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https://www.readbyqxmd.com/read/29144250/case-not-closed-prescription-errors-12-years-after-computerized-physician-order-entry-implementation
#1
Gili Kadmon, Michal Pinchover, Avichai Weissbach, Shirley Kogan Hazan, Elhanan Nahum
OBJECTIVE: To assess the prolonged impact of computerized physician order entry (CPOE) on medication prescription errors in pediatric intensive care patients. STUDY DESIGN: This observational study was conducted at a pediatric intensive care unit in which a CPOE (Metavision, iMDsoft, Israel) with a limited clinical decision support system was implemented between 2004 and 2007. Since then, no changes were made to the systems. We analyzed 2500 electronic prescriptions (1250 prescriptions from 2015 and 1250 prescriptions from 2016)...
November 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/29119475/comparative-cost-effectiveness-analysis-of-three-different-automated-medication-systems-implemented-in-a-danish-hospital-setting
#2
Bettina Wulff Risør, Marianne Lisby, Jan Sørensen
INTRODUCTION: Automated medication systems have been found to reduce errors in the medication process, but little is known about the cost-effectiveness of such systems. The objective of this study was to perform a model-based indirect cost-effectiveness comparison of three different, real-world automated medication systems compared with current standard practice. METHODS: The considered automated medication systems were a patient-specific automated medication system (psAMS), a non-patient-specific automated medication system (npsAMS), and a complex automated medication system (cAMS)...
November 8, 2017: Applied Health Economics and Health Policy
https://www.readbyqxmd.com/read/29092694/reducing-antibiotic-prescribing-in-australian-general-practice-time-for-a-national-strategy
#3
REVIEW
Christopher B Del Mar, Anna Mae Scott, Paul P Glasziou, Tammy Hoffmann, Mieke L van Driel, Elaine Beller, Susan M Phillips, Jonathan Dartnell
In Australia, the antibiotic resistance crisis may be partly alleviated by reducing antibiotic use in general practice, which has relatively high prescribing rates - antibiotics are mostly prescribed for acute respiratory infections, for which they provide only minor benefits. Current surveillance is inadequate for monitoring community antibiotic resistance rates, prescribing rates by indication, and serious complications of acute respiratory infections (which antibiotic use earlier in the infection may have averted), making target setting difficult...
November 6, 2017: Medical Journal of Australia
https://www.readbyqxmd.com/read/29076013/hospital-staff-views-of-prescribing-and-discharge-communication-before-and-after-electronic-prescribing-system-implementation
#4
Pamela Ruth Mills, Anita Elaine Weidmann, Derek Stewart
Background Electronic prescribing system implementation is recommended to improve patient safety and general practitioner's discharge information communication. There is a paucity of information about hospital staff perspectives before and after system implementation. Objective To explore hospital staff views regarding prescribing and discharge communication systems before and after hospital electronic prescribing and medicines administration (HEPMA) system implementation. Setting A 560 bed United Kingdom district general hospital...
December 2017: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/29049113/the-us-opioid-crisis-current-federal-and-state-legal-issues
#5
REVIEW
Cobin D Soelberg, Raeford E Brown, Derick Du Vivier, John E Meyer, Banu K Ramachandran
The United States is in the midst of a devastating opioid misuse epidemic leading to over 33,000 deaths per year from both prescription and illegal opioids. Roughly half of these deaths are attributable to prescription opioids. Federal and state governments have only recently begun to grasp the magnitude of this public health crisis. In 2016, the Centers for Disease Control and Prevention released their Guidelines for Prescribing Opioids for Chronic Pain. While not comprehensive in scope, these guidelines attempt to control and regulate opioid prescribing...
