We sought to determine how well the HL7/ASTM Continuity of Care Document (CCD) standard supports the requirements underlying the Joint Commission medication reconciliation recommendations. In particular, the Joint Commission emphasizes that transition points in the continuum of care are vulnerable to communication breakdowns, and that these breakdowns are a common ...

The medical management of marathon casualties involves several potential treatment pathways. It is helpful to develop defined treatment protocols for commonly experienced conditions addressing intervention selection criteria and monitoring response to therapy. Providing intravenous (IV) fluids for runners post marathon should be scrutinised based upon the effectiveness and safety of ...

Children are a particularly challenging group of patients when trying to ensure the safe use of medicines. The increased need for calculations, dilutions and manipulations of paediatric medicines, together with a need to dose on an individual patient basis using age, gestational age, weight and surface area, means that they ...

This study describes nurses' perceptions about medication errors and the effects of physician order entry and barcode medication administration on medication errors. A convenience sample of 61 medical-surgical nurses was surveyed. All nurses surveyed perceived that information technology decreases medication errors. However, medication errors continue to occur despite the availability ...

BACKGROUND: A clear understanding of patients' understanding and perceived risk of medical errors is needed. Multiwave telephone interviews were conducted in 2002 with 1,656 inpatients from 12 Midwestern hospitals regarding patients' conceptualization of medical errors and perceived risk of seven types of medical errors. RESULTS: Patients defined medical errors to ...

This article will review widely publicized cases involving healthcare providers against whom criminal charges have been brought, just at the moment that the idea of medical error disclosure is getting traction. This article will attempt to find similarities or patterns and propose that some level of control can be exercised ...

All medical personnel are concerned with patient safety. Nurses are well positioned, with their constant interaction with patients, to observe for errors and to analyze the systems that led to those errors. The Patient Safety and Information Act, legislation passed in 2005, encourages voluntary reporting of errors without fear of ...

Radiology reports are written primarily in natural language. Automated extraction of malignant findings from narrative reports is an important technique for clinical support or alert generation for physicians. This paper proposes a method for automatically extracting malignant findings from narrative radiological reports written in Japanese. First, sentences are parsed and ...

Medical errors and patient safety are urgent healthcare management challenges. To date, not enough has occurred to provide a systematic organizational design framework for reducing medical errors and improving patient safety. The authors offer such a framework by integrating multiple organizational factors and using well-accepted organization theory, citing relevant empirical ...

Medication errors are a major concern in the Emergency Department (ED). We examined medication prescribing errors among consecutive adult ED patients during two 10-day periods before and during one 9-day period after implementing computerized provider order entry in an adult ED. 2,073 patients had 5,950, orders. Before (after) implementation there ...

This project examined the accuracy of medication administration by nurses at a large tertiary hospital. Registered nurses were prepared to directly observe medication administration. Observations were made of 1514 doses administered by 30 nurses on 3 units, on day and evening shifts. Few (5%) medication errors were found. The most ...

OBJECTIVES: The purpose of this work was to characterize medication errors and adverse drug events intercepted by a system of pediatric clinical pharmacists and to determine whether the addition of a computerized physician order entry system would improve medication safety. METHODS: The study included 16,938 medication orders for 678 admissions ...

Medical errors have become a leading cause of death, killing more people each year than AIDS or aeroplane crashes. These medical errors can be classified into five categories: poor decision making, poor communication, inadequate patient monitoring, patient misidentification, inability to respond rapidly and poor patient tracking. Employing innovative information technologies ...

BACKGROUND: An ethnobotanical and medical study was carried out in the Navarre Pyrenees, an area known both for its high biological diversity and its cultural significance. As well as the compilation of an ethnopharmacological catalogue, a quantitative ethnobotanical comparison has been carried out in relation to the outcomes from other ...

BACKGROUND: Spt7 is an integral component of the multi-subunit SAGA complex that is required for the expression of approximately 10% of yeast genes. Two forms of Spt7 have been identified, the second of which is truncated at its C-terminus and found in the SAGA-like (SLIK) complex. RESULTS: We have found ...

Practical strategies for preventing medication errors in pediatric patients are needed. Medication safety can be improved by assessing current practices, developing evidence-based interventions to improve such practices, evaluating the impact of new evidence-based innovations, and providing feedback to clinicians [20]. Nurses at the point of care are well positioned to ...

The 1999 release of the Institute of Medicine's document To Err is Human was akin to removing the lid of Pandora's box. Not only were the magnitude and impact of medical errors now apparent to those working in the health care industry, but consumers or health care were alerted to ...

