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Prescribing errors

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https://www.readbyqxmd.com/read/28340029/the-proportion-of-errors-in-medical-prescriptions-and-their-executions-among-hospitalized-children-before-and-during-accreditation
#1
Tal Margalit Mekory, Hilla Bahat, Benjamin Bar-Oz, Orna Tal, Matitiahu Berkovitch, Eran Kozer
Objective: To evaluate the rate of medication related errors in the pediatric ward and pediatric emergency department (PED), before and after implementing intervention strategies according to the Joint Commission International (JCI) accreditation program. Design: A retrospective cross-sectional study that included chart review. Setting: A university affiliated pediatric ward and PED. Participants: Children 0-18 years old admitted on February 2013 (before the JCI program) and February 2014 (during implementation of the JCI program)...
March 10, 2017: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/28336760/analysis-of-variations-in-the-display-of-drug-names-in-computerized-prescriber-order-entry-systems
#2
Arbor J L Quist, Thu-Trang T Hickman, Mary G Amato, Lynn A Volk, Alejandra Salazar, Alexandra Robertson, Adam Wright, David W Bates, Shobha Phansalkar, Bruce L Lambert, Gordon D Schiff
PURPOSE: The variations in how drug names are displayed in computerized prescriber-order-entry (CPOE) systems were analyzed to determine their contribution to potential medication errors. METHODS: A diverse set of 10 inpatient and outpatient CPOE system vendors and self-developed CPOE systems in 6 U.S. healthcare institutions was evaluated. A team of pharmacists, physicians, patient-safety experts, and informatics experts created a CPOE assessment tool to standardize the assessment of CPOE features across the systems studied...
April 1, 2017: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/28335778/radiation-dose-escalation-based-on-fdg-pet-driven-dose-painting-by-numbers-in-oropharyngeal-squamous-cell-carcinoma-a-dosimetric-comparison-between-tomotherapy-ha-and-rapidarc
#3
Sarah Differding, Edmond Sterpin, Nicolas Hermand, Bianca Vanstraelen, Sandra Nuyts, Nathalie de Patoul, Jean-Marc Denis, John Aldo Lee, Vincent Grégoire
PURPOSE: Validation of dose escalation through FDG-PET dose painting (DP) for oropharyngeal squamous cell carcinoma (SCC) requires randomized clinical trials with large sample size, potentially involving different treatment planning and delivery systems. As a first step of a joint clinical study of DP, a planning comparison was performed between Tomotherapy HiArt® (HT) and Varian RapidArc® (RA). METHODS: The planning study was conducted on five patients with oropharyngeal SCC...
March 23, 2017: Radiation Oncology
https://www.readbyqxmd.com/read/28331354/utilization-and-prescribing-patterns-of-direct-oral-anticoagulants
#4
Maegan M Whitworth, Krystal K Haase, David S Fike, Ravindra M Bharadwaj, Rodney B Young, Eric J MacLaughlin
BACKGROUND: Scant literature exists evaluating utilization patterns for direct oral anticoagulants (DOACs). OBJECTIVES: The primary objective was to assess DOAC prescribing in patients with venous thromboembolism (VTE) and nonvalvular atrial fibrillation (NVAF) in outpatient clinics. Secondary objectives were to compare utilization between family medicine (FM) and internal medicine (IM) clinics, characterize potentially inappropriate use, and identify factors associated with adverse events (AEs)...
2017: International Journal of General Medicine
https://www.readbyqxmd.com/read/28327202/patients-perspective-of-disease-and-medication-adherence-for-type-2-diabetes-in-an-urban-area-in-bangladesh-a-qualitative-study
#5
Sheikh Mohammed Shariful Islam, Tuhin Biswas, Faiz A Bhuiyan, Kamrun Mustafa, Anwar Islam
BACKGROUND: Patients' perspective of diabetes and adherence to its prescribed medications is a significant predictor of glycemic control and overall management of the disease. However, there is a paucity of such information in Bangladesh. This study aimed to explore patients' perspective of diabetes, their experience of taking oral hypoglycemic medications and explore factors that contribute to medication adherence in patients with type 2 diabetes in Bangladesh. METHODS: We conducted in-depth face-to-face interviews with 12 type 2 diabetes patients attending a tertiary hospital in Dhaka city between February and March, 2014...
