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[PMID]:29489684
[Au] Autor:Mongaret C; Quillet P; Vo TH; Aubert L; Fourgeaud M; Michelet-Huot E; Bonnet M; Bedouch P; Slimano F; Gangloff SC; Drame M; Hettler D
[Ad] Endereço:Pharmacy Department, University Hospital of Reims, Rue du General Koenig.
[Ti] Título:Predictive factors for clinically significant pharmacist interventions at hospital admission.
[So] Source:Medicine (Baltimore);97(9):e9865, 2018 Mar.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Pharmaceutical care activities at hospital admission have a significant impact on patient safety. The objective of this study was to identify predictive factors for clinically significant pharmacist interventions (PIs) performed during medication reconciliation and medication review at patient hospital admission.A 4-week prospective study was conducted in 4 medicine wards. At hospital admission, medication reconciliation and medication review were conducted and PIs were performed by the pharmaceutical team. The clinical impact of PIs was determined using the clinical economic and organizational (CLEO) tool. Clinical characteristics, laboratory results, and medication data for each patient were collected and analyzed as potential predictive factors of clinically significant PIs. Univariate and multivariate binary logistic regression were subsequently used to identify independent predictive factors for clinically relevant PIs.Among 265 patients admitted, 150 patients were included. Among 170 PIs performed at hospital admission, 71 were related to unintentional discrepancies (41.8%) during medication reconciliation, and 99 were related to drug-related problems (DRPs) (58.8%) during medication review. Overall, 115 PIs (67.7%) were considered to have a clinical impact. By multivariate analysis, number of medications ≥5 (P = .01) based on the best possible medication history, and Charlson comorbidity index score ≥2 (P < .01) were found to be independent predictive factors of clinically significant PIs at hospital admission.Identifying predictive factors of clinically significant PIs is valuable to optimize clinical pharmacist practices at hospital admission during both medication reconciliation and medication review. These 2 steps of the pharmaceutical care process improve medication safety at hospital admission.
[Mh] Termos MeSH primário: Erros de Medicação/estatística & dados numéricos
Reconciliação de Medicamentos/métodos
Admissão do Paciente/estatística & dados numéricos
Serviço de Farmácia Hospitalar/métodos
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Feminino
Seres Humanos
Modelos Logísticos
Masculino
Meia-Idade
Análise Multivariada
Estudos Prospectivos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180307
[Lr] Data última revisão:
180307
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180301
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009865


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[PMID]:28453820
[Au] Autor:Bourne RS; Shulman R; Tomlin M; Borthwick M; Berry W; Mills GH
[Ad] Endereço:Departments of Pharmacy and Critical Care, Sheffield Teaching Hospitals NHS Foundation Trust, Northern General Hospital, Herries Road, Sheffield S5 7 AU, UK.
[Ti] Título:Reliability of clinical impact grading by healthcare professionals of common prescribing error and optimisation cases in critical care patients.
[So] Source:Int J Qual Health Care;29(2):250-255, 2017 Apr 01.
[Is] ISSN:1464-3677
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Objective: To identify between and within profession-rater reliability of clinical impact grading for common critical care prescribing error and optimisation cases. To identify representative clinical impact grades for each individual case. Design: Electronic questionnaire. Setting: 5 UK NHS Trusts. Participants: 30 Critical care healthcare professionals (doctors, pharmacists and nurses). Intervention: Participants graded severity of clinical impact (5-point categorical scale) of 50 error and 55 optimisation cases. Main Outcome Measures: Case between and within profession-rater reliability and modal clinical impact grading. Methods: Between and within profession rater reliability analysis used linear mixed model and intraclass correlation, respectively. Results: The majority of error and optimisation cases (both 76%) had a modal clinical severity grade of moderate or higher. Error cases: doctors graded clinical impact significantly lower than pharmacists (-0.25; P < 0.001) and nurses (-0.53; P < 0.001), with nurses significantly higher than pharmacists (0.28; P < 0.001). Optimisation cases: doctors graded clinical impact significantly lower than nurses and pharmacists (-0.39 and -0.5; P < 0.001, respectively). Within profession reliability grading was excellent for pharmacists (0.88 and 0.89; P < 0.001) and doctors (0.79 and 0.83; P < 0.001) but only fair to good for nurses (0.43 and 0.74; P < 0.001), for optimisation and error cases, respectively. Conclusions: Representative clinical impact grades for over 100 common prescribing error and optimisation cases are reported for potential clinical practice and research application. The between professional variability highlights the importance of multidisciplinary perspectives in assessment of medication error and optimisation cases in clinical practice and research.
[Mh] Termos MeSH primário: Cuidados Críticos
Pessoal de Saúde/psicologia
Pessoal de Saúde/estatística & dados numéricos
Erros de Medicação/estatística & dados numéricos
[Mh] Termos MeSH secundário: Seres Humanos
Corpo Clínico Hospitalar/psicologia
Corpo Clínico Hospitalar/estatística & dados numéricos
Recursos Humanos de Enfermagem no Hospital/psicologia
Recursos Humanos de Enfermagem no Hospital/estatística & dados numéricos
Farmacêuticos/psicologia
Farmacêuticos/estatística & dados numéricos
Garantia da Qualidade dos Cuidados de Saúde/métodos
Reprodutibilidade dos Testes
Inquéritos e Questionários
Reino Unido
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170429
[St] Status:MEDLINE
[do] DOI:10.1093/intqhc/mzx003