Medication error is a major source of iatrogenic injuries in children. Dosing errors are the most common type of medication errors in pediatrics. Sicker patients in intensive care units and emergency departments are more often harmed by such errors. Strategies that have been found to be effective in reducing medication ...

Prevalence of hepatitis C (HCV) in injection drug users (IDUs) is high and once HCV has been detected, follow-up medical care is essential. Six hundred and one current and former IDUs who tested positive for HCV antibodies received referrals for medical care. Twenty-four percent (147) of participants returned to be ...

BACKGROUND: It has been estimated that medication error harms 1-2% of patients admitted to general hospitals. There has been no previous systematic review of the incidence, cause or type of medication error in mental healthcare services. METHODS: A systematic literature search for studies that examined the incidence or cause of ...

BACKGROUND: A recent randomized controlled trial in critical-care units revealed that the elimination of extended-duration work shifts (> or =24 h) reduces the rates of significant medical errors and polysomnographically recorded attentional failures. This raised the concern that the extended-duration shifts commonly worked by interns may contribute to the risk ...

OBJECTIVE: Dispatch-assisted chest compressions only CPR (CC-CPR) has gained widespread acceptance, and recent research suggests that increasing the proportion of compression time during CPR may increase survival from out-of-hospital cardiac arrest. We created a simplified CC-CPR protocol to reduce time to start chest compressions and to increase the proportion of ...

OBJECTIVE: To examine the types of prescribing, administration and dispensing incidents reported to an on-line incident-reporting scheme and determine the types of healthcare professionals responsible for reporting such incidents. METHOD: Retrospective analysis of medication-related incidents reported to an on-line incident-reporting scheme in a large (1000-bed) teaching hospital in the UK. ...

Immunotherapy of childhood malignancies has a magic aura of promising an easy way to cure. It is not only the public, but also the medical community, which has caused this hope. Therefore, it was worthwhile to bring together a panel of experts working in the field of immunotherapy in order ...

We tested the suggestion that Sense of Coherence (SOC) may enhance medical well-being by virtue of a favorably balanced profile of psychosocial assets relative to liabilities. Results derived from a sample of 81 young adults who responded to a battery of inventories supported the Psychosocial Resilience Model. Our findings provide ...

Confusion about patients' medication regimens during the hospital admission and discharge process accounts for many preventable and serious medication errors. Many organizations have begun to redesign their clinical processes to address this patient safety concern. Partners HealthCare, an integrated delivery network in Boston, Massachusetts, has answered this interdisciplinary challenge by ...

OBJECTIVE: The objective of this study was to determine the frequency and types of pediatric medication errors attributable to design features of a computerized order entry system. METHODS: A total of 352 randomly selected, inpatient, pediatric admissions were reviewed retrospectively for identification of medication errors, 3 to 12 months after ...

With the combination of technical equipment, medication administration, and caregiver-delivered treatment, opportunities for adverse events and medical errors exist in hemodialysis units. There are no studies describing the type and frequency of medical errors and adverse events in hemodialysis units. This study examines standard adverse events and medical errors reported ...

INTRODUCTION: Federal Aviation Administration (FAA) regulations require pilots to report all medications and medical conditions for review and consideration as to the overall suitability of the pilot for flight activities. METHODS: Specimens were collected by local pathologists from aviation accidents and sent to the Bioaeronautical Sciences Research Laboratory for analysis. ...

In recent decades, an interdisciplinary quality assurance (QA) movement has emerged in health care studies, which has included increased attention to medical errors. Implicit in this QA effort is a conflict between (1) external agents encouraging the medical profession to adopt strategies for reducing errors and (2) sociological characteristics of ...

OBJECTIVE: To describe the characteristics of verbal orders at a tertiary care children's hospital. STUDY DESIGN: Between August 2003 and January 2004, the computerized provider order entry (CPOE) system was evaluated for the characteristics of verbal orders. The rate of total orders represented by verbal orders and the rate of ...

BACKGROUND/OBJECTIVE: Discrepancies in records used within the medication use system have been identified as a contributing factor of medication errors. The objective of this study was to determine the frequency and type of discrepancies in the medication use system in one tertiary care hospital. METHODS: Using a sample of patients ...

Institute for Safe Medication Practices Canada (ISMP Canada) is involved in collaborative initiatives focusing on opioid safety in two Canadian provinces: Ontario and Alberta. Baseline survey responses from these provinces indicate opportunities for improvements to the opioid system that might be applicable nationally. Information about the Ontario project and preliminary ...

BACKGROUND: Continuing quality improvement (CQI) reviews reflect that medication administration errors occur in the prehospital setting. These include errors involving dose, medication, route, concentration, and treatment. METHODS: A survey was given to paramedics in San Diego County. The survey tool was established based on previous literature reviews and questions developed ...

