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Referências encontradas : 605 [refinar]
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[PMID]:28067700
[Au] Autor:Meyer MJ; Dzik WH; Levine WC
[Ad] Endereço:From the Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, Massachusetts.
[Ti] Título:Fresh-Frozen Plasma: Ordering Patterns and Utilization in the Operating Rooms of a Tertiary Referral Hospital.
[So] Source:Anesth Analg;124(2):618-622, 2017 Feb.
[Is] ISSN:1526-7598
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Blood product transfusion is the most commonly performed hospital procedure. Intraoperative blood product utilization varies between institutions and anesthesiologists. In the United States in 2011, nearly 4 million plasma units were transfused. METHODS: A retrospective analysis of intraoperative plasma ordering patterns and utilization (thawing and transfusing) was performed at a tertiary, academic hospital between January 2015 and March 2016. RESULTS: Over 15 months, 46,002 operative procedures were performed. In 1540 of them, plasma was thawed or transfused: 8297 plasma units were thawed and 3306 of those units were transfused. These 3306 plasma units were transfused in 749 cases with a median of 2 plasma units (interquartile range, 2-4) transfused. The percentage of average monthly procedures with plasma thawed and none transfused was 51.3% (confidence interval, 49.0%-53.6%). The cardiac surgery service requested the greatest number of plasma units to be thawed (2143) but only transfused 712 (33.2%) of them. Of all plasma units not transfused, 45% were generated by procedures with 1 to 4 units of plasma thawed; 95.7% of these units were thawed as even integers (ie, 2, 4). CONCLUSIONS: For operative procedures, far more plasma was thawed than was transfused and this practice occurred across surgical specialties and anesthesiologists. Considering the plasma that was not transfused, 45% occurred in procedures with 4 or fewer units of plasma requested suggesting these low-volume requests were a primary source of potential waste. Further studies are needed to examine associations between plasma utilization and clinical outcomes.
[Mh] Termos MeSH primário: Sistemas de Distribuição no Hospital/organização & administração
Salas Cirúrgicas/organização & administração
Plasma
Centros de Atenção Terciária/organização & administração
[Mh] Termos MeSH secundário: Transfusão de Sangue/métodos
Seres Humanos
Resíduos de Serviços de Saúde
Estudos Retrospectivos
Cirurgia Torácica/estatística & dados numéricos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Medical Waste)
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170719
[Lr] Data última revisão:
170719
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170110
[St] Status:MEDLINE
[do] DOI:10.1213/ANE.0000000000001789


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[PMID]:27079320
[Au] Autor:Nizzi F
[Ad] Endereço:Blood Systems, Scottsdale, Arizona.
[Ti] Título:Redefining the role of blood establishments as raw material suppliers, manufacturers, and distributors for new cell therapies: the Blood Systems experience.
[So] Source:Transfusion;56(4):29S-31S, 2016 Apr.
[Is] ISSN:1537-2995
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Bancos de Sangue/organização & administração
Bancos de Sangue/tendências
Terapia Baseada em Transplante de Células e Tecidos
Sistemas de Distribuição no Hospital
Papel Profissional
Engenharia Tecidual
Coleta de Tecidos e Órgãos
[Mh] Termos MeSH secundário: Bancos de Sangue/economia
Terapia Baseada em Transplante de Células e Tecidos/economia
Terapia Baseada em Transplante de Células e Tecidos/métodos
Terapia Baseada em Transplante de Células e Tecidos/normas
Terapia Baseada em Transplante de Células e Tecidos/tendências
Competência Clínica/normas
Comércio/organização & administração
Setor de Assistência à Saúde/economia
Setor de Assistência à Saúde/organização & administração
Setor de Assistência à Saúde/normas
Sistemas de Distribuição no Hospital/economia
Sistemas de Distribuição no Hospital/organização & administração
Sistemas de Distribuição no Hospital/normas
Seres Humanos
Indústria Manufatureira/economia
Indústria Manufatureira/organização & administração
Indústria Manufatureira/normas
Determinação de Necessidades de Cuidados de Saúde/organização & administração
Engenharia Tecidual/economia
Engenharia Tecidual/métodos
Engenharia Tecidual/normas
Coleta de Tecidos e Órgãos/economia
Coleta de Tecidos e Órgãos/métodos
Coleta de Tecidos e Órgãos/normas
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1608
[Cu] Atualização por classe:160415
[Lr] Data última revisão:
160415
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160416
[St] Status:MEDLINE
[do] DOI:10.1111/trf.13568