March 21, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/28326127/detecting-peatland-drains-with-object-based-image-analysis-and-geoeye-1-imagery
#6
J Connolly, N M Holden
BACKGROUND: Peatlands play an important role in the global carbon cycle. They provide important ecosystem services including carbon sequestration and storage. Drainage disturbs peatland ecosystem services. Mapping drains is difficult and expensive and their spatial extent is, in many cases, unknown. An object based image analysis (OBIA) was performed on a very high resolution satellite image (Geoeye-1) to extract information about drain location and extent on a blanket peatland in Ireland...
December 2017: Carbon Balance and Management
https://www.readbyqxmd.com/read/28321300/identifying-highlighting-and-reducing-polypharmacy-in-a-uk-hospice-inpatient-unit-using-improvement-science-methods
#7
Alison Phippen, Jennie Pickard, Douglas Steinke, Matt Cope, Dai Roberts
Polypharmacy, the concurrent use of multiple medications by one individual is a growing global issue driven by an ageing population and increasing prevalence of multi-morbidity[1]. Polypharmacy can be problematic: interactions between medications, reduced adherence to medication, burden of medication to patients, administration time, increased risk of errors and increased cost. Quality improvement methods were applied to identify and highlight polypharmacy patients with the aim of reducing their average number of regular tablets/capsules per day by 25%...
2017: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/28306610/30-day-potentially-avoidable-readmissions-due-to-adverse-drug-events
#8
Olivia Dalleur, Patrick E Beeler, Jeffrey L Schnipper, Jacques Donzé
OBJECTIVE: To analyze the patterns of potentially avoidable readmissions due to adverse drug events (ADEs) to identify the most appropriate risk reduction interventions. METHODS: In this observational study, we analyzed a random sample of 534 potentially avoidable 30-day readmissions from 10,275 consecutive discharges from the medical department of an academic hospital. Readmissions due to ADEs were reviewed to identify the causative drugs and the severity and interventions to prevent them...
March 17, 2017: Journal of Patient Safety
https://www.readbyqxmd.com/read/28302112/automation-bias-in-electronic-prescribing
#9
David Lyell, Farah Magrabi, Magdalena Z Raban, L G Pont, Melissa T Baysari, Richard O Day, Enrico Coiera
BACKGROUND: Clinical decision support (CDS) in e-prescribing can improve safety by alerting potential errors, but introduces new sources of risk. Automation bias (AB) occurs when users over-rely on CDS, reducing vigilance in information seeking and processing. Evidence of AB has been found in other clinical tasks, but has not yet been tested with e-prescribing. This study tests for the presence of AB in e-prescribing and the impact of task complexity and interruptions on AB. METHODS: One hundred and twenty students in the final two years of a medical degree prescribed medicines for nine clinical scenarios using a simulated e-prescribing system...
March 16, 2017: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/28300430/calculated-daily-insulin-dosages-overestimate-prescribed-insulin-doses-in-type-2-diabetes
#10
Karel Kostev, Wolfgang Rathmann
BACKGROUND: The aim was to compare the prescribed and calculated daily insulin dosages based on prescription data in type 2 diabetes patients in a general practice database. METHODS: A total of 17 782 type 2 diabetes patients (age: 70.0 ± 11.5 years; 52% males; 16% diabetologist care) with ≥2 insulin prescriptions from 834 practices were analyzed (Disease Analyser: 01/2011-12/2015). Prescribed daily dosage (PDD) (physician documentation) and calculated daily dose (CDD) (pack size × strength × volume / days between 2 prescriptions) were calculated for short-acting, long-acting, and premixed insulins...
October 1, 2016: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/28296331/treatment-accuracy-without-rotational-setup-corrections-in-intracranial-srt
#11
Eeva Boman, Mika Kapanen, Marko Laaksomaa, Hanna Mäenpää, Simo Hyödynmaa, Pirkko-Liisa Kellokumpu-Lehtinen
The aim of this study was to evaluate the impact of actual rotational setup errors on dose distributions in intracranial stereotactic radiotherapy (SRT) with different alternatives for treatment position selection. A total of 38 SRT fractions from 18 patients were retrospectively evaluated with rotational setup errors obtained from actual treatments. The planning computed tomography (CT) images were rotated according to online cone-beam CT (CBCT) images and the dose distribution was recalculated to the rotated CT images using three different patient positionings derived from: 1) an automatic 6D match neglecting rotation correction (Auto6D); 2) an automatic 3D match (Auto3D); and 3) a manual 3D match from actual treatment (Treat3D)...
