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https://www.readbyqxmd.com/read/28698381/reasons-for-computerised-provider-order-entry-cpoe-based-inpatient-medication-ordering-errors-an-observational-study-of-voided-orders
#1
Joanna Abraham, Thomas G Kannampallil, Alan Jarman, Shivy Sharma, Christine Rash, Gordon Schiff, William Galanter
OBJECTIVE: Medication voiding is a computerised provider order entry (CPOE)-based discontinuation mechanism that allows clinicians to identify erroneous medication orders. We investigated the accuracy of voiding as an indicator of clinician identification and interception of a medication ordering error, and investigated reasons and root contributors for medication ordering errors. METHOD: Using voided orders identified with a void alert, we conducted interviews with ordering and voiding clinicians, followed by patient chart reviews...
July 11, 2017: BMJ Quality & Safety
https://www.readbyqxmd.com/read/28671038/electronic-health-record-innovations-helping-physicians-one-less-click-at-a-time
#2
Uta Guo, Lu Chen, Parag H Mehta
BACKGROUND: Physician burnout is becoming an epidemic, due to the pressures of being productive, an imperfect electronic health record (EHR) system, and limited face-to-face time with patients. Poor usability in EHR-user interface can force users to go through more steps (i.e. more clicks on the computer) in accomplishing a task. OBJECTIVE: This increased 'click burden' is a source of frustration for physicians. In the light of increased click burden and time due to meaningful use requirements, there is a need to improve the physician's experience by creating innovations in EHR...
January 1, 2017: HIM Journal
https://www.readbyqxmd.com/read/28670711/later-school-start-times-for-supporting-the-education-health-and-well-being-of-high-school-students
#3
REVIEW
Robert Marx, Emily E Tanner-Smith, Colleen M Davison, Lee-Anne Ufholz, John Freeman, Ravi Shankar, Lisa Newton, Robert S Brown, Alyssa S Parpia, Ioana Cozma, Shawn Hendrikx
BACKGROUND: A number of school systems worldwide have proposed and implemented later school start times as a means of avoiding the potentially negative impacts that early morning schedules can have on adolescent students. Even mild sleep deprivation has been associated with significant health and educational concerns: increased risk for accidents and injuries, impaired learning, aggression, memory loss, poor self-esteem, and changes in metabolism. Although researchers have begun to explore the effects of delayed school start time, no one has conducted a rigorous review of evidence to determine whether later school start times support adolescent health, education, and well-being...
July 3, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28662850/patient-dose-monitoring-systems-a-new-way-of-managing-patient-dose-and-quality-in-the-radiology-department
#4
N Fitousi
PURPOSE: Due to the upcoming European Directive (2013/59/EURATOM) and the increased focus on patient safety in international guidelines and regulations, Patient Dose Monitoring Systems, also called Dose Management Systems (DMS), are introduced in medical imaging departments. This article focusses on the requirements for a DMS, its benefits and the necessary implementation steps. METHOD: The implementation of a DMS can be perceived as a lengthy, yet worthy, procedure: users have to select the appropriate system for their applications, prepare data collection, validate, perform configuration, and start using the results in quality improvement projects...
June 26, 2017: Physica Medica: PM
https://www.readbyqxmd.com/read/28662372/parenteral-nutrition-errors-and-potential-errors-reported-over-the-past-10-years
#5
Peggi Guenter, Phil Ayers, Joseph I Boullata, Kathleen M Gura, Beverly Holcombe, Gordon S Sacks
Parenteral nutrition (PN) is a complex, high-alert medication, and errors associated with the use of this therapy may lead to significant harm to patients. This document reviews error reports from the Institute for Safe Medication Practices' Medication Errors Reporting Program that are associated with the PN use process over the past 10 years. Actual PN-related errors are outlined, with most occurring in the PN-compounding/dispensing and PN administration steps. Clinicians involved in any phase of the PN use process should review their institutional or homecare company's processes for reporting of PN errors and collaborate with their medical safety officer and/or committees involved with medication error reporting...