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[PMID]:26546939
[Au] Autor:Tuan F; Perone V; Verdini R; Pell MB; Traverso ML
[Ad] Endereço:Laboratorio LATIV, SA. Presidente Roca 1902, (2000) Rosario. Argentina. aseg.calidad@lativsa.com.ar.
[Ti] Título:[Validation of cold chain during distribution of parenteral nutrition].
[Ti] Título:Validación de la conservación de la cadena de frío durante la distribución de mezclas de nutrición parenteral..
[So] Source:Farm Hosp;39(5):269-74, 2015 Sep 01.
[Is] ISSN:0214-753X
[Cp] País de publicação:Spain
[La] Idioma:spa
[Ab] Resumo:OBJECTIVE: this study aims to demonstrate the suitability of the process used to condition the extemporaneous mixtures of parenteral nutrition for distribution, considering the objective of preserving the cold chain during transport until it reaches the patient, necessary to ensure stability, effectiveness and safety of these mixtures. METHOD: concurrent validation, design and implementation of a protocol for evaluating the process of packaging and distribution of MNPE developed by a pharmaceutical laboratory. Running tests, according to predefined acceptance criteria. It is performed twice, in summer and on routes that require longer transfer time. Evaluation of conservation of temperature by monitoring the internal temperature values of each type of packaging, recorded by data loggers calibrated equipment. RESULTS: the different tests meet the established criteria. The collected data ensure the maintenance of the cold chain for longer than the transfer time to the most distant points. CONCLUSIONS: this study establishes the suitability of the processes to maintaining the cold chain for transfer from the laboratory to the patient pharmacist. Whereas the breaking of cold chain can cause changes of compatibility and stability of parenteral nutrition and failures nutritional support, this study contributes to patient safety, one of the relevant dimensions of quality of care the health.
[Mh] Termos MeSH primário: Soluções de Nutrição Parenteral/normas
Nutrição Parenteral/normas
Refrigeração/normas
[Mh] Termos MeSH secundário: Embalagem de Medicamentos
Estabilidade de Medicamentos
Sistemas de Distribuição no Hospital
Seres Humanos
Segurança do Paciente
Farmacêuticos
[Pt] Tipo de publicação:JOURNAL ARTICLE; VALIDATION STUDIES
[Nm] Nome de substância:
0 (Parenteral Nutrition Solutions)
[Em] Mês de entrada:1701
[Cu] Atualização por classe:170119
[Lr] Data última revisão:
170119
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:151108
[St] Status:MEDLINE
[do] DOI:10.7399/fh.2015.39.5.8869


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[PMID]:26451162
[Au] Autor:Liao HC; Chen YK; Wang YH
[Ad] Endereço:Department of Health Services Administration, Chung Shan Medical University, No. 110, Sec. 1, Jian-Koa N. Road, Taichung 402, Taiwan ; Department of Medical Education, Chung Shan Medical University Hospital, No. 110, Sec. 1, Jian-Koa N. Road, Taichung 402, Taiwan.
[Ti] Título:The Study of an Optimal Robust Design and Adjustable Ordering Strategies in the HSCM.
[So] Source:Comput Math Methods Med;2015:517245, 2015.
[Is] ISSN:1748-6718
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The purpose of this study was to establish a hospital supply chain management (HSCM) model in which three kinds of drugs in the same class and with the same indications were used in creating an optimal robust design and adjustable ordering strategies to deal with a drug shortage. The main assumption was that although each doctor has his/her own prescription pattern, when there is a shortage of a particular drug, the doctor may choose a similar drug with the same indications as a replacement. Four steps were used to construct and analyze the HSCM model. The computation technology used included a simulation, a neural network (NN), and a genetic algorithm (GA). The mathematical methods of the simulation and the NN were used to construct a relationship between the factor levels and performance, while the GA was used to obtain the optimal combination of factor levels from the NN. A sensitivity analysis was also used to assess the change in the optimal factor levels. Adjustable ordering strategies were also developed to prevent drug shortages.
[Mh] Termos MeSH primário: Sistemas de Distribuição no Hospital/estatística & dados numéricos
Administração de Materiais no Hospital/estatística & dados numéricos
Preparações Farmacêuticas/provisão & distribuição
[Mh] Termos MeSH secundário: Algoritmos
Simulação por Computador
Equipamentos e Provisões Hospitalares/estatística & dados numéricos
Seres Humanos
Modelos Estatísticos
Serviço de Farmácia Hospitalar/organização & administração
Serviço de Farmácia Hospitalar/estatística & dados numéricos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Pharmaceutical Preparations)
[Em] Mês de entrada:1606
[Cu] Atualização por classe:170220
[Lr] Data última revisão:
170220
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:151010
[St] Status:MEDLINE
[do] DOI:10.1155/2015/517245


