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Prescribing errors

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https://www.readbyqxmd.com/read/28529113/integrating-natural-language-processing-expertise-with-patient-safety-event-review-committees-to-improve-the-analysis-of-medication-events
#1
Allan Fong, Nicole Harriott, Donna M Walters, Hanan Foley, Richard Morrissey, Raj R Ratwani
OBJECTIVES: Many healthcare providers have implemented patient safety event reporting systems to better understand and improve patient safety. Reviewing and analyzing these reports is often time consuming and resource intensive because of both the quantity of reports and length of free-text descriptions in the reports. METHODS: Natural language processing (NLP) experts collaborated with clinical experts on a patient safety committee to assist in the identification and analysis of medication related patient safety events...
May 11, 2017: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/28527149/characterisation-of-drug-related-problems-and-associated-factors-at-a-clinical-pharmacist-service-na%C3%A3-ve-hospital-in-northern-sweden
#2
Cecilia Peterson, Maria Gustafsson
BACKGROUND: Polypharmacy and increased sensitivity to side effects cause adverse drug events, drug-drug interactions and medication errors in the elderly. OBJECTIVE: The objective of this study was to investigate the prevalence and type of drug-related problems and associated factors among patients admitted to a clinical pharmacist service-naïve medical ward in an inland hospital in northern Sweden. METHODS: During September-November 2015 and February-April 2016, clinical pharmacists working as part of a ward team on the medical ward conducted 103 medication reviews...
May 19, 2017: Drugs—Real World Outcomes
https://www.readbyqxmd.com/read/28521708/implementation-and-evaluation-of-a-technology-system-to-improve-safety-in-the-pharmacotherapeutic-process-in-oncohematology
#3
Maria Teresa Aznar Saliente, Mauricio Martínez Ramírez, Maria Amparo Talens Bolós, Paola Herraiz Robles, Nuria Bujadón Querejeta, Maria Dolores Camacho Romera, Laia Pons M Artínez, Manuel Bonete Sánchez, Borja Marcos Ribes, Maria Teresa Martínez Lazcano, Francisco Martínez Granados
OBJECTIVE The objective of the study was to describe the process of implementing a technology system to improve safety and quality in all processes involved in the treatment with parenteral antineoplastic agents within an interdisciplinary team and to analyze the errors detected and avoided thanks to this system at the different stages of the process. MATERIALS AND METHODS Observational and retrospective study where the implementation of an expert technology system in all phases of the therapeutic process is described: prescription, validation, preparation and administration of drugs, in which errors found in the different phases are analysed...
May 18, 2017: Current Drug Safety
https://www.readbyqxmd.com/read/28508788/kalis-an-ehealth-system-for-biomedical-risk-analysis-of-drugs
#4
Alban Shoshi, Ulrich Müller, Arben Shoshi, Venus Ogultarhan, Ralf Hofestädt
BACKGROUND: In Germany, adverse drug reactions and events cause hospitalizations, which lead to numerous thousands of deaths and several million Euros in additional health costs annually. OBJECTIVES: Approximately one in two deaths could be avoided by an appropriate system for risk analysis of drugs. METHODS: The integration and storage of several data sources from life sciences are an ongoing need to address various questions with respect to drug therapy...
2017: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/28492168/accidental-intravenous-administration-of-paracetamol-syrup-in-a-child
#5
D El Mazloum, A Boner, A Pietrobelli
OBJECTIVE AND IMPORTANCE: Medication administration errors occur frequently in clinical practice. CLINICAL PRESENTATION: An 18-month-old child presented with vomiting and diarrhea. Due to a rise in temperature, paracetamol syrup was prescribed, but a nurse inadvertently administered the drug IV through the peripheral venous access. INTERVENTION: The child was referred to the pediatric intensive care unit where his clinical condition improved and the risk of peripheral venous and pulmonary embolism was excluded...