November 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29029694/prescriber-response-to-computerized-drug-alerts-for-electronic-prescriptions-among-hospitalized-patients
#6
Yael Zenziper Straichman, Daniel Kurnik, Ilan Matok, Hillel Halkin, Noa Markovits, Amitai Ziv, Ari Shamiss, Ronen Loebstein
BACKGROUND: Clinical decision support systems (CDSS) reduce prescription errors, but their effectiveness is reduced by high alert rates, "alert fatigue", and indiscriminate rejection. OBJECTIVES: To compare acceptance rates of alerts generated by the SafeRx(®) prescription CDSS among different alert types and departments in a tertiary care hospital, identify factors associated with alert acceptance, and determine whether alert overrides were justified. METHODS: In a retrospective study, we compared acceptance rates of all prescription alerts generated in 2013 in 18 departments of Israel's largest tertiary care center...
November 2017: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/29018058/impact-of-an-inpatient-electronic-prescribing-system-on-prescribing-error-causation-a-qualitative-evaluation-in-an-english-hospital
#7
Seetal Jheeta Puaar, Bryony Dean Franklin
BACKGROUND: Few studies have applied a systems approach to understanding the causes of specific prescribing errors in the context of hospital electronic prescribing (EP). A comprehensive understanding of underlying causes is essential for developing effective interventions to improve prescribing safety. Our objectives were to explore prescribers' perspectives of the causes of errors occurring with EP and to make recommendations to maximise benefits and minimise risks. METHODS: We studied a large hospital using inpatient EP...
October 10, 2017: BMJ Quality & Safety
https://www.readbyqxmd.com/read/28972499/impact-of-pharmacy-reform-on-the-dynamics-of-the-use-of-drugs-and-psychoactive-substances-according-to-the-2013-2016-clinical-data-from-the-center-for-mental-health-and-prevention-of-addiction
#8
L Kiladze, Kh Todadze, T Balkhamishvili, E Gadelia, G Lezhava
Use of medications without doctor's prescription widely established in Georgia had negative impact on the health of the population and on the whole social situation. The use of home-made drugs "Krokodil", "Jeff" and "Vint" produced from the preparations bought without prescriptions (Codeine, Ephedrine), became a special matter of concern. Psychoactive substances became available for teenagers causing damage to their central nervous system and formation of drug-addiction in them. Due to the situation Georgian Government took a number of legislative measures, particularly, it set Criminal Liability for illegal circulation of pharmaceutical products containing Codeine and Ephedrine and Administrative Measures for issuing the psychoactive substances without prescription...
September 2017: Georgian Medical News
https://www.readbyqxmd.com/read/28932389/challenges-facing-the-veterinary-profession-in-ireland-2-on-farm-use-of-veterinary-antimicrobials
#9
Manuel Magalhães-Sant'Ana, Simon J More, David B Morton, Alison J Hanlon
BACKGROUND: Antimicrobial resistance has emerged in recent years as a significant public health threat, which requires both an ethical and a scientific approach. In a recent Policy Delphi study, on-farm use of antimicrobials was a key concern identified by veterinary professionals in Ireland. In this case study (the second in a series of three resulting from a research workshop exploring the challenges facing the veterinary profession in Ireland; the other two case studies investigate clinical veterinary services and emergency/casualty slaughter certification) we aim to provide a value-based reflection on the constraints and possible opportunities for responsible use of veterinary antimicrobials in Ireland...
2017: Irish Veterinary Journal
https://www.readbyqxmd.com/read/28874948/impact-of-internally-developed-electronic-prescription-on-prescribing-errors-at-discharge-from-the-emergency-department
#10
Eveline Hitti, Hani Tamim, Rinad Bakhti, Dina Zebian, Afif Mufarrij
INTRODUCTION: Medication errors are common, with studies reporting at least one error per patient encounter. At hospital discharge, medication errors vary from 15%-38%. However, studies assessing the effect of an internally developed electronic (E)-prescription system at discharge from an emergency department (ED) are comparatively minimal. Additionally, commercially available electronic solutions are cost-prohibitive in many resource-limited settings. We assessed the impact of introducing an internally developed, low-cost E-prescription system, with a list of commonly prescribed medications, on prescription error rates at discharge from the ED, compared to handwritten prescriptions...
