduction software known as drug libraries. Automatic integration of these systems, termed intravenous (IV) interoperability, should serve as the goal toward which all healthcare systems work to maximize patient safety...
November 2016: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
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