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Prescribing errors

Dhara Shah, Shannon Manzi
OBJECTIVES: This study aimed to assess the frequency, type, and potential severity of errors intercepted by pharmacists on review of discharge prescriptions in a pediatric emergency department (ED). METHODS: This was a retrospective, observational study conducted in the ED of a pediatric teaching hospital. A daily report of prescriptions from the previous day was reviewed by a pharmacist for safety and efficacy. If an intervention was deemed necessary, the prescriber was contacted for clarification...
October 4, 2016: Pediatric Emergency Care
Emma Suggett, John Marriott
BACKGROUND: A number of methods exist for the risk assessment of hospital inpatients to determine the likelihood of patients experiencing drug-related problems (DRPs), including manual review of a patient's medication (medication reviews) and more complex electronic assessment using decision support alerts in electronic prescribing systems. A systematic review was conducted to determine the evidence base for potential risks associated with adult hospital inpatients that could not only lead to medication-related issues but might also be directly associated with pharmacist intervention...
September 2016: Drugs—Real World Outcomes
Aradhana Nagarsekar, Ridhima Gaunkar, Meena Aras
OBJECTIVE: This survey was undertaken to assess dentist's opinion regarding the occurrence and pattern of food impaction in relation to fixed partial denture (FPD) prostheses, its commonly observed consequences, factors contributing to it, and its management. METHODS: A descriptive survey was conducted on a sample size of 150 dental practitioners. The pro forma consisted of informed consent, demographic information, and questionnaire. The results were tallied and quantitative analysis was performed to obtain the descriptive statistics for the data using SPSS version 20...
October 2016: Journal of Indian Prosthodontic Society
Brandon Battis, Linda Clifford, Mostaqul Huq, Edrick Pejoro, Scott Mambourg
OBJECTIVES: Patients treated with oral chemotherapy appear to have less contact with the treating providers. As a result, safety, adherence, medication therapy monitoring, and timely follow-up may be compromised. The trend of treating cancer with oral chemotherapy agents is on the rise. However, standard clinical guidance is still lacking for prescribing, monitoring, patient education, and follow-up of patients on oral chemotherapy across the healthcare settings. The purpose of this project is to establish an oral chemotherapy monitoring clinic, to create drug and lab specific provider order sets for prescribing and lab monitoring, and ultimately to ensure safe and effective treatment of the veterans we serve...
October 12, 2016: Journal of Oncology Pharmacy Practice
Michael R Cohen, Judy L Smetzer
These medication errors have occurred in health care facilities at least once. They will happen again-perhaps where you work. Through education and alertness of personnel and procedural safeguards, they can be avoided. You should consider publishing accounts of errors in your newsletters and/or presenting them at your inservice training programs. Your assistance is required to continue this feature. The reports described here were received through the Institute for Safe Medication Practices (ISMP) Medication Errors Reporting Program...
November 2015: Hospital Pharmacy
Li Sheng, Zidong Wang, Engang Tian, Fuad E Alsaadi
This paper deals with the H∞ state estimation problem for a class of discrete-time neural networks with stochastic delays subject to state- and disturbance-dependent noises (also called (x,v)-dependent noises) and fading channels. The time-varying stochastic delay takes values on certain intervals with known probability distributions. The system measurement is transmitted through fading channels described by the Rice fading model. The aim of the addressed problem is to design a state estimator such that the estimation performance is guaranteed in the mean-square sense against admissible stochastic time-delays, stochastic noises as well as stochastic fading signals...
September 19, 2016: Neural Networks: the Official Journal of the International Neural Network Society
Sara Modig, Cecilia Lenander, Nina Viberg, Patrik Midlöv
BACKGROUND: There is an urgent need to improve patient safety in the area of medication treatment among the elderly. The aim of this study was to explore which improvement needs and strengths, relating to medication safety, arise from a multi-professional intervention in primary care and further to describe and follow up on the agreements for change that were established within the intervention. METHODS: The SÄKLÄK project was a multi-professional intervention in primary care consisting of self-assessment, peer-review, feedback and written agreements for change...
October 4, 2016: BMC Family Practice
L Cortejoso, R A Dietz, G Hofmann, M Gosch, A Sattler
BACKGROUND: Inappropriate pharmacotherapy among older adults remains a critical issue in our health care systems. Besides polypharmacy and multiple comorbidities, the age-related pharmacokinetic and pharmacodynamic changes may increase the risk of adverse drug reactions and medication errors. OBJECTIVE: The main target of this study was to describe the characteristics of pharmaceutical interventions in two geriatric wards (orthogeriatric ward and geriatric day unit) of a general teaching hospital and to evaluate the clinical significance of the detected medication errors...