December 2016: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/28484385/an-evaluation-of-the-accuracy-of-classical-models-for-computing-the-membrane-potential-and-extracellular-potential-for-neurons
#6
Aslak Tveito, Karoline H Jæger, Glenn T Lines, Łukasz Paszkowski, Joakim Sundnes, Andrew G Edwards, Tuomo Māki-Marttunen, Geir Halnes, Gaute T Einevoll
Two mathematical models are part of the foundation of Computational neurophysiology; (a) the Cable equation is used to compute the membrane potential of neurons, and, (b) volume-conductor theory describes the extracellular potential around neurons. In the standard procedure for computing extracellular potentials, the transmembrane currents are computed by means of (a) and the extracellular potentials are computed using an explicit sum over analytical point-current source solutions as prescribed by volume conductor theory...
2017: Frontiers in Computational Neuroscience
https://www.readbyqxmd.com/read/28480481/physicians-compliance-with-a-clinical-decision-support-system-alerting-during-the-prescribing-process
#7
Fatih Baypinar, Hylke Jan Kingma, Ruud T M van der Hoeven, Matthijs L Becker
Clinical decision support systems have been shown to improve practitioner performance. Most systems designed to prevent medication errors generate lists with patients who fulfill the criteria of the algorithm. These lists are reviewed by a pharmacist and physicians are contacted by telephone. Presenting pop-up alerts as part of the workflow with a clear recommendation is a feature critical to success. Therefore we implemented three algorithms in a clinical decision support system alerting during the medication ordering process...
June 2017: Journal of Medical Systems
https://www.readbyqxmd.com/read/28477342/estimating-patient-dose-from-ct-exams-that-use-automatic-exposure-control-development-and-validation-of-methods-to-accurately-estimate-tube-current-values
#8
Kyle McMillan, Maryam Bostani, Christopher H Cagnon, Lifeng Yu, Shuai Leng, Cynthia H McCollough, Michael F McNitt-Gray
PURPOSE: The vast majority of body CT exams are performed with automatic exposure control (AEC), which adapts the mean tube current to the patient size and modulates the tube current either angularly, longitudinally or both. However, most radiation dose estimation tools are based on fixed tube current scans. Accurate estimates of patient dose from AEC scans require knowledge of the tube current values, which is usually unavailable. The purpose of this work was to develop and validate methods to accurately estimate the tube current values prescribed by one manufacturer's AEC system to enable accurate estimates of patient dose...
May 5, 2017: Medical Physics
https://www.readbyqxmd.com/read/28476877/incidence-of-clinically-relevant-medication-errors-in-the-era-of-electronically-prepopulated-medication-reconciliation-forms-a-retrospective-chart-review
#9
Kaitlin R Stockton, Maeve E Wickham, Simon Lai, Katherin Badke, Karen Dahri, Diane Villanyi, Vi Ho, Corinne M Hohl
BACKGROUND: To reduce medication discrepancies (unintended differences between a patient's outpatient and inpatient medication regimens), Canadian institutions have implemented medication reconciliation forms that are prepopulated with outpatient medication dispensing data. These may prompt prescribers to reorder discontinued medications or continue newly contraindicated medications. Our objective was to evaluate the incidence of medication discrepancies and errors of commission after the implementation of such forms...
May 5, 2017: CMAJ Open
https://www.readbyqxmd.com/read/28474821/application-of-physiologically-based-pharmacokinetic-modeling-to-predict-drug-disposition-in-pregnant-populations
#10
Vamshi Krishna Jogiraju, Suvarchala Avvari, Rakesh Gollen, David R Taft
Pregnancy is associated with numerous physiologic changes that influence absorption, distribution, metabolism and excretion. Moreover, the magnitude of these effects changes as pregnancy matures. For most medications, there is limited information available about changes in drug disposition that can occur in pregnant patients, yet most women are prescribed one or more medications during pregnancy. In this investigation, PBPK modeling was used to assess the impact of pregnancy on the pharmacokinetic profiles of three medications (metformin, tacrolimus, oseltamivir) using the Simcyp® Simulator...