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[PMID]:26102048
[Au] Autor:Morchel H; Ogedegbe C; Desai N; Faley B; Mahmood N; Moro GD; Feldman J
[Ad] Endereço:Attending Physician, Research Physician, Director of Emergency Medicine Residency Simulation Laboratory, Mobile Satellite Emergency Department Technical Consultant, Emergency Trauma Department, Hackensack University Medical Center, Hackensack, New Jersey.
[Ti] Título:Use of an automated drug distribution cabinet system in a disaster response mobile emergency department.
[So] Source:Am J Disaster Med;10(1):75-8, 2015.
[Is] ISSN:1932-149X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: This article describes the innovative use of an automated drug distribution cabinet system for medication supply in a disaster response mobile Emergency Department vehicle. Prior to the use of the automated drug distribution cabinet system described in this article, the mobile hospitals were stocked as needed with drugs in individual boxes and draws. Experience with multiple deployments found this method to be very cumbersome and labor intensive, both in preparation, operational use, and demobilization. SETTING: For a recent deployment to provide emergency medical care at the 2014 Super Bowl football event, the automated drug distribution cabinet system in the Institution's main campus Emergency Department was duplicated and incorporated into the mobile Emergency Department. RESULTS: This method of drug stocking and dispensing was found to be far more efficient than gathering and placing drugs in onboard draws and racks. CONCLUSIONS: Automated drug distribution cabinet systems can be used to significantly improve patient care and overall efficiency in mobile hospital deployments.
[Mh] Termos MeSH primário: Serviços Médicos de Emergência/organização & administração
Sistemas de Distribuição no Hospital/organização & administração
Unidades Móveis de Saúde/organização & administração
Serviço de Farmácia Hospitalar/organização & administração
[Mh] Termos MeSH secundário: Desastres
Seres Humanos
New Jersey
Desenvolvimento de Programas
Esportes
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1508
[Cu] Atualização por classe:150624
[Lr] Data última revisão:
150624
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:150624
[St] Status:MEDLINE


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[PMID]:25664611
[Au] Autor:Cohen D; Manuel DG; Tugwell P; Sanmartin C; Ramsay T
[Ad] Endereço:Department of Population Health, University of Ottawa, Institute for Clinical Evaluative Sciences, 35 Soho Crescent, Ottawa, ON, Canada, K1N6N5.
[Ti] Título:Does Higher Spending Improve Survival Outcomes for Myocardial Infarction? Examining the Cost-Outcomes Relationship Using Time-Varying Covariates.
[So] Source:Health Serv Res;50(5):1589-605, 2015 Oct.
[Is] ISSN:1475-6773
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: Previous patient-level acute myocardial infarction (AMI) research has found higher hospital spending to be associated with improved survival; however, survivor-treatment selection bias traditionally has been overlooked. The purpose of this study was to examine the AMI cost-outcome relationship, taking into account this form of bias. DATA SOURCES: Hospital Discharge Abstract data tracked costs for AMI hospitalizations. Ontario Vital Statistics data tracked patient mortality. STUDY DESIGN: A standard Cox survival model was compared to an extended Cox model using hospital costs as a time-varying covariate to examine the impact of cost on 1-year survival in a cohort of 30,939 first-time AMI patients in Ontario, Canada, from 2007 to 2010. PRINCIPAL FINDINGS: Higher patient-level AMI spending decreased the hazard of dying (Standard Model: log-cost hazard ratio: 0.513, 95 percent CI: 0.479-0.549; Extended Model: log-cost hazard ratio: 0.700, 95 percent CI: 0.645-0.758); however, the protective effect was overestimated by 62 percent when survivor-treatment bias was overlooked. In the extended model, a 10 percent increase in spending was associated with a 3.6 percent decrease in hazard of death. CONCLUSION: The findings of this study suggest that if survivor-treatment bias is overlooked, future research may materially overstate the protective effect of patient-level spending on outcomes.
[Mh] Termos MeSH primário: Economia Hospitalar/estatística & dados numéricos
Infarto do Miocárdio/mortalidade
Avaliação de Resultados (Cuidados de Saúde)/estatística & dados numéricos
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Custos e Análise de Custo
Feminino
Sistemas de Distribuição no Hospital
Seres Humanos
Tempo de Internação/estatística & dados numéricos
Masculino
Meia-Idade
Ontário
Readmissão do Paciente/estatística & dados numéricos
Modelos de Riscos Proporcionais
Fatores Socioeconômicos
Fatores de Tempo
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T; REVIEW
[Em] Mês de entrada:1601
[Cu] Atualização por classe:161019
[Lr] Data última revisão:
161019
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:150210
[St] Status:MEDLINE
[do] DOI:10.1111/1475-6773.12286


