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https://www.readbyqxmd.com/read/29674328/catastrophic-circulatory-collapse-after-inadvertent-subcutaneous-injection-of-treprostinil
#1
John J Radosevich, Mohan Dutt, Jeremy Feldman
PURPOSE: A case of life-threatening cardiovascular collapse after inadvertent subcutaneous injection of undiluted treprostinil is reported. SUMMARY: A 29-year-old, 76-kg woman with group 1 pulmonary arterial hypertension managed with subcutaneous treprostinil infusion arrived at the emergency department (ED) with headache, nausea, vomiting, and a syncopal episode. Her vital signs were stable on presentation. Admission orders were placed, and the appropriate 3-mL syringe containing 7...
April 19, 2018: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/29670762/rolling-refresher-simulation-improves-performance-and-retention-of-paediatric-intensive-care-unit-nurse-code-cart-management
#2
Marcy N Singleton, Kimberly F Allen, Zhongze Li, Kevin McNerney, Urs H Naber, Matthew S Braga
Introduction: Paediatric Intensive Care Unit Nurses (PICU RNs) manage the code cart during paediatric emergencies at the Children's Hospital at Dartmouth-Hitchcock. These are low -frequency, high-stakes events. Methods: An uncontrolled intervention study with 6-month follow-up. A collaboration of physician and nursing experts developed a rolling-refresher training programme consisting of five simulated scenarios, including 22 code cart skills, to establish nursing code cart competency...
April 2018: BMJ simulation & technology enhanced learning
https://www.readbyqxmd.com/read/29659463/maintaining-short-peripheral-catheter-patency-a-comparison-of-saline-lock-versus-continuous-infusion-in-the-acute-care-setting
#3
Sheila Serr Roszell, Holly Barlowe Rabinovich, Cheryl A Smith-Miller
Sparse evidence exists about how short peripheral catheter (SPC) duration is affected by the presence of a saline lock versus continually infusing fluids. Often the choice to lock an SPC with saline is based on provider preference, rather than available evidence or patient-centered factors. This study compared the duration of 85 SPCs: locked with saline versus continuously running fluids. A secondary analysis considered the influence of a number of intermittent medications and flushes. Although the saline-locked group had a slightly longer duration time, it was not statistically significant...
May 2018: Journal of Infusion Nursing: the Official Publication of the Infusion Nurses Society
https://www.readbyqxmd.com/read/29659462/making-an-infusion-error-the-second-victims-of-infusion-therapy-related-medication-errors
#4
Linda A Treiber, Jackie H Jones
Infusion therapy-related adverse events can result in distress and professional suffering for the nurse involved with the event, with long-lasting consequences. This article discusses the second victim syndrome and its impacts on nurses. Original research on 168 recent nursing graduates and their experiences with second victim syndrome after making an infusion-related error is also presented. The article concludes with strategies to help nurses cope with the aftermath of making an infusion therapy-related medication error...
May 2018: Journal of Infusion Nursing: the Official Publication of the Infusion Nurses Society
https://www.readbyqxmd.com/read/29652752/practice-change-from-intermittent-medication-boluses-to-bolusing-from-a-continuous-infusion-in-pediatric-critical-care-a-quality-improvement-project
#5
Jessica L Hochstetler, A Jill Thompson, Natalie M Ball, Melissa C Evans, Shaun C Frame, A Lauren Haney, Amelia K Little, Jaime L O'Donnell, Bryna M Rickett, Elizabeth H Mack
OBJECTIVES: To determine whether implementing a guideline to bolus medications from continuous infusions in PICUs affects nursing satisfaction, patient safety, central line entries, medication utilization, or cost. DESIGN: This is a pre- and postimplementation quality improvement study. SETTING: An 11-bed ICU and 14-bed cardiac ICU in a university-affiliated children's hospital. PATIENTS: Patients less than 18 years old admitted to the PICU or pediatric cardiac ICU receiving a continuous infusion of dexmedetomidine, midazolam, fentanyl, morphine, vecuronium, or cisatracurium from May 2015 to May 2016, excluding November 2015 (washout period), were eligible for inclusion...