August 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28837665/the-effectiveness-of-computerised-decision-support-on-antibiotic-use-in-hospitals-a-systematic-review
#11
REVIEW
Christopher E Curtis, Fares Al Bahar, John F Marriott
BACKGROUND: Inappropriate antimicrobial use has been shown to be an important determinant of the emergence of antimicrobial resistance (AMR). Health information technology (HIT) in the form of Computerised Decision Support (CDS) represents an option for improving antimicrobial prescribing and containing AMR. OBJECTIVES: To evaluate the evidence for CDS in improving quantitative and qualitative measures of antibiotic prescribing in inpatient hospital settings. METHODS: A systematic literature search was conducted of articles published from inception to 20th December 2014 using eight electronic databases: MEDLINE, EMBASE, PUBMED, Web of Science, CINAHL, Cochrane Library, HMIC and PsychINFo...
2017: PloS One
https://www.readbyqxmd.com/read/28826908/-comparison-of-predictive-models-for-the-selection-of-high-complexity-patients
#12
Marcos Estupiñán-Ramírez, Rita Tristancho-Ajamil, María Consuelo Company-Sancho, Hilda Sánchez-Janáriz
OBJECTIVE: To compare the concordance of complexity weights between Clinical Risk Groups (CRG) and Adjusted Morbidity Groups (AMG). To determine which one is the best predictor of patient admission. To optimise the method used to select the 0.5% of patients of higher complexity that will be included in an intervention protocol. METHOD: Cross-sectional analytical study in 18 Canary Island health areas, 385,049 citizens were enrolled, using sociodemographic variables from health cards; diagnoses and use of healthcare resources obtained from primary health care electronic records (PCHR) and the basic minimum set of hospital data; the functional status recorded in the PCHR, and the drugs prescribed through the electronic prescription system...
August 18, 2017: Gaceta Sanitaria
https://www.readbyqxmd.com/read/28793906/the-impact-of-a-hospital-electronic-prescribing-and-medication-administration-system-on-medication-administration-safety-an-observational-study
#13
Seetal Jheeta, Bryony Dean Franklin
BACKGROUND: The aim of the study was to explore the impact of the implementation of an electronic prescribing and medication administration system (ePA) on the safety of medication administration in an inpatient hospital setting. Objectives were to compare the prevalence and types of: 1) medication administration errors, and 2) documentation discrepancies, between a paper and an ePA system. Additionally, we wanted to describe any observed changes to medication administration practices...
August 9, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28793128/elaboration-and-validation-of-the-medication-prescription-safety-checklist
#14
Aline de Oliveira Meireles Pires, Maria Beatriz Guimarães Ferreira, Kleiton Gonçalves do Nascimento, Márcia Marques Dos Santos Felix, Patrícia da Silva Pires, Maria Helena Barbosa
Objective: to elaborate and validate a checklist to identify compliance with the recommendations for the structure of medication prescriptions, based on the Protocol of the Ministry of Health and the Brazilian Health Surveillance Agency. Method: methodological research, conducted through the validation and reliability analysis process, using a sample of 27 electronic prescriptions. Results: the analyses confirmed the content validity and reliability of the tool...
August 3, 2017: Revista Latino-americana de Enfermagem
https://www.readbyqxmd.com/read/28793078/impact-of-interventions-to-promote-the-use-of-generic-drugs-a-systematic-review
#15
Marília Cruz Guttier, Marysabel Pinto Telis Silveira, Vera Lucia Luiza, Andréa Dâmaso Bertoldi
The need to increase access to medicines, coupled with the limited acceptance of generics has sparked the search for effective interventions to promote it. This systematic review aimed to conduct a survey on interventions to promote the use of generic drugs and its impact. Randomized clinical trials, non-randomized controlled trials, controlled before-after studies and interrupted time series were included. The analysis of the impact of interventions and quality of evidence followed Cochrane's guidelines. Impact of interventions was rated from "very large" to "very small" and the quality of evidence was rated from "high" to "very low"...