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[PMID]:25481933
[Au] Autor:Angelino E
[Ti] Título:[Effective implementation of change into routine work. Thinking over ways and means of a learning experience in cardiology].
[Ti] Título:Introdurre I'innovazione nella quotidianità. Riflessioni sul metodo e sugli strumenti utilizzati in una esperienza formativa in cardiologia..
[So] Source:Monaldi Arch Chest Dis;82(1):5-9, 2014 Mar.
[Is] ISSN:1122-0643
[Cp] País de publicação:Italy
[La] Idioma:ita
[Ab] Resumo:Effective implementation of change in patients' care is a substantive problem. Organizational learning is viewed as process of seeking, selecting, and adapting new "routines" to improve performance but learning from experience is not automatic, but rather may result from action and reflection within the organization.
[Mh] Termos MeSH primário: Cardiologia
Competência Clínica
Aprendizagem
[Mh] Termos MeSH secundário: Lista de Checagem
Sistemas de Distribuição no Hospital
Seres Humanos
[Pt] Tipo de publicação:ENGLISH ABSTRACT; JOURNAL ARTICLE
[Em] Mês de entrada:1501
[Cu] Atualização por classe:161020
[Lr] Data última revisão:
161020
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:141209
[St] Status:MEDLINE


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[PMID]:25033448
[Au] Autor:Baron JL; Vikram A; Duda S; Stout JE; Bibby K
[Ad] Endereço:Department of Infectious Diseases and Microbiology, University of Pittsburgh, Graduate School of Public Health, Pittsburgh, Pennsylvania, United States of America; Special Pathogens Laboratory, Pittsburgh, Pennsylvania, United States of America.
[Ti] Título:Shift in the microbial ecology of a hospital hot water system following the introduction of an on-site monochloramine disinfection system.
[So] Source:PLoS One;9(7):e102679, 2014.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Drinking water distribution systems, including premise plumbing, contain a diverse microbiological community that may include opportunistic pathogens. On-site supplemental disinfection systems have been proposed as a control method for opportunistic pathogens in premise plumbing. The majority of on-site disinfection systems to date have been installed in hospitals due to the high concentration of opportunistic pathogen susceptible occupants. The installation of on-site supplemental disinfection systems in hospitals allows for evaluation of the impact of on-site disinfection systems on drinking water system microbial ecology prior to widespread application. This study evaluated the impact of supplemental monochloramine on the microbial ecology of a hospital's hot water system. Samples were taken three months and immediately prior to monochloramine treatment and monthly for the first six months of treatment, and all samples were subjected to high throughput Illumina 16S rRNA region sequencing. The microbial community composition of monochloramine treated samples was dramatically different than the baseline months. There was an immediate shift towards decreased relative abundance of Betaproteobacteria, and increased relative abundance of Firmicutes, Alphaproteobacteria, Gammaproteobacteria, Cyanobacteria and Actinobacteria. Following treatment, microbial populations grouped by sampling location rather than sampling time. Over the course of treatment the relative abundance of certain genera containing opportunistic pathogens and genera containing denitrifying bacteria increased. The results demonstrate the driving influence of supplemental disinfection on premise plumbing microbial ecology and suggest the value of further investigation into the overall effects of premise plumbing disinfection strategies on microbial ecology and not solely specific target microorganisms.
[Mh] Termos MeSH primário: Cloraminas/farmacologia
Desinfecção/métodos
Água Potável/microbiologia
Sistemas de Distribuição no Hospital
Purificação da Água/métodos
[Mh] Termos MeSH secundário: Actinobacteria/genética
Actinobacteria/crescimento & desenvolvimento
Sequência de Bases
Biofilmes/efeitos dos fármacos
Biofilmes/crescimento & desenvolvimento
Cianobactérias/genética
Cianobactérias/crescimento & desenvolvimento
DNA Bacteriano/genética
Desinfetantes/farmacologia
Proteobactérias/genética
Proteobactérias/crescimento & desenvolvimento
RNA Ribossômico 16S/genética
Engenharia Sanitária
Análise de Sequência de DNA
Centros de Atenção Terciária
Microbiologia da Água
Qualidade da Água
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Chloramines); 0 (DNA, Bacterial); 0 (Disinfectants); 0 (Drinking Water); 0 (RNA, Ribosomal, 16S); KW8K411A1P (chloramine)
[Em] Mês de entrada:1512
[Cu] Atualização por classe:170220
[Lr] Data última revisão:
170220
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:140718
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0102679