2016: Clinical Interventions in Aging
Nicola Rudall, Catherine McKenzie, June Landa, Richard S Bourne, Ian Bates, Rob Shulman
PURPOSE: Clinical pharmacist (CP) interventions from the PROTECTED-UK cohort, a multi-site critical care interventions study, were further analysed to assess effects of: time on critical care, number of interventions, CP expertise and days of week, on impact of intervention and ultimately contribution to patient care. METHODS: Intervention data were collected from 21 adult critical care units over 14 days. Interventions could be error, optimisation or consults, and were blind-coded to ensure consistency, prior to bivariate analysis...
October 4, 2016: International Journal of Pharmacy Practice
I Cuesta López, M Sánchez Cuervo, Á Candela Toha, J Benedí González, T Bermejo Vicedo
WHAT IS KNOWN AND OBJECTIVE: The correct management of high-alert medications is a priority issue in expert recommendations for improving the clinical safety of patients. Objectives were to assess the impact of the implementation of vasoactive drug (VAD) protocols on safety and efficacy in the treatment of critically ill patients. METHODS: A prospective before-and-after study on the implementation of different VAD protocols, comparing medication errors (MEs) rates, mean intensive care unit (ICU) stay, mean blood pressure (MAP), heart rate (HR) and oxygen saturation...
October 4, 2016: Journal of Clinical Pharmacy and Therapeutics
Michael R Cohen, Judy L Smetzer
These medication errors have occurred in health care facilities at least once. They will happen again-perhaps where you work. Through education and alertness of personnel and procedural safeguards, they can be avoided. You should consider publishing accounts of errors in your newsletters and/or presenting them at your inservice training programs. Your assistance is required to continue this feature. The reports described here were received through the Institute for Safe Medication Practices (ISMP) Medication Errors Reporting Program...
September 2016: Hospital Pharmacy
Simon Rj Maxwell
Prescribing is the most important tool used by physicians to cure illness, relieve symptoms and prevent future disease. It is also a complex intellectual task that requires formulation of an appropriate treatment regimen from the many thousands available, taking into account the infinite variation in the patients they encounter. Unfortunately, the selection of a medicine and dosage regimen is sometimes suboptimal, leading to poor patient outcomes (eg treatment failure, avoidable adverse reactions). This article will highlight some of the common prescribing errors and will develop a rational approach that includes making a diagnosis, estimating prognosis, establishing the goals of therapy, selecting the most appropriate treatment and monitoring the effects of the treatment...
October 2016: Clinical Medicine: Journal of the Royal College of Physicians of London
R Garrastazu, J L García-Rivero, M Ruiz-Nuñez, J M Helguera, S Arenal, C Bonnardeux, C León, M Miravitlles, M Santibañez
INTRODUCTION/OBJECTIVE: One of main limitations in studies of COPD in health databases could be the low quality of the information. Our first aim was evaluate reliability of the registry of COPD diagnosis register in Primary Care. A description and comparison is also presented of the characteristics of the patients according to the diagnostic confirmation. MATERIAL AND METHODS: A cross-sectional study using healthcare databases of Cantabria. A pre-selected sample of 1,457 patients was obtained in which COPD diagnosis was specifically registered...
September 27, 2016: Semergen
R McCarthy, R Segurado, M Crealey, A Twomey
Parenteral Nutrition may be prescribed as a standard PN (SPN) formulation or as an individualised PN (IPN) formulation. SPN may have advantages in terms of rapid availability, less prescription errors, decreased risk of infection and cost savings but IPN, specifically tailored to an infants needs, may achieve better outcomes in terms of nutrient intake and weight gain. The aim of our study was to determine if VLBW infants in our NICU benefited from receiving IPN over currently available SPN solutions. Our findings were that VLBW infants prescribed IPN received significantly more amino acid (28%), glucose (6%), energy (11%) and calcium (8%) from the aqueous phase of PN than had they received a similar volume of SPN...