June 1, 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28662260/meditation-s-effect-on-attentional-efficiency-stress-and-mindfulness-characteristics-of-nursing-students
#6
Kathleen G Burger, Joan Such Lockhart
BACKGROUND: Strengthening attention-regulation efficiency of nurse graduates is important to the quality and safety of nursing practice in increasingly complex and cognitively distracting workplaces. Neuroscientific evidence suggests that regular practice of focused meditation can enhance attentional skills. This study explored meditation as an educational strategy for enhancing nursing students' attentional efficiency. METHOD: A randomized-control trial with 52 prelicensure nursing students examined differences between those who meditated and those who did not on measurements of alerting, orienting, and executive attention...
July 1, 2017: Journal of Nursing Education
https://www.readbyqxmd.com/read/28662000/using-prospective-risk-analysis-tools-to-improve-safety-in-pharmacy-settings-a-systematic-review-and-critical-appraisal
#7
Tatjana Stojkovic, Valentina Marinkovic, Tanja Manser
OBJECTIVES: This study aimed to review and critically appraise the published literature on 2 selected prospective risk analysis tools, Failure Mode and Effects Analysis and Socio-Technical Probabilistic Risk Assessment, as applied to the dispensing of medicines in both inpatient and outpatient pharmacy settings. METHODS: A comprehensive search of electronic databases (PubMed and Scopus) was conducted (January 1990-March 2016), supplemented by hand search of reference lists...
June 29, 2017: Journal of Patient Safety
https://www.readbyqxmd.com/read/28661403/accelerated-approval-of-drugs-ethics-versus-efficacy
#8
Krishnan V Chary, Kumaresh Pandian
OBJECTIVE: To analyse the post-marketing status of molecules approved through the expedited review process in the last quintile. METHODS: This observational study was carried out between January 2016 and June 2016. The details of the time taken to approve drugs were collected from the official website of United States Food and Drug Administration (FDA). The average time taken to review drugs and take a decision following the review were ascertained from the FDA's annual release of novel drugs from 2011 to 2015...
June 27, 2017: Indian Journal of Medical Ethics
https://www.readbyqxmd.com/read/28653472/residual-risk-of-bacterial-contamination-of-platelets-six-years-of-experience-with-sterility-testing
#9
Sandra Ramirez-Arcos, Caesar DiFranco, Terri McIntyre, Mindy Goldman
BACKGROUND: Canadian Blood Services screens 100% of platelet concentrates (PCs) for bacterial contamination with the BacT/ALERT system. Quality-control sterility testing of 1% (≥10 units) of outdated PCs is performed monthly. Data from routine screening, quality-control testing, and septic reactions obtained from 2010 to 2016 are presented herein. STUDY DESIGN AND METHODS: In total, 601,988 buffy coat PC pools and 186,737 apheresis PCs were routinely screened with aerobic cultures over 6 years...
June 26, 2017: Transfusion
https://www.readbyqxmd.com/read/28651030/clinical-alerts-to-decrease-high-risk-medication-use-in-older-adults
#10
Wilhelmina Lord-Adem, Nicole J Brandt
High-risk medications (HRMs) account for 14.6% to 54.6% of all medications used in older adults, and have been linked to >50% of adverse drug events (ADEs). HRM-related ADEs lead to increased morbidity and mortality, increased hospital length of stay, and financial costs for patients and health care systems. It has been well documented that incorporating information technology in patient care in the form of clinical alert systems can effectively decrease HRM use and improve patient safety. The current article seeks to identify and discuss clinical alert systems focusing on HRMs, their impact on prescribing for older adults, and challenges to the implementation of electronic decision systems...
July 1, 2017: Journal of Gerontological Nursing
https://www.readbyqxmd.com/read/28644298/omission-of-high-alert-medications-a-hidden-danger
#11
Matthew C Grissinger
The Pennsylvania Patient Safety Reporting System is a confidential, statewide Internet reporting system to which all Pennsylvania hospitals, outpatient-surgery facilities, birthing centers, and abortion facilities must file information on incidents and serious events.Safety Monitor is a column from Pennsylvania's Patient Safety Authority, the authority that informs nurses on issues that can affect patient safety and presents strategies they can easily integrate into practice. For more information on the authority, visit www...
