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https://www.readbyqxmd.com/read/29745986/using-cellulose-nanofibers-and-its-palm-oil-pickering-emulsion-as-fat-substitutes-in-emulsified-sausage
#1
Yanan Wang, Wenhang Wang, Hongjiao Jia, Guixian Gao, Xiao Wang, Xiaowei Zhang, Yabin Wang
Nano cellulose is attracting great interest in food and nutraceutical fields and also provides a potential additive to develop functional meat products such as low fat sausage. Here, we compared 1 wt% aqueous dispersion of cellulose nanofiber (CNF) and its palm oil Pickering emulsion (CPOE) at the ratio of 1:1 (water: oil, v:v) for being fat alternatives replacing 30% and 50% of the original fat of the emulsified sausage. Replacing fat by CPOE and CNF resulted in lower fat content, lower cooking loss and higher moisture content and higher lightness values (P ≤ 0...
May 10, 2018: Journal of Food Science
https://www.readbyqxmd.com/read/29725636/treatment-of-hyperkalemia-with-a-low-dose-insulin-protocol-is-effective-and-results-in-reduced-hypoglycemia
#2
Bairbre A McNicholas, Mai H Pham, Katrina Carli, Chang Huei Chen, Nancy Colobong-Smith, Arthur Eric Anderson, Hien Pham
Introduction: Complications associated with insulin treatment for hyperkalemia are serious and common. We hypothesize that, in chronic kidney disease (CKD) and end-stage renal disease (ESRD), giving 5 units instead of 10 units of i.v. regular insulin may reduce the risk of causing hypoglycemia when treating hyperkalemia. Methods: A retrospective quality improvement study on hyperkalemia management (K+  ≥ 6 mEq/l) from June 2013 through December 2013 was conducted at an urban emergency department center...
March 2018: KI Reports
https://www.readbyqxmd.com/read/29720041/correlation-between-different-carboplatin-dosing-patterns-and-its-toxicity-analysis-in-patients-with-advanced-lung-cancers-a-retrospective-study
#3
Adi Kartolo, Andrew Robinson
Objective To evaluate the current NCI-CTEP recommendation and the clinical use of Calvert Formula-derived carboplatin dosing pattern in the treatment of advanced lung cancer patients and assess carboplatin-related toxicity in relation to the degree of dose fluctuation. Methodology This retrospective study involved all histologically confirmed inoperable lung cancer patients receiving palliative-intent carboplatin or carboplatin-combination chemotherapy from 2012 to 2016 at Kingston Health Sciences Centre. The carboplatin dosing pattern and carboplatin-related toxicity were collected and analysed on SPSS IBM for Windows version 24...
January 1, 2018: Journal of Oncology Pharmacy Practice
https://www.readbyqxmd.com/read/29682619/path-of-least-resistance-how-computerised-provider-order-entry-can-lead-to-and-reduce-wasteful-practices
#4
Joseph Choi, Cori Rebecca Atlin
Background: Computerised provider order entry (CPOE) is rapidly becoming the mainstay in clinical care and has the potential to improve provider efficiency and accuracy. However, this hinges on careful planning and implementation. Poorly planned CPOE order sets can lead to undetected errors and waste. In our emergency department (ED), lactate dehydrogenase (LDH) was bundled into various blood work panels but had little clinical value. Objectives: This quality improvement initiative aimed to reduce unnecessary LDH testing in the ED...
2018: BMJ Open Quality
https://www.readbyqxmd.com/read/29674327/incorporating-medication-indications-into-the-prescribing-process
#5
Kevin Kron, Sara Myers, Lynn Volk, Aaron Nathan, Pamela Neri, Alejandra Salazar, Mary G Amato, Adam Wright, Sam Karmiy, Sarah McCord, Enrique Seoane-Vazquez, Tewodros Eguale, Rosa Rodriguez-Monguio, David W Bates, Gordon Schiff
PURPOSE: The incorporation of medication indications into the prescribing process to improve patient safety is discussed. SUMMARY: Currently, most prescriptions lack a key piece of information needed for safe medication use: the patient-specific drug indication. Integrating indications could pave the way for safer prescribing in multiple ways, including avoiding look-alike/sound-alike errors, facilitating selection of drugs of choice, aiding in communication among the healthcare team, bolstering patient understanding and adherence, and organizing medication lists to facilitate medication reconciliation...