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[PMID]:29425084
[Au] Autor:Sponsler KC; Mixon AS
[Ad] Endereço:Assistant Professor, Department of Medicine, Division of General Internal Medicine and Public Health, Section of Hospital Medicine, Vanderbilt University Medical Center, Nashville, TN, USA. kelly.sponsler@vanderbilt.edu.
[Ti] Título:Finding balance: Optimizing medication prescribing in older patients.
[So] Source:Cleve Clin J Med;85(2):136-137, 2018 02.
[Is] ISSN:1939-2869
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Prescrições de Medicamentos
Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos
[Mh] Termos MeSH secundário: Seres Humanos
Erros de Medicação
[Pt] Tipo de publicação:EDITORIAL; COMMENT
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180302
[Lr] Data última revisão:
180302
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180210
[St] Status:MEDLINE
[do] DOI:10.3949/ccjm.85a.17087


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[PMID]:29293199
[Au] Autor:Wolf ZR
[Ad] Endereço:La Salle University, Philadelphia, Pennsylvania. Zane Robinson Wolf, PhD, RN, FAAN, is dean emerita, professor in the School of Nursing and Health Sciences of La Salle University in Philadelphia. Her interest in medication errors and nurses' experience with them motivated her to conduct this scoping review. Adverse outcomes of infusion-associated medication errors are often more severe than those involving oral medications. Additional research needs to be conducted on protocols and standardized equipment to determine the impact of such safety strategies on infusion-linked medication errors.
[Ti] Título:Strategies to Reduce Patient Harm From Infusion-Associated Medication Errors: A Scoping Review.
[So] Source:J Infus Nurs;36(1):58-65, 2018 Jan/Feb.
[Is] ISSN:1539-0667
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:A scoping review of the literature examined strategies to prevent infusion-associated medication errors. Twenty articles were appraised and revealed studies using different research designs and types of literature reviews. Most were rated low quality. Observations in clinical agencies and laboratory settings were sites of some investigations. The work environment-including staffing, health care providers' education and supervision, standardizing equipment, protocols that supported medication decision-making and administration processes, medication lists, computerized devices, and cognitive aids-were addressed as strategies. The array of studies points to aspects of the complexity of the administration process for infusion-associated medications.
[Mh] Termos MeSH primário: Administração Intravenosa
Infusões Intravenosas/métodos
Erros de Medicação/prevenção & controle
Dano ao Paciente/prevenção & controle
[Mh] Termos MeSH secundário: Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180227
[Lr] Data última revisão:
180227
[Sb] Subgrupo de revista:N
[Da] Data de entrada para processamento:180103
[St] Status:MEDLINE
[do] DOI:10.1097/NAN.0000000000000263


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[PMID]:29194242
[Au] Autor:Hurley TV
[Ad] Endereço:About the Author Teresa V. Hurley, DHEd, MS, RN, is associate professor of nursing, Mount Saint Mary College School of Nursing, Newburgh, New York. For more information, contact her at teresa.hurley@msmc.edu.
[Ti] Título:Experiential Teaching Increases Medication Calculation Accuracy Among Baccalaureate Nursing Students.
[So] Source:Nurs Educ Perspect;38(1):34-36, 2017 Jan/Feb.
[Is] ISSN:1536-5026
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Safe medication administration is an international goal. Calculation errors cause patient harm despite education. The research purpose was to evaluate the effectiveness of an experiential teaching strategy to reduce errors in a sample of 78 baccalaureate nursing students at a Northeastern college. A pretest-posttest design with random assignment into equal-sized groups was used. The experiential strategy was more effective than the traditional method (t = -0.312, df = 37, p = .004, 95% CI) with a reduction in calculation errors. Evaluations of error type and teaching strategies are indicated to facilitate course and program changes.
[Mh] Termos MeSH primário: Cálculos da Dosagem de Medicamento
Bacharelado em Enfermagem/métodos
Erros de Medicação/prevenção & controle
Ensino/tendências
[Mh] Termos MeSH secundário: Adulto
Competência Clínica
Feminino
Seres Humanos
Masculino
Pesquisa em Educação de Enfermagem
Avaliação de Programas e Projetos de Saúde
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180227
[Lr] Data última revisão:
180227
[Sb] Subgrupo de revista:N
[Da] Data de entrada para processamento:171202
[St] Status:MEDLINE
[do] DOI:10.1097/01.NEP.0000000000000097