April 12, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29625693/-implementation-and-assessment-of-anticancer-drugs-batch-preparation-circuit-in-a-teaching-hospital
#6
M Moine, L Hachon, D Sankhare, A Ade, I Madelaine, N Jourdan
INTRODUCTION: In 2011, the anticancer preparation unit in a teaching hospital implemented a circuit for batch preparation of anticancer drugs. In this circuit, a manual and a semi-automatic production process coexist. The aim of the study is to describe the circuit in 2016 and to assess the impact of batch preparation in a anticancer preparation unit. MATERIAL AND METHODS: Eligible anticancer drugs for batch preparation satisfy two conditions: solution stability up to 28 days, prescription frequency up to one every two days...
April 3, 2018: Annales Pharmaceutiques Françaises
https://www.readbyqxmd.com/read/29562843/irinotecan-associated-dysarthria-a-single-institution-case-series-with-management-implications-in-patients-with-gastrointestinal-malignancies
#7
David B Zhen, Rachel L McDevitt, Mark M Zalupski, Vaibhav Sahai
Irinotecan (Camptosar© , CPT-11), a topoisomerase I inhibitor, is a commonly used cytotoxic chemotherapeutic in the treatment of multiple malignancies, particularly of gastrointestinal origin. Dysarthria secondary to irinotecan has been described as a rare side effect in a few case reports with limited data to recommend appropriate management. We describe herein a large single institution experience of patients with gastrointestinal malignancies who experienced dysarthria while being treated with irinotecan-based chemotherapy regimens (FOLFIRINOX or FOLFIRI+/-bevacizumab)...
January 1, 2018: Journal of Oncology Pharmacy Practice
https://www.readbyqxmd.com/read/29557999/sublingual-sufentanil-tablet-system-zalviso%C3%A2-for-postoperative-analgesia-after-knee-replacement-in-fast-track-surgery-a-pilot-observational-study
#8
Marco Scardino, Tiziana D'Amato, Federica Martorelli, Giorgia Fenocchio, Vincenzo Simili, Berardo Di Matteo, Dario Bugada, Elizaveta Kon
BACKGROUND: Currently many TKA protocols rely on multimodal analgesic protocols with patient-controlled analgesia systems that administer opioids through a patient controlled IV infusion pump, in addition to concomitant peripheral nerve blocks and local anesthetics. Although effective, PCA IV opioids do not provide optimal results with fast track rehabilitation protocols. METHODS: The present is a retrospective study comparing the novel sublingual sufentanil PCA system (SSTS) to our standard of care foreseeing continuous femoral nerve block (cFNB) within a multimodal analgesic in a TKA fast-track protocol...
March 20, 2018: Journal of Experimental Orthopaedics
https://www.readbyqxmd.com/read/29556886/intravenous-lipid-emulsion-overdose-in-infancy-a-case-report-and-overview-of-opportunities-challenges-and-prevention
#9
REVIEW
Wasim Khasawneh, Salar Bani Hani
Medication errors remain among the major problems seen in hospitals. Such errors can relate to the prescription, dispensation, or administration of drugs. Human factors account for most of these mistakes, but other factors such as infusion pump programming defects should always be considered. Worldwide, medication errors have been reported to affect 2-30% of patients, depending on the institution. Intravenous lipid emulsion (ILE) infusion is frequently used as part of total parenteral nutrition in patients of all ages with feeding and gastrointestinal issues...
March 19, 2018: Drug Safety—Case Reports
https://www.readbyqxmd.com/read/29547612/member-input-the-challenge-of-staffing-in-ambulatory-infusion-settings
#10
(no author information available yet)
The Oncology Nursing Society (ONS) has conducted several member surveys that included questions about staffing but has not established nurse-patient ratios, given the number and complexity of variables that must be considered. The 2016 ONS member survey showed that staffing was the most frequently cited challenge in the practice setting. With the implementation of ONS Communities in 2017, members have the opportunity to network and connect about issues. Staffing in chemotherapy infusion centers has been a frequent topic...