May 5, 2017: Biopharmaceutics & Drug Disposition
https://www.readbyqxmd.com/read/28473134/underuse-of-prevention-and-lifestyle%C3%A2-counseling-in-patients-with-peripheral-artery-disease
#11
Jeffrey S Berger, Joseph A Ladapo
BACKGROUND: Little is known about patterns of medication use and lifestyle counseling in patients with peripheral artery disease (PAD) in the United States. OBJECTIVES: The authors sought to evaluate trends in both medical therapy and lifestyle counseling for PAD patients in the United States from 2005 through 2012. METHODS: Data from 1,982 outpatient visits among patients with PAD were obtained from the National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey, a nationally representative assessment of office-based and hospital outpatient department practice...
May 9, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28469432/systematic-review-of-medical-informatics-supported-medication-decision-making
#12
REVIEW
Brittany L Melton
This systematic review sought to assess the applications and implications of current medical informatics-based decision support systems related to medication prescribing and use. Studies published between January 2006 and July 2016 which were indexed in PubMed and written in English were reviewed, and 39 studies were ultimately included. Most of the studies looked at computerized provider order entry or clinical decision support systems. Most studies examined decision support systems as a means of reducing errors or risk, particularly associated with medication prescribing, whereas a few studies evaluated the impact medical informatics-based decision support systems have on workflow or operations efficiency...
2017: Biomedical Informatics Insights
https://www.readbyqxmd.com/read/28468867/medication-errors-by-caregivers-at-home-in-neonates-discharged-from-the-neonatal-intensive-care-unit
#13
Ritanshu Solanki, Nivedita Mondal, Thulasingam Mahalakshmy, Vishnu Bhat
OBJECTIVE: To determine the frequency of medication errors by caregivers at home in neonates discharged from the neonatal intensive care unit and to identify the associated risk factors. METHODS: A descriptive, cross-sectional study was conducted in the High Risk Newborn Follow-up Clinic of our institute, on a sample of 166 children, <3 months old. The medications prescribed (syrup preparations of vitamin D, multivitamins, calcium, iron and levetiracetam, tablet L-thyroxine and ursodeoxycholic acid and human milk fortifier powder) were noted from the discharge summary...
May 3, 2017: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/28468255/using-tri-axial-accelerometry-in-daily-elite-swim-training-practice
#14
Sander Ganzevles, Rik Vullings, Peter Jan Beek, Hein Daanen, Martin Truijens
Background: Coaches in elite swimming carefully design the training programs of their swimmers and are keen on achieving strict adherence to those programs by their athletes. At present, coaches usually monitor the compliance of their swimmers to the training program with a stopwatch. However, this measurement clearly limits the monitoring possibilities and is subject to human error. Therefore, the present study was designed to examine the reliability and practical usefulness of tri-axial accelerometers for monitoring lap time, stroke count and stroke rate in swimming...
April 29, 2017: Sensors
https://www.readbyqxmd.com/read/28467437/differences-in-antimicrobial-consumption-prescribing-and-isolation-rate-of-multidrug-resistant-klebsiella-pneumoniae-pseudomonas-aeruginosa-and-acinetobacter-baumannii-on-surgical-and-medical-wards
#15
Vladimir Zivanovic, Ljiljana Gojkovic-Bukarica, Radisav Scepanovic, Teodora Vitorovic, Radmila Novakovic, Nenad Milanov, Zoran Bukumiric, Biljana Carevic, Jasmina Trajkovic, Jovana Rajkovic, Vladimir Djokic
In order to provide guidance data for clinically rational use of an antibiotics consuption, prescribing and prevalence of multidrug resistant (MDR) Klebsiella pneumoniae, Pseudomonas aeruginosa and Acinetobacter baumannii were monitored on the surgical (S) and medical (M) wards of the University Hospital Center "Dr. Dragisa Misovic-Dedinje" (Belgrade, Serbia), in the study period from 2012 to 2015. Appropriateness of antimicrobial use was evaluated using the Global-Prevalence Survey method designed by the University of Antwerp...