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[PMID]:29210769
[Au] Autor:Foster MJ; Gary JC; Sooryanarayana SM
[Ad] Endereço:Medical Sciences Library (Ms Foster) and College of Architecture (Ms Sooryanarayana), Texas A&M University, College Station; and College of Nursing, Texas A&M University Health Science Center, Bryan (Dr Gary).
[Ti] Título:Direct Observation of Medication Errors in Critical Care Setting: A Systematic Review.
[So] Source:Crit Care Nurs Q;41(1):76-92, 2018 Jan/Mar.
[Is] ISSN:1550-5111
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Medication errors continue to be an issue for the critically ill and are costly to both patients and health care facilities. This article reviews published research about these errors and reports results of observational studies. The types of errors, incidence, and root causes have been considered along with adverse consequences. The implications for bedside practice as a result of this review are fairly straightforward. Medication errors are happening at an alarming rate in the critical care environment, and these errors are preventable. It is imperative that all personnel respect and follow established guidelines and procedural safeguards to ensure flawless drug delivery to patients.
[Mh] Termos MeSH primário: Cuidados Críticos/métodos
Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos
Erros de Medicação
[Mh] Termos MeSH secundário: Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/economia
Seres Humanos
Erros de Medicação/efeitos adversos
Erros de Medicação/economia
Segurança do Paciente/normas
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180226
[Lr] Data última revisão:
180226
[Sb] Subgrupo de revista:N
[Da] Data de entrada para processamento:171207
[St] Status:MEDLINE
[do] DOI:10.1097/CNQ.0000000000000188


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[PMID]:29177256
[Au] Autor:Chen Y; Huang J; Wang Y; Xie S; He F
[Ad] Endereço:Nuclear medicine department of Quanzhou, East Road 248#, Licheng District, Quanzhou City, China, 362000. 1526797743@qq.com.
[Ti] Título:Errors in the absorbed and the administered I therapeutic dose in patients with Graves' disease. A suggested more precise technique.
[So] Source:Hell J Nucl Med;20(3):217-221, 2017 Sep-Dec.
[Is] ISSN:1790-5427
[Cp] País de publicação:Greece
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: The aim of this study was to evaluate the relative error (RE) in the thyroid absorbed dose (TD) of iodine-131 ( I) in patients with Graves' disease comparing the simplified Quimby-Marinelli-Hine formula method (sQMHF) and the Standard Operational Procedures for dosimetry (SOPD) recommended by the European Association of Nuclear Medicine. PATIENTS AND METHODS: This study included 45 patients with Graves' disease 12 men and 33 women; age 44.1±12.8 years. Thyroid mass (TM) was measured using ultrasound. Uptake of I (RAIU) was tested at 2, 4-6, 24, 48-72, and 96-168h after its administration and the half-life (T ) and resident time (RT) of I were computed. According to the sQMHF, a prescribed TD of 75Gy required 3.7MBq/g of I, correction based on the RAIU and T . Subsequently, the therapeutic TD was computed according to the SOPD and the RE was recorded. The data were analyzed using t-tests. RESULTS: The TM, RAIU , therapeutic TD, and RE were 36.5±23.9g, 0.54±0.14, 89.4±9.4Gy, and -0.01±0.02, respectively. There was a significant difference (t-value 9.84, P<0.01) between the prescribed and therapeutic TD because the sQMHF ignores the absorbed dose deposited in the thyroid during the first 24h, which is included in the SOPD. In addition, the RE was significantly smaller than the variable coefficient (VC) of the therapeutic TD (t=-39.6, P<0.01). CONCLUSION: When the activity of I was calculated using the simplified Q-M-H formula, the therapeutic absorbed thyroid dose was significantly higher than what was expected for the prescribed dose. Precision of the individualized therapeutic absorbed dose could be improved by computing the activity of I using the standard operational procedures for dosimetry of the EANM.
[Mh] Termos MeSH primário: Absorção Fisico-Química
Esquema de Medicação
Doença de Graves/metabolismo
Doença de Graves/radioterapia
Radioisótopos do Iodo/administração & dosagem
Radioisótopos do Iodo/farmacocinética
Erros de Medicação/prevenção & controle
[Mh] Termos MeSH secundário: Adulto
Feminino
Seres Humanos
Masculino
Taxa de Depuração Metabólica
Compostos Radiofarmacêuticos/administração & dosagem
Compostos Radiofarmacêuticos/farmacocinética
Dosagem Radioterapêutica
Estudos Retrospectivos
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Iodine Radioisotopes); 0 (Iodine-131); 0 (Radiopharmaceuticals)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180223
[Lr] Data última revisão:
180223
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171128
[St] Status:MEDLINE
[do] DOI:10.1967/s002449910602