April 1, 2018: Clinical Journal of Oncology Nursing
https://www.readbyqxmd.com/read/29547611/in-remission-a-patient-s-experience-of-continued-care-after-chronic-lymphocytic-leukemia
#11
Andrew Schorr, Esther Schorr
Being a patient with chronic lymphocytic leukemia and now in the midst of infusion treatment after a 17-year remission, I cannot praise oncology nurses enough. I am overwhelmed by their professionalism and warmth and I am delighted to share my perspective as a patient.
April 1, 2018: Clinical Journal of Oncology Nursing
https://www.readbyqxmd.com/read/29547602/liposomal-irinotecan-nursing-considerations-in-an-outpatient-cancer-center
#12
Karen Kinsley, Wendy Pritchett
Recent approaches in treating pancreatic adenocarcinoma, an aggressive disease with limited survival, include the use of liposomal irinotecan as an option when first-line therapy has failed. Liposomal irinotecan has been approved in combination with 5-fluorouracil and leucovorin for patients with metastatic pancreatic cancer. Liposomal irinotecan is a newer therapy requiring oncology nurses to obtain knowledge and skills for proper administrating, monitoring of hypersensitivity reactions during infusion, managing side effects, and providing patient education...
April 1, 2018: Clinical Journal of Oncology Nursing
https://www.readbyqxmd.com/read/29544234/-addisonian-crisis-risk-assessment-and-appropriate-treatment
#13
Gesine Meyer, Klaus Badenhoop
An adrenal crisis (Addisonian crisis) is an acute life-threatening complication of adrenal insufficiency. It occurs when hydrocortisone demand is not met by supplementation in the context of an infection - often gastrointestinal, fever, trauma, acute psychological or physical stress. Symptoms of weakness, nausea, muscle/joint pain and drowsiness may develop out of robust health within few hours. If overlooked, treated too late, with insufficient dose or route of application, there exists a considerable risk of mortality...
March 2018: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/29526614/safety-immunogenicity-and-clinical-outcomes-in-patients-with-morquio-a-syndrome-participating-in-2-sequential-open-label-studies-of-elosulfase-alfa-enzyme-replacement-therapy-mor-002-mor-100-representing-5-years-of-treatment
#14
Christian Hendriksz, Saikat Santra, Simon A Jones, Tarekegn Geberhiwot, Lynne Jesaitis, Brian Long, Yulan Qi, Sara M Hawley, Celeste Decker
Elosulfase alfa is an enzyme replacement therapy for Morquio A syndrome (mucopolysaccharidosis IVA), a multisystemic progressive lysosomal storage disorder. This report includes the primary treatment outcomes and immunogenicity profile of elosulfase alfa in patients with Morquio A syndrome from 2 sequential studies, MOR-002 (ClinicalTrials.govNCT00884949) and MOR-100 (NCT01242111), representing >5 years of clinical study data. MOR-002 was an open-label, single-arm phase 1/2 study that evaluated the pharmacokinetics, safety, immunogenicity, and preliminary efficacy of 3 sequential doses of elosulfase alfa (0...
February 19, 2018: Molecular Genetics and Metabolism
https://www.readbyqxmd.com/read/29523211/pediatric-rheumatology-infusion-center-report-on-therapeutic-protocols-and-infusions-given-over-4-years-with-focus-on-adverse-events-over-1-year
#15
Surabhi S Vinod, Annelle B Reed, Jamelle Maxwell, Randy Q Cron, Matthew L Stoll
BACKGROUND: Children with chronic rheumatic disease often require intravenous (IV) therapy. Our center has instituted standardized protocols for use of IV medications in rheumatology patients. Herein, we introduce the therapeutic protocols and report on their short-term safety. METHODS: This was an institutional review board (IRB) approved retrospective chart review of all patients who had received IV infusions between the years 2012 and 2015 at a single center, prescribed by a pediatric rheumatologist...