April 19, 2018: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/29667038/complex-drug-drug-gene-disease-interactions-involving-cytochromes-p450-systematic-review-of-published-case-reports-and-clinical-perspectives
#6
REVIEW
Flavia Storelli, Caroline Samer, Jean-Luc Reny, Jules Desmeules, Youssef Daali
Drug pharmacokinetics (PK) is influenced by multiple intrinsic and extrinsic factors, among which concomitant medications are responsible for drug-drug interactions (DDIs) that may have a clinical relevance, resulting in adverse drug reactions or reduced efficacy. The addition of intrinsic factors affecting cytochromes P450 (CYPs) activity and/or expression, such as genetic polymorphisms and diseases, may potentiate the impact and clinical relevance of DDIs. In addition, greater variability in drug levels and exposures has been observed when such intrinsic factors are present in addition to concomitant medications perpetrating DDIs...
April 17, 2018: Clinical Pharmacokinetics
https://www.readbyqxmd.com/read/29588820/determinant-of-successful-implementation-of-computerized-provider-order-entry-cpoe-system-from-physicians-perspective-feasibility-study-prior-to-implementation
#7
Parasto Amiri, Bahlol Rahimi, Hamid Reza Khalkhali
Background: Health information technology is a solution for medical error reduction through the implementation of Computerized Provider Order Entry (CPOE). Objective: The aim of this study was to determine physicians' attitudes toward the implementation of CPOE. Methods: This cross-sectional study was started in March 2017 and completed in June 2017. The study used a questionnaire to collect data from physicians in hospitals affiliated to Urmia University of Medical Sciences...
January 2018: Electronic Physician
https://www.readbyqxmd.com/read/29572298/impact-of-a-commercial-order-entry-system-on-prescribing-errors-amenable-to-computerised-decision-support-in-the-hospital-setting-a-prospective-pre-post-study
#8
Sarah K Pontefract, James Hodson, Ann Slee, Sonal Shah, Alan J Girling, Robin Williams, Aziz Sheikh, Jamie J Coleman
BACKGROUND: In this UK study, we investigated the impact of computerised physician order entry (CPOE) and clinical decision support (CDS) implementation on the rate of 78 high-risk prescribing errors amenable to CDS. METHODS: We conducted a preintervention/postintervention study in three acute hospitals in England. A predefined list of prescribing errors was incorporated into an audit tool. At each site, approximately 4000 prescriptions were reviewed both pre-CPOE and 6 months post-CPOE implementation...
March 23, 2018: BMJ Quality & Safety
https://www.readbyqxmd.com/read/29547577/pharmacists-as-interprofessional-collaborators-and-leaders-through-clinical-pathways
#9
Sherine Ismail, Mohamed Osman, Rayf Abulezz, Hani Alhamdan, K H Mujtaba Quadri
Pharmacists possess pivotal competencies and expertise in developing clinical pathways (CPs). We present a tertiary care facility experience of pharmacists vis-a-vis interprofessional collaboration for designing and implementing CPs. We participated in the development of CPs as leading members of a collaborative team of healthcare professionals. We reviewed literature, aligning it with hospital formulary and institutional standards, and participated in weekly team meetings for six months. Several tools and services were adapted to guide prescribing and standardization of care through time-bound order sets...