July 2017: American Journal of Nursing
https://www.readbyqxmd.com/read/28643434/improved-yield-of-minimal-proportional-sample-volume-platelet-bacterial-culture
#12
Hany Kamel, Mary Townsend, Marjorie Bravo, Ralph R Vassallo
BACKGROUND: Reports of septic transfusion reactions (STRs) after transfusion of culture-negative platelets (PLTs) justify more effective prevention strategies. Pathogen reduction technologies or performance of additional point-of-issue testing are proposed strategies to enhance safety through Day 5 of storage. STUDY DESIGN AND METHODS: Trima leukoreduced apheresis PLTs (APs) were collected during two study periods (45 and 31 months) using standard procedures, with target settings adjusted during the second period to maintain split rate after increased culture volume...
June 22, 2017: Transfusion
https://www.readbyqxmd.com/read/28625557/-more-than-3-hours-and-less-than-3-years-safety-of-anaesthetic-procedures-in-infants-less-than-3-years-old-subected-to-surgery-for-more-the-3-hours
#13
Julián Álvarez Escudero, Rosa María Paredes Esteban, Francisco José Cambra Lasaosa, Máximo Vento, Maite López Gil, Juan Carlos de Agustín Asencio, María Teresa Moral Pumarega
An FDA alert in December 2016 on the safety of general anesthesia and sedations in patients less than 3 years of age and pregnant women has raised doubts in relation to the attitude that professionals implicated in these procedures should adopt in relation to these specific group of patients. Confronted with this situation, the following medical scientific societies: Sociedad Española de Anestesia y Reanimación (SEDAR), Sociedad Española de Cirugía Pediátrica (SECP), Sociedad Española de Cuidados Intensivos Pediátricos (SECIP) y Sociedad Española de Neonatología (SENeo), have established a working group to analyze and clarify the safety of these techniques...
June 15, 2017: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
https://www.readbyqxmd.com/read/28622825/mutagenicity-of-%C3%AF-3-fatty-acid-peroxidation-products-in-the-ames-test
#14
Petr Grúz, Masatomi Shimizu, Kei-Ichi Sugiyama, Masamitsu Honma
Polyunsaturated fatty acids (PUFA) represent one of the main building blocks of cellular membranes and their varying composition impacts lifespan as well as susceptibility to cancer and other degenerative diseases. Increased intake of ω-3 PUFA is taught to compensate for the abundance of ω-6 PUFA in modern human diet and prevent cardiocirculatory diseases. However, highly unsaturated PUFA of marine and seed origin easily oxidize to aldehydic products which form DNA adducts. With increased PUFA consumption it is prudent to re-evaluate ω-3 PUFA safety and the genotoxic hazards of their metabolites...
July 2017: Mutation Research
https://www.readbyqxmd.com/read/28622144/a-technological-advance-for-21st-century-obstetricians-the-electronically-controlled-vacuum-extractor
#15
Nicola Perone
OBJECTIVE: To describe an innovative electronically-controlled vacuum extractor (VE) in detail and to illustrate its performance characteristics, as observed in a laboratory study. DESIGN: Thirty simulated, vacuum-assisted deliveries. MAIN OUTCOME MEASURE(S): (1) The ability to measure in real-time of the pull applied and to sound an alert, when the traction approaches the negative pressure under the cup, to prevent its detachment. (2) The recording and printing of a graphic representation of the pull applied (vacuum delivery graph)...
June 5, 2017: Journal of Perinatal Medicine
https://www.readbyqxmd.com/read/28606765/genotoxicity-assessment-of-piperitenone-oxide-an-in%C3%A2-vitro-and-in-silico-evaluation
#16
Antonella Di Sotto, Silvia Di Giacomo, Lorena Abete, Mijat Božović, Olga A Parisi, Fabio Barile, Annabella Vitalone, Angelo A Izzo, Rino Ragno, Gabriela Mazzanti
Piperitenone oxide, a natural flavouring agent also known as rotundifolone, has been studied for the genotoxicity assessment by an integrated in vitro and in silico experimental approach, including the bacterial reverse mutation assay, the micronucleus test, the comet assay and the computational prediction by Toxtree and VEGA tools. Under our experimental conditions, the monoterpene showed to induce both point mutations (i.e. frameshift, base-substitution and/or oxidative damage) and DNA damage (i.e. clastogenic or aneuploidic damage, or single-strand breaks)...