July 2016: Journal of Applied Clinical Medical Physics
https://www.readbyqxmd.com/read/28296314/effect-of-the-normalized-prescription-isodose-line-on-the-magnitude-of-monte-carlo-vs-pencil-beam-target-dose-differences-for-lung-stereotactic-body-radiotherapy
#12
Dandan Zheng, Qinghui Zhang, Xiaoying Liang, Xiaofeng Zhu, Vivek Verma, Shuo Wang, Sumin Zhou
In lung stereotactic body radiotherapy (SBRT) cases, the pencil beam (PB) dose calculation algorithm is known to overestimate target dose as compared to the more accurate Monte Carlo (MC) algorithm. We investigated whether changing the normalized prescription isodose line affected the magnitude of MC vs. PB target dose differences. Forty-eight patient plans and twenty virtual-tumor phantom plans were studied. For patient plans, four alternative plans prescribed to 60%, 70%, 80%, and 90% isodose lines were each created for 12 patients who previously received lung SBRT treatments...
July 2016: Journal of Applied Clinical Medical Physics
https://www.readbyqxmd.com/read/28287671/genetic-testing-for-psychopharmacology-is-it-ready-for-prime-time
#13
Laura G Leahy
Genetic testing in psychiatric practice may be a beneficial adjunct to the nursing toolbox of considerations used to improve patient outcomes. Since 2004, the psychiatric community has used genotyping to personalize medication options for their patients. Although not a definitive or exact science, pharmacogenetic testing for psychopharmacological treatment options offers nurses and their patients insights into potential treatments that will reduce the current trial-and-error prescribing practices and more quickly improve patients' quality of life...
March 1, 2017: Journal of Psychosocial Nursing and Mental Health Services
https://www.readbyqxmd.com/read/28283306/-if-no-one-stops-me-i-ll-make-the-mistake-again-changing-prescribing-behaviours-through-feedback-a-perceptual-control-theory-perspective
#14
Jane Ferguson, Chris Keyworth, Mary P Tully
BACKGROUND: Doctors at all levels make prescribing errors which can prolong patients' hospital stay, increase the risk of death, and place a significant financial burden on the health system. Doctors have previously reported receiving little or no feedback on their prescribing errors. The effectiveness of feedback in modifying future practice varies widely, depending on how feedback is delivered. To date there is little evidence about why and how feedback interventions do or do not work...
March 2, 2017: Research in Social & Administrative Pharmacy: RSAP
https://www.readbyqxmd.com/read/28279430/coupled-disturbance-observer-based-position-tracking-control-for-a-cascade-electro-hydraulic-system
#15
Qing Guo, Jing-Min Yin, Tian Yu, Dan Jiang
The disturbance suppression is one of the most common control problems in electro-hydraulic systems. especially largely an unknown disturbance often obviously degrades the dynamic performance by biasing the desired actuator outputs (e.g., load forces or torques). In order to reject the dynamic disturbances in some multi-degree-of-freedom manipulators driven by electro-hydraulic actuators, this paper proposes a state feedback control of the cascade electro-hydraulic system based on a coupled disturbance observer with backstepping...