2016: Irish Medical Journal
Tatsuya Inoue, Joachim Widder, Lisanne V van Dijk, Hideki Takegawa, Masahiko Koizumi, Masaaki Takashina, Keisuke Usui, Chie Kurokawa, Satoru Sugimoto, Anneyuko I Saito, Keisuke Sasai, Aart A Van't Veld, Johannes A Langendijk, Erik W Korevaar
PURPOSE: To investigate the impact of setup and range uncertainties, breathing motion, and interplay effects using scanning pencil beams in robustly optimized intensity modulated proton therapy (IMPT) for stage III non-small cell lung cancer (NSCLC). METHODS AND MATERIALS: Three-field IMPT plans were created using a minimax robust optimization technique for 10 NSCLC patients. The plans accounted for 5- or 7-mm setup errors with ±3% range uncertainties. The robustness of the IMPT nominal plans was evaluated considering (1) isotropic 5-mm setup errors with ±3% range uncertainties; (2) breathing motion; (3) interplay effects; and (4) a combination of items 1 and 2...
November 1, 2016: International Journal of Radiation Oncology, Biology, Physics
Mary G Amato, Alejandra Salazar, Thu-Trang T Hickman, Arbor Jl Quist, Lynn A Volk, Adam Wright, Dustin McEvoy, William L Galanter, Ross Koppel, Beverly Loudin, Jason Adelman, John D McGreevey, David H Smith, David W Bates, Gordon D Schiff
OBJECTIVE: To examine medication errors potentially related to computerized prescriber order entry (CPOE) and refine a previously published taxonomy to classify them. MATERIALS AND METHODS: We reviewed all patient safety medication reports that occurred in the medication ordering phase from 6 sites participating in a United States Food and Drug Administration-sponsored project examining CPOE safety. Two pharmacists independently reviewed each report to confirm whether the error occurred in the ordering/prescribing phase and was related to CPOE...
September 27, 2016: Journal of the American Medical Informatics Association: JAMIA
Abraham A Brody, Bryan Gibson, David Tresner-Kirsch, Heidi Kramer, Iona Thraen, Matthew E Coarr, Randall Rupper
OBJECTIVES: To describe the prevalence of discrepancies between medication lists that referring providers and home healthcare (HH) nurses create. DESIGN: The active medication list from the hospital at time of HH initiation was compared with the HH agency's plan of care medication list. An electronic algorithm was developed to compare the two lists for discrepancies. SETTING: Single large hospital and HH agency in the western United States...
September 27, 2016: Journal of the American Geriatrics Society
D J Brinkman, J Tichelaar, T Schutte, S Benemei, Y Böttiger, B Chamontin, T Christiaens, R Likic, R Mačiulaitis, T Marandi, E C Monteiro, P Papaioannidou, Y M Pers, C Pontes, A Raskovic, R Regenthal, E J Sanz, B I Tamba, K Wilson, T P de Vries, M C Richir, M A van Agtmael
European medical students should have acquired adequate prescribing competencies before graduation, but it is not known whether this is the case. In this international multicenter study, we evaluated the essential knowledge, skills, and attitudes in clinical pharmacology and therapeutics (CPT) of final-year medical students across Europe. In a cross-sectional design, 26 medical schools from 17 European countries were asked to administer a standardized assessment and questionnaire to 50 final-year students. Although there were differences between schools, our results show an overall lack of essential prescribing competencies among final-year students in Europe...
September 20, 2016: Clinical Pharmacology and Therapeutics
Gina Stassinos, Wendy Klein-Schwartz
CONTEXT: The rise in atypical antipsychotic prescribing increases the risk of pediatric exposures. Published studies in children are limited. OBJECTIVE: The objectives are to evaluate national poison center data on atypical antipsychotic exposures in young children and compare toxicity amongst selected agents. MATERIALS AND METHODS: A retrospective study of U.S. National Poison Data System single substance exposures, from 2005 to 2013, of five atypical antipsychotics in children <6 years old, followed to known outcome was performed...
September 20, 2016: Clinical Toxicology
Karen Hendler, Shiva Mehravaran, Xiang Lu, Stuart I Brown, Bartly J Mondino, Anne L Coleman
PURPOSE: To report the outcomes of full ophthalmic examination for preschool children in LA County who failed screening with the Retinomax Autorefractor. DESIGN: Retrospective, cross-sectional study. METHODS: Between August 2012 and May 2013, the University of California Los Angeles (UCLA) preschool vision program screened 11,260 preschool children aged 3-5 years in Los Angeles County using the Retinomax Autorefractor only. Of those, 1007 children who failed the screening were examined by an ophthalmologist on the UCLA Mobile Eye Clinic...
September 14, 2016: American Journal of Ophthalmology
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