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[PMID]:29280844
[Au] Autor:Claffey C
[Ad] Endereço:Colleen Claffey is an ED nurse at Broward Health Coral Springs in Coral Springs, Fla.
[Ti] Título:Near-miss medication errors provide a wake-up call.
[So] Source:Nursing;48(1):53-55, 2018 Jan.
[Is] ISSN:1538-8689
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Enfermagem em Emergência
Erros de Medicação/prevenção & controle
Near Miss
Gestão de Riscos/organização & administração
[Mh] Termos MeSH secundário: Tecnologia Biomédica
Revelação
Seres Humanos
Responsabilidade Social
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180222
[Lr] Data última revisão:
180222
[Sb] Subgrupo de revista:N
[Da] Data de entrada para processamento:171228
[St] Status:MEDLINE
[do] DOI:10.1097/01.NURSE.0000527615.45031.9e


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[PMID]:28468867
[Au] Autor:Solanki R; Mondal N; Mahalakshmy T; Bhat V
[Ad] Endereço:Department of Neonatology, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India.
[Ti] Título:Medication errors by caregivers at home in neonates discharged from the neonatal intensive care unit.
[So] Source:Arch Dis Child;102(7):651-654, 2017 07.
[Is] ISSN:1468-2044
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo: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. The caregiver who usually administered the medicines to the child at home was asked the names of the medications, frequency of their administration and to show in a measuring cup/syringe/dropper the dose of the medication. The names, doses and frequency of the drugs as reported were matched against those actually prescribed in the discharge summary. Various risk factors probably associated with medication errors, were noted. RESULTS: The frequency of medication errors by caregivers in infants discharged from the neonatal intensive care unit was 66.3%. Dose administration error, that is, measurement of a dose different from what was prescribed was the most common error (54%). A prescription containing more than three drugs was found to have statistically significant association (OR 4.19, CI 1.59 to 11.07, p=0.00). CONCLUSION: Medication errors by caregivers in infants less than 3 months of age are very common, dose administration error being the most common type. A prescription of more than three drugs increases the odds of an error.
[Mh] Termos MeSH primário: Cuidadores
Erros de Medicação/estatística & dados numéricos
[Mh] Termos MeSH secundário: Estudos Transversais
Feminino
Assistência Domiciliar
Seres Humanos
Índia
Lactente
Recém-Nascido
Masculino
Fatores de Risco
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:180221
[Lr] Data última revisão:
180221
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170505
[St] Status:MEDLINE
[do] DOI:10.1136/archdischild-2016-311877


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[PMID]:29303376
[Au] Autor:Manias E
[Ad] Endereço:a Faculty of Health, School of Nursing and Midwifery , Deakin University , Burwood , Australia.
[Ti] Título:Effects of interdisciplinary collaboration in hospitals on medication errors: an integrative review.
[So] Source:Expert Opin Drug Saf;17(3):259-275, 2018 Mar.
[Is] ISSN:1744-764X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: Medication errors are commonly affected by breakdowns in communication. Interdisciplinary collaboration is an important means of facilitating communication between health professionals in clinical practice. To date, there has been little systematic examination of past research in this area. Areas covered: The aims of this integrative review are to examine how interdisciplinary collaboration influences medication errors in hospitals, the araes of interdisciplinary collaboration that have been researched in previous work, and recommendations for future research and practice. An integrative review was undertaken of research papers (N = 30) published from inception to August 2017 using MEDLINE, the Cochrane Library, CINAHL, PsycINFO, and Embase. Expert opinion: Five different areas of interdisciplinary collaboration were identified in research involving medication errors. These areas were: communication through tools including guidelines, protocols, and communication logs; participation of pharmacists in interdisciplinary teams; collaborative medication review on admission and at discharge; collaborative workshops and conferences; and complexity of role differentiation and environment. Despite encouraging results demonstrated in past research, medication errors continued to occur. Increased focus is needed on developing tailored, individualized strategies that can be applied in particular contexts to create further reductions in medication errors. Greater understandings are also needed about the changing roles of various disciplines.
[Mh] Termos MeSH primário: Comunicação Interdisciplinar
Erros de Medicação/prevenção & controle
Equipe de Assistência ao Paciente/organização & administração
[Mh] Termos MeSH secundário: Comportamento Cooperativo
Hospitais
Seres Humanos
Admissão do Paciente
Alta do Paciente
Farmacêuticos/organização & administração
Guias de Prática Clínica como Assunto
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180215
[Lr] Data última revisão:
180215
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180106
[St] Status:MEDLINE
[do] DOI:10.1080/14740338.2018.1424830



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