March 6, 2017: ISA Transactions
https://www.readbyqxmd.com/read/28275552/dietary-practices-in-isovaleric-acidemia-a-european-survey
#16
A Pinto, A Daly, S Evans, M F Almeida, M Assoun, A Belanger-Quintana, S Bernabei, S Bollhalder, D Cassiman, H Champion, H Chan, J Dalmau, F de Boer, C de Laet, A de Meyer, A Desloovere, A Dianin, M Dixon, K Dokoupil, S Dubois, F Eyskens, A Faria, I Fasan, E Favre, F Feillet, A Fekete, G Gallo, C Gingell, J Gribben, K Kaalund-Hansen, N Horst, C Jankowski, R Janssen-Regelink, I Jones, C Jouault, G E Kahrs, I L Kok, A Kowalik, C Laguerre, S Le Verge, R Lilje, C Maddalon, D Mayr, U Meyer, A Micciche, M Robert, J C Rocha, H Rogozinski, C Rohde, K Ross, I Saruggia, A Schlune, K Singleton, E Sjoqvist, L H Stolen, A Terry, C Timmer, L Tomlinson, A Tooke, K Vande Kerckhove, E van Dam, T van den Hurk, L van der Ploeg, M van Driessche, M van Rijn, A van Teeffelen-Heithoff, A van Wegberg, C Vasconcelos, H Vestergaard, I Vitoria, D Webster, F J White, L White, H Zweers, A MacDonald
BACKGROUND: In Europe, dietary management of isovaleric acidemia (IVA) may vary widely. There is limited collective information about dietetic management. AIM: To describe European practice regarding the dietary management of IVA, prior to the availability of the E-IMD IVA guidelines (E-IMD 2014). METHODS: A cross-sectional questionnaire was sent to all European dietitians who were either members of the Society for the Study of Inborn Errors of Metabolism Dietitians Group (SSIEM-DG) or whom had responded to previous questionnaires on dietetic practice (n = 53)...
September 2017: Molecular Genetics and Metabolism Reports
https://www.readbyqxmd.com/read/28269428/the-impact-of-different-leaf-limited-accelerations-on-leaf-positional-error-of-a-self-developed-mlc-prototype
#17
Xiang Zhang, Peiqing Ye, Hui Zhang
Multi-leaf collimator (MLC) provides an available approach to achieve sophisticated radiotherapy techniques and plays an important role in advanced high quality radiation therapy. Delivery accuracy of radiation therapy mainly depends on the leaf sequence generated by treatment plans and dynamic performance of MLCs. Previous studies have explored the influence of various leaf limited velocities and dose rates on the leaf-positional error. However, there is a lack of research on the influence of different leaf limited accelerations on the delivery accuracy or leaf-positional error...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28268935/deep-neural-network-architectures-for-forecasting-analgesic-response
#18
Paul Nickerson, Patrick Tighe, Benjamin Shickel, Parisa Rashidi
Response to prescribed analgesic drugs varies between individuals, and choosing the right drug/dose often involves a lengthy, iterative process of trial and error. Furthermore, a significant portion of patients experience adverse events such as post-operative urinary retention (POUR) during inpatient management of acute postoperative pain. To better forecast analgesic responses, we compared conventional machine learning methods with modern neural network architectures to gauge their effectiveness at forecasting temporal patterns of postoperative pain and analgesic use, as well as predicting the risk of POUR...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28261918/methotrexate-induced-pancytopenia-a-case-series-of-46-patients
#19
Sajal Ajmani, Yogesh Preet Singh, Shiva Prasad, Abhra Chowdhury, Amita Aggarwal, Able Lawrence, Ramnath Misra, Richa Mishra, Vikas Agarwal
AIM: Methotrexate (MTX) has the potential to cause serious adverse reactions and even mortality. We analyzed the predisposing factors and outcome in patients with MTX-induced pancytopenia admitted into our unit from 1996 to 2015. METHODS: Patients were identified by departmental database search. Pancytopenia was defined as white blood cell count (WBC) < 3500 cells/mm(3) , hemoglobin (Hb) < 11 g/dL and platelet count < 150 000 cells/mm(3) . Severe pancytopenia was defined as WBC < 2000 cells/mm(3) , Hb < 10 g/dL and platelet count < 50 000 cells/mm(3) ...
March 5, 2017: International Journal of Rheumatic Diseases
https://www.readbyqxmd.com/read/28250000/assessment-of-rapid-blood-culture-identification-results-interpretation-and-antibiotic-prescribing-practices
#20
Linsey M Donner, W Scott Campbell, Elizabeth Lyden, Trevor C Van Schooneveld
Background: Rapid pathogen identification can alter antibiotic prescribing if interpreted correctly. Microbiology reporting can be difficult to understand and new technology has made it more challenging. Nebraska Medicine recently implemented the Biofire FilmArray® Blood Culture Identification Panel (BCID) coupled with stewardship-based education on interpretation.Methods: Physician BCID result interpretation and prescribing was assessed via an electronic survey with a response rate of 40.8% (156/382). Seven questions required respondents to interpret BCID results and identify the most likely pathogen, then choose therapy based on the results...
March 1, 2017: Journal of Clinical Microbiology
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