March 16, 2018: Pharmacy (Basel, Switzerland)
https://www.readbyqxmd.com/read/29523537/implementation-of-an-integrated-computerized-prescriber-order-entry-system-for-chemotherapy-in-a-multisite-safety-net-health-system
#10
Clement Chung, Shital Patel, Rosetta Lee, Lily Fu, Sean Reilly, Tuyet Ho, Jason Lionetti, Michael D George, Pam Taylor
PURPOSE: The development of a computerized prescriber order-entry (CPOE) system for chemotherapy in a multisite safety-net health system and the challenges to its successful implementation are described. SUMMARY: Before CPOE for chemotherapy was first implemented and embedded in the electronic medical record system of Harris Health System (HHS), pharmacy personnel relied on regimen-specific preprinted order sets. However, due to differences in practice styles and workflow logistics, the paper orders across the 3 facilities were mostly site specific, with varying clinical content...
March 15, 2018: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/29471324/effectiveness-of-practices-to-support-appropriate-laboratory-test-utilization-a-laboratory-medicine-best-practices-systematic-review-and-meta-analysis
#11
Matthew Rubinstein, Robert Hirsch, Kakali Bandyopadhyay, Bereneice Madison, Thomas Taylor, Anne Ranne, Millie Linville, Keri Donaldson, Felicitas Lacbawan, Nancy Cornish
Objectives: To evaluate the effectiveness of practices used to support appropriate clinical laboratory test utilization. Methods: This review followed the Centers for Disease Control and Prevention (CDC) Laboratory Medicine Best Practices A6 cycle method. Eligible studies assessed one of the following practices for effect on outcomes relating to over- or underutilization: computerized provider order entry (CPOE), clinical decision support systems/tools (CDSS/CDST), education, feedback, test review, reflex testing, laboratory test utilization (LTU) teams, and any combination of these practices...
February 17, 2018: American Journal of Clinical Pathology
https://www.readbyqxmd.com/read/29425622/prevalence-of-computerized-physician-order-entry-systems-related-medication-prescription-errors-a-systematic-review
#12
REVIEW
Virginie Korb-Savoldelli, Abdelali Boussadi, Pierre Durieux, Brigitte Sabatier
OBJECTIVE: The positive impact of computerized physician order entry (CPOE) systems on prescription safety must be considered in light of the persistence of certain types of medication-prescription errors. We performed a systematic review, based on the PRISMA statement, to analyze the prevalence of prescription errors related to the use of CPOE systems. MATERIALS AND METHODS: We searched MEDLINE, EMBASE, CENTRAL, DBLP, the International Clinical Trials Registry, the ISI Web of Science, and reference lists of relevant articles from March 1982 to August 2017...
March 2018: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/29367187/quality-of-decision-support-in-computerized-provider-order-entry-systematic-literature-review
#13
REVIEW
Delphine Carli, Guillaume Fahrni, Pascal Bonnabry, Christian Lovis
BACKGROUND: Computerized decision support systems have raised a lot of hopes and expectations in the field of order entry. Although there are numerous studies reporting positive impacts, concerns are increasingly high about alert fatigue and effective impacts of these systems. One of the root causes of fatigue alert reported is the low clinical relevance of these alerts. OBJECTIVE: The objective of this systematic review was to assess the reported positive predictive value (PPV), as a proxy to clinical relevance, of decision support systems in computerized provider order entry (CPOE)...
January 24, 2018: JMIR Medical Informatics
https://www.readbyqxmd.com/read/29353243/impact-of-order-set-design-on-urine-culturing-practices-at-an-academic-medical-centre-emergency-department
#14
Satish Munigala, Ronald R Jackups, Robert F Poirier, Stephen Y Liang, Helen Wood, S Reza Jafarzadeh, David K Warren
BACKGROUND: Urinalysis and urine culture are commonly ordered tests in the emergency department (ED). We evaluated the impact of removal of order sets from the 'frequently ordered test' in the computerised physician order entry system (CPOE) on urine testing practices. METHODS: We conducted a before (1 September to 20 October 2015) and after (21 October to 30 November 2015) study of ED patients. The intervention consisted of retaining 'urinalysis with reflex to microscopy' as the only urine test in a highly accessible list of frequently ordered tests in the CPOE system...