August 2017: Ciência & Saúde Coletiva
https://www.readbyqxmd.com/read/28760793/pim-check-development-of-an-international-prescription-screening-checklist-designed-by-a-delphi-method-for-internal-medicine-patients
#16
Aude Desnoyer, Anne-Laure Blanc, Valérie Pourcher, Marie Besson, Caroline Fonzo-Christe, Jules Desmeules, Arnaud Perrier, Pascal Bonnabry, Caroline Samer, Bertrand Guignard
OBJECTIVES: Potentially inappropriate medication (PIM) occurs frequently and is a well-known risk factor for adverse drug events, but its incidence is underestimated in internal medicine. The objective of this study was to develop an electronic prescription-screening checklist to assist residents and young healthcare professionals in PIM detection. DESIGN: Five-step study involving selection of medical domains, literature review and 17 semistructured interviews, a two-round Delphi survey, a forward/back-translation process and an electronic tool development...
July 31, 2017: BMJ Open
https://www.readbyqxmd.com/read/28760143/decision-support-during-electronic-prescription-to-stem-antibiotic-overuse-for-acute-respiratory-infections-a-long-term-quasi-experimental-study
#17
Jeneen Gifford, Elisabeth Vaeth, Katherine Richards, Tariq Siddiqui, Christine Gill, Lucy Wilson, Sylvain DeLisle
BACKGROUND: Interventions to support decision-making can reduce inappropriate antibiotic use for acute respiratory infections (ARI), but they may not be sustainable. The objective of the study is to evaluate the long-term effectiveness of a clinical decision-support system (CDSS) interposed at the time of electronic (e-) prescriptions for selected antibiotics. METHODS: This is a retrospective, observational intervention study, conducted within a large, statewide Veterans Affairs health system...
July 31, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28756438/feedback-and-training-to-improve-use-of-an-electronic-prescribing-system-a-randomised-controlled-trial
#18
Scott Leung, Wu Yi Zheng, Anmol Sandhu, Richard Day, Ling Li, Melissa Baysari
Excessive presentation of alerts in electronic prescribing systems (ePS) results in 'alert fatigue' which reduces alert effectiveness and frustrates users. Previous research at our study site showed high rates of duplication alerts, some of which were the result of doctors not using available short-cut functions in the ePS. This study aimed to improve uptake of short-cut functions and so reduce alert fatigue by trialing two interventions: feedback and training. Fifty doctors were randomised to one of three groups: Control, Feedback or Training...
2017: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/28745564/patient-and-clinician-perspectives-of-an-integrated-electronic-medication-prescribing-and-dispensing-system-a-qualitative-study-at-a-multisite-australian-hospital-network
#19
Grace Lau, Jayde Ho, Susan Lin, Karen Yeoh, Tiffany Wan, Marisa Hodgkinson
BACKGROUND: While clinician attitudes towards electronic prescribing (e-prescribing) systems have been widely studied, little is known about the perspectives of patients, despite being the primary beneficiaries of these systems. OBJECTIVE: The objective of this study is to explore and compare patient and clinician attitudes towards an integrated e-prescribing and dispensing system, in order to guide improvements in system implementation, service delivery and enhancements to system functionality...
January 1, 2017: HIM Journal
https://www.readbyqxmd.com/read/28737062/community-level-electronic-prescribing-and-adverse-drug-event-hospitalizations-among-older-adults
#20
Grishma P Bhavsar, Janice C Probst, Kevin J Bennett, James W Hardin, Zaina Qureshi
This study sought to determine how the proportion of physicians using electronic prescribing in nine US states was associated with the hospitalization rate for adverse drug events among older adult patients. A discharge-level analysis of the relationship between county electronic prescribing and adverse drug event hospitalization rates was conducted. Data from the 2011 State Inpatient Databases, the Office of the National Coordinator Health IT Dashboard, and the Area Health Resource File were obtained for nine US states...
July 1, 2017: Health Informatics Journal
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