June 10, 2017: Food and Chemical Toxicology
https://www.readbyqxmd.com/read/28603504/the-safety-of-ingested-caffeine-a-comprehensive-review
#17
REVIEW
Jennifer L Temple, Christophe Bernard, Steven E Lipshultz, Jason D Czachor, Joslyn A Westphal, Miriam A Mestre
Caffeine is the most widely consumed psychoactive drug in the world. Natural sources of caffeine include coffee, tea, and chocolate. Synthetic caffeine is also added to products to promote arousal, alertness, energy, and elevated mood. Over the past decade, the introduction of new caffeine-containing food products, as well as changes in consumption patterns of the more traditional sources of caffeine, has increased scrutiny by health authorities and regulatory bodies about the overall consumption of caffeine and its potential cumulative effects on behavior and physiology...
2017: Frontiers in Psychiatry
https://www.readbyqxmd.com/read/28574956/identifying-high-alert-medications-in-a-university-hospital-by-applying-data-from-the-medication-error-reporting-system
#18
Lotta Tyynismaa, Anni Honkala, Marja Airaksinen, Kenneth Shermock, Lasse Lehtonen
OBJECTIVES: To facilitate safe use of high-alert medications, lists of medications posing higher risks for medication errors (MEs) and harmful effects have been compiled. These lists can be general or reflect clinical practices in specific settings. Less common has been to compile a hospital-specific list applying data from the organization's ME reporting system. Our objective was to demonstrate a method for compiling such a high-alert medication list in a university hospital. METHODS: Of the eighteen 136 MEs reported during 2007 to 2013, ME reports with medications coded as a contributing factor to the incident were included (n = 249)...
June 1, 2017: Journal of Patient Safety
https://www.readbyqxmd.com/read/28567500/treatment-of-sleep-dysfunction-in-parkinson-s-disease
#19
REVIEW
Amy W Amara, Lana M Chahine, Aleksandar Videnovic
Impaired sleep and alertness affect the majority of Parkinson's disease (PD) patients, negatively impacting safety and quality of life. The etiology of impaired sleep-wake cycle in PD is multifactorial and encompasses medication side effects, nocturnal PD motor symptoms, and presence of co-existent sleep and neuropsychiatric disorders. The primary neurodegenerative process of PD involves brain regions that regulate the sleep-wake cycle, such as brainstem and hypothalamic nuclei. Sleep disorders in PD include insomnia, REM sleep behavior disorder (RBD), sleep disordered breathing (SDB), restless legs syndrome (RLS), and circadian disruption...
July 2017: Current Treatment Options in Neurology
https://www.readbyqxmd.com/read/28554241/interdisciplinary-implementation-of-tacrolimus-intravenous-standard-concentration-in-hematopoietic-stem-cell-transplantation-recipients
#20
Brandon R Shank, Melissa Deaver, Angela Baker, Alan L Myers, Yan-Ping Zhang, Brent Anderegg, Roland Bassett, Michael Westmoreland
Purpose Reduction in waste of intravenous (IV) tacrolimus, an immunosuppressant used to prevent graft-versus-host disease in allogeneic hematopoietic stem cell transplantation recipients, was evaluated after standardizing the concentration. Methods A single-center, retrospective cohort study at a large academic comprehensive cancer center was performed comparing patient-specific intravenous tacrolimus doses (tacrolimus doses in 50, 100, or 250 mL of normal saline based on manufacturer's recommended concentration) to tacrolimus intravenous standard concentration (tacrolimus 1 mg in 250 mL of normal saline) continuous intravenous infusion titrated to prescribed dose...
January 1, 2017: Journal of Oncology Pharmacy Practice
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