2017: PloS One
https://www.readbyqxmd.com/read/28465538/how-doctors-diagnose-diseases-and-prescribe-treatments-an-fmri-study-of-diagnostic-salience
#16
Marcio Melo, Gustavo D F Gusso, Marcelo Levites, Edson Amaro, Eduardo Massad, Paulo A Lotufo, Peter Zeidman, Cathy J Price, Karl J Friston
Understanding the brain mechanisms involved in diagnostic reasoning may contribute to the development of methods that reduce errors in medical practice. In this study we identified similar brain systems for diagnosing diseases, prescribing treatments, and naming animals and objects using written information as stimuli. Employing time resolved modeling of blood oxygen level dependent (BOLD) responses enabled time resolved (400 milliseconds epochs) analyses. With this approach it was possible to study neural processes during successive stages of decision making...
May 2, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28463216/-inadequate-doses-of-hemodialysis-predisposing-factors-causes-and-prevention
#17
Pehuén Fernández, Silvana Núñez, Javier De Arteaga, Carlos Chiurchiu, Walter Douthat, Jorge De La Fuente
Patients receiving sub-optimal dose of hemodialysis have increased morbidity and mortality. The objectives of this study were to identify predisposing factors and causes of inadequate dialysis, and to design a practical algorithm for the management of these patients. A cross-sectional study was conducted. Ninety patients in chronic hemodialysis at Hospital Privado Universitario de Córdoba were included, during September 2015. Twenty two received sub-optimal dose of hemodialysis. Those with urea distribution volume (V) greater than 40 l (72 kg body weight approximately) are 11 times more likely (OR = 11...
2017: Medicina
https://www.readbyqxmd.com/read/28461295/an-evidence-based-point-of-care-tool-to%C3%A2-guide-completion-of-asthma-action-plans%C3%A2-in-practice
#18
Andrew Kouri, Louis-Philippe Boulet, Alan Kaplan, Samir Gupta
Asthma action plans (AAPs) reduce healthcare utilisation, improve quality of life and are recommended across guidelines. However, fewer than 25% of patients receive an AAP, partly due to prescribers' inability to complete "yellow zone" instructions (how to intensify therapy for acute loss of control). We sought to review best evidence to develop a practical, evidence-based tool to facilitate yellow zone guidance in adults.We reviewed recent asthma guidelines and adult studies addressing acute loss of asthma control (January 2010 to March 2016)...
May 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/28459698/fuzzy-adaptive-output-feedback-control-of-uncertain-nonlinear-systems-with-prescribed-performance
#19
Jin-Xi Zhang, Guang-Hong Yang
This paper investigates the tracking control problem for a family of strict-feedback systems in the presence of unknown nonlinearities and immeasurable system states. A low-complexity adaptive fuzzy output feedback control scheme is proposed, based on a backstepping method. In the control design, a fuzzy adaptive state observer is first employed to estimate the unmeasured states. Then, a novel error transformation approach together with a new modification mechanism is introduced to guarantee the finite-time convergence of the output error to a predefined region and ensure the closed-loop stability...
April 24, 2017: IEEE Transactions on Cybernetics
https://www.readbyqxmd.com/read/28456065/improving-hiv-post-exposure-prophylaxis-rates-after-pediatric-acute-sexual-assault
#20
Samantha Schilling, Stephanie A Deutsch, Rebecca Gieseker, Jennifer Molnar, Jane M Lavelle, Philip V Scribano
The purpose of our study was to increase the rate of children with appropriate HIV-PEP regimens among those diagnosed with sexual assault in The Children's Hospital of Philadelphia Emergency Department (ED). The outcome measure was the percent of patients receiving correct HIV-PEP. We retrospectively reviewed 97 charts over 31 months to define the baseline rate of children receiving appropriate HIV-PEP regimens (pre QI-implementation period: 2/2012-8/2014). Among children in which HIV-PEP was indicated following sexual assault, 40% received the recommended 28-day course...
April 26, 2017: Child Abuse & Neglect
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