January 20, 2018: BMJ Quality & Safety
https://www.readbyqxmd.com/read/29351893/a-clinical-decision-support-engine-based-on-a-national-medication-repository-for-the-detection-of-potential-duplicate-medications-design-and-evaluation
#15
Cheng-Yi Yang, Yu-Sheng Lo, Ray-Jade Chen, Chien-Tsai Liu
BACKGROUND: A computerized physician order entry (CPOE) system combined with a clinical decision support system can reduce duplication of medications and thus adverse drug reactions. However, without infrastructure that supports patients' integrated medication history across health care facilities nationwide, duplication of medication can still occur. In Taiwan, the National Health Insurance Administration has implemented a national medication repository and Web-based query system known as the PharmaCloud, which allows physicians to access their patients' medication records prescribed by different health care facilities across Taiwan...
January 19, 2018: JMIR Medical Informatics
https://www.readbyqxmd.com/read/29340732/-electronic-decision-support-to-promote-medication-safety
#16
REVIEW
Walter E Haefeli, Hanna M Seidling
Because of its inherent complexity, it is a considerable challenge to tailor drug treatment to a prevalent disease and its subgroups, which are increasingly defined by genomic variability (personalized medicine) and require consideration of context information such as co-morbidity, co-medication, patient preferences, and the specific characteristics of the healthcare sector. Thus, optimum treatment decisions might not be taken intuitively any longer, because decisions must be made both rapidly and increasingly based on analyses of complex relations of numerous variables that exceed the processing performance of a human brain...
March 2018: Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz
https://www.readbyqxmd.com/read/29212546/electronic-laboratory-medicine-ordering-with-evidence-based-order-sets-in-primary-care-elmo-study-protocol-for-a-cluster-randomised-trial
#17
Nicolas Delvaux, An De Sutter, Stijn Van de Velde, Dirk Ramaekers, Steffen Fieuws, Bert Aertgeerts
BACKGROUND: Laboratory testing is an important clinical act with a valuable role in screening, diagnosis, management and monitoring of diseases or therapies. However, inappropriate laboratory test ordering is frequent, burdening health care spending and negatively influencing quality of care. Inappropriate tests may also result in false-positive results and potentially cause excessive downstream activities. Clinical decision support systems (CDSSs) have shown promising results to influence the test-ordering behaviour of physicians and to improve appropriateness...
December 6, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/29195706/longitudinal-study-of-user-experiences-of-a-cpoe-system-in-a-pediatric-hospital
#18
Melissa T Baysari, Rae-Anne Hardie, Rebecca Lake, Lauren Richardson, Cheryl McCullagh, Alan Gardo, Johanna Westbrook
OBJECTIVE: To explore the views of nurses and doctors during the early stages of implementation of a computerized provider order entry (CPOE) system in a pediatric hospital and to examine changes in perceptions and reported behaviors as use of the CPOE system became routine. METHODS: Semi-structured interviews were undertaken at four time points following CPOE implementation: during week one, week three, week six and then six months following implementation. In total, 122 users were interviewed...
January 2018: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/29144250/case-not-closed-prescription-errors-12-years-after-computerized-physician-order-entry-implementation
#19
COMPARATIVE STUDY
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/29135851/the-impact-of-an-electronic-medication-administration-record-emar-and-computerized-physician-order-entry-cpoe-on-nurse-extender-and-unit-clerk-staffing
#20
Edmondo J Robinson, Meredith R Bergey, Elizabeth Brady, Alexandra M Mapp, Jennifer C Goldsack
OBJECTIVE: The aim of this study is to describe the impact of the introduction of health information technology (HIT) on the utilization and payroll costs of nurse extenders and unit clerks in medicine and surgery units in a large regional health system. BACKGROUND: Long-term policy goals of HIT implementation are reported to include system-level reductions in labor costs, achieved through improved efficiency. METHODS: Using a retrospective cohort model, we analyzed how hours worked per patient day and staffing costs per patient day varied with the implementation of HIT over time at 2 different hospitals within a health system...
December 2017: Journal of Nursing Administration
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