March 9, 2018: Pediatric Rheumatology Online Journal
https://www.readbyqxmd.com/read/29518017/adherence-to-oral-anticancer-medications-evolving-interprofessional-roles-and-pharmacist-workforce-considerations
#16
Gennaro A Paolella, Andrew D Boyd, Scott M Wirth, Sandra Cuellar, Neeta K Venepalli, Stephanie Y Crawford
Interprofessional care is exhibited in outpatient oncology practices where practitioners from a myriad of specialties (e.g., oncology, nursing, pharmacy, health informatics and others) work collectively with patients to enhance therapeutic outcomes and minimize adverse effects. Historically, most ambulatory-based anticancer medication therapies have been administrated in infusion clinics or physician offices. Oral anticancer medications (OAMs) have become increasingly prevalent and preferred by patients for use in residential or other non-clinic settings...
March 8, 2018: Pharmacy (Basel, Switzerland)
https://www.readbyqxmd.com/read/29505664/higher-versus-lower-amino-acid-intake-in-parenteral-nutrition-for-newborn-infants
#17
REVIEW
David A Osborn, Tim Schindler, Lisa J Jones, John Kh Sinn, Srinivas Bolisetty
BACKGROUND: Sick newborn and preterm infants frequently are not able to be fed enterally, necessitating parenteral fluid and nutrition. Potential benefits of higher parenteral amino acid (AA) intake for improved nitrogen balance, growth, and infant health may be outweighed by the infant's ability to utilise high intake of parenteral AA, especially in the days after birth. OBJECTIVES: The primary objective is to determine whether higher versus lower intake of parenteral AA is associated with improved growth and disability-free survival in newborn infants receiving parenteral nutrition...
March 5, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29505155/laboratory-monitoring-of-children-on-home-parenteral-nutrition-a-prospective-study
#18
Amber Smith, Mary Beth Feuling, Catherine Larson-Nath, Catherine Karls, Megan Van Hoorn, Cassandra L S Walia, Carly Leon, Elaine Danner, Pam Opichka, Lori Duesing, Alfonso Martinez, Praveen S Goday
BACKGROUND: The primary hypothesis of this article is that a team approach in creating a protocolized laboratory monitoring schedule for home parenteral nutrition (PN) patients improves patient safety by decreasing the occurrence of nutrition deficiencies and is cost-effective. METHODS: In this prospective cohort study of home PN patients, each patient followed an established protocol of laboratory monitoring and weekly review by an interdisciplinary team of dietitians, nurses, and physicians...
January 2018: JPEN. Journal of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/29500794/the-art-and-science-of-using-diuretics-in-the-treatment-of-heart-failure-in-diverse-clinical-settings
#19
Md Shahidul Islam
It is important to understand the rationale for appropriate use of different diuretics, alone or in combination, in different heart failure patients, under diverse clinical settings. Clinicians and nurses engaged in heart failure care, must be familiar with different diuretics, their appropriate doses, methods of administration, monitoring of the responses, and the side-effects. Inappropriate use of diuretics, both under-treatment and overtreatment, and poor follow-up can lead to failures, and adverse outcomes...
March 3, 2018: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/29481295/medication-safety-in-oncology-care-mapping-checking-procedures-from-prescription-to-administration-of-chemotherapy
#20
Yvonne Pfeiffer, Stephan S Gut, David L B Schwappach
PURPOSE: To increase medication safety in oncology, checking procedures are increasingly applied by nurses, physicians, and pharmacists. However, little is known about the number, types, and consistency of implemented checks. The aim of the study was to assess the number and types of different checking procedures that are performed along the lifecycle of a chemotherapy prescription across three hospitals, different care settings, administration routes, and professional groups. METHODS: A scheme to evaluate checking procedures and a mapping approach to illustrate the checks along the phases of the medication process were developed...
February 26, 2018: Journal of Oncology Practice
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