BACKGROUND: Homicide is one ofthe oldest crimes in human civilization. For every person who dies as a result of homicide, many more are injured. A study of the patterns of homicide in a society is one of the first steps in developing strategies to prevent it. This study was conducted ...

In this paper, I use nationally representative survey data to examine the relationship between patient-physician racial/ethnic concordance and perceived medical errors in the USA. After adjusting for potential confounding factors, we find that White patients treated by White physicians have 33% lower odds of reporting medical errors than White patients ...

BACKGROUND: Although medication errors are 1 of the most common types of medical errors, their frequency in pediatric patients receiving oral outpatient chemotherapeutic agents is unknown. The prescribing, dispensing, and parental administration of these medications to children receiving treatment for acute lymphoblastic leukemia (ALL) were systematically reviewed to determine the ...

BACKGROUND: The atrial fibrillation cycle length (AFCL) is a critical parameter for the perpetuation and termination of AF. In the present study, we evaluated a new method to measure the AFCL based on transthoracic tissue Doppler imaging (TDI) of the right atrium (RA) and left atrium (LA). METHODS: Twenty patients ...

The present study explores driving skills in a group of 50 media-recruited driving-fearful and 50 control drivers, all of whom were women. Participants completed an on-road practical driving assessment with a professional driving instructor. Diagnostic as well as pre-post self-report and instructor driving assessments were conducted. Fearful drivers made more ...

CONTEXT: Medical errors are associated with feelings of distress in physicians, but little is known about the magnitude and direction of these associations. OBJECTIVE: To assess the frequency of self-perceived medical errors among resident physicians and to determine the association of self-perceived medical errors with resident quality of life, burnout, ...

BACKGROUND: Physician disclosure of medical errors to institutions, patients, and colleagues is important for patient safety, patient care, and professional education. However, the variables that may facilitate or impede disclosure are diverse and lack conceptual organization. OBJECTIVE: To develop an empirically derived, comprehensive taxonomy of factors that affects voluntary disclosure ...

IMPROVING PATIENT SAFETY has become one of the driving forces in health care delivery. Honest, accurate disclosure of medical errors and close calls is crucial to gain a better grasp of problems, make effective changes, and evaluate progress. ALTHOUGH FEAR OF MALPRACTICE litigation remains a major deterrent to medical-error reporting, ...

Case histories are based on actual medical negligence claims or medicolegal referrals, however certain facts have been omitted or changed by the author to ensure the anonymity of the parties involved. This article outlines a medication error involving childhood immunisation and examines the underlying causes of the incident. Advice about ...

Clinicians are increasingly using handheld computers (HC) during patient care. We sought to assess the role of HC-based clinical reference software in medical practice by conducting a survey and assessing actual usage behavior. During a 2-week period in February 2005, 3600 users of a HC-based clinical reference application were asked ...

BACKGROUND: Highly active antiretroviral therapy (HAART) has improved survival for persons living with human immunodeficiency virus (HIV) infection. However, effective therapy requires high levels of adherence over extended periods of time. Previous studies suggest that patients receiving long-term medication are at risk for unintended medication discrepancies at the time of ...

PURPOSE: Failure mode and effects analysis (FMEA) was used to evaluate a smart i.v. pump as it was implemented into a redesigned medication-use process. SUMMARY: A multidisciplinary team conducted a FMEA to guide the implementation of a smart i.v. pump that was designed to prevent pump programming errors. The smart ...

The Advanced Technology Solar Telescope (ATST) is an off-axis Gregorian astronomical telescope design. The ATST is expected to be subject to thermal and gravitational effects that result in misalignments of its mirrors and warping of its primary mirror. These effects require active, closed-loop correction to maintain its as-designed diffraction-limited optical ...

OBJECTIVES: The study was performed to determine the incidence of symptomatic venous thromboembolism in outpatients with an acute medical event causing temporary reduced mobility. Risk factors for venous thromboembolism and thromboprophylaxis practices were also studied. DESIGN: This was a prospective, observational, multicentre, cohort study. SETTING: General practitioners randomly selected from ...

OBJECTIVES: (1) To identify the extent to which information provided by parents in the pediatric emergency department (ED) can drive the assessment and categorization of data on allergies to medications, and (2) to identify errors related to the capture and documentation of allergy data at specific process level steps during ...

Harmful pediatric medication errors are common in hospitals and health systems. Understanding what products are involved in these errors is important in the prevention of future errors. We used data from a voluntary medication error reporting system (MEDMARX) and identified 816 harmful outcomes involving 242 medications during a 5-year period. ...