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[PMID]:24435595
[Au] Autor:Coghlin DT; Leyenaar JK; Shen M; Bergert L; Engel R; Hershey D; Mallory L; Rassbach C; Woehrlen T; Cooperberg D
[Ad] Endereço:The Warren Alpert Medical School of Brown University, Hasbro Children's Hospital, Providence, Rhode Island;
[Ti] Título:Pediatric discharge content: a multisite assessment of physician preferences and experiences.
[So] Source:Hosp Pediatr;4(1):9-15, 2014 Jan.
[Is] ISSN:2154-1663
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND AND OBJECTIVES: Professional medical societies endorse prompt, consistent discharge communication to primary care providers (PCPs) on discharge. However, evidence is limited about what clinical elements to communicate. Our main goal was to identify and compare the clinical elements considered by PCPs and pediatric hospitalists to be essential to communicate to PCPs within 2 days of pediatric hospital discharge. A secondary goal was to describe experiences of the PCPs and pediatric hospitalists regarding sending and receiving discharge information. METHODS: A survey of physician preferences and experiences regarding discharge communication was sent to 320 PCPs who refer patients to 16 hospitals, with an analogous survey sent to 147 hospitalists. Descriptive statistics were calculated, and χ² analyses were performed. RESULTS: A total of 201 PCPs (63%) and 71 hospitalists (48%) responded to the survey. Seven clinical elements were reported as essential by >75% of both PCPs and hospitalists: dates of admission and discharge; discharge diagnoses; brief hospital course; discharge medications; immunizations given during hospitalization; pending laboratory or test results; and follow-up appointments. PCPs reported reliably receiving discharge communication significantly less often than hospitalists reported sending it (71.8% vs 85.1%; P < .01), and PCPs considered this communication to be complete significantly less often than hospitalists did (64.9% vs 79.1%; P < .01). CONCLUSIONS: We identified 7 core clinical elements that PCPs and hospitalists consider essential in discharge communication. Consistently and promptly communicating at least these core elements after discharge may enhance PCP satisfaction and patient-level outcomes. Reported rates of transmission and receipt of this information were suboptimal and should be targeted for improvement.
[Mh] Termos MeSH primário: Atitude do Pessoal de Saúde
Sistemas de Distribuição no Hospital/organização & administração
Médicos de Atenção Primária
[Mh] Termos MeSH secundário: Estudos Transversais
Médicos Hospitalares
Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, N.I.H., EXTRAMURAL
[Em] Mês de entrada:1411
[Cu] Atualização por classe:161025
[Lr] Data última revisão:
161025
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:140118
[St] Status:MEDLINE
[do] DOI:10.1542/hpeds.2013-0022


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[PMID]:24409805
[Au] Autor:Zhang L; Qian J; Hu L; Chen Y
[Ad] Endereço:Equipment Department of Huashan Hospital Affiliated to Fudan University. liweijia19850315@163.com
[Ti] Título:[Quality improvement and performance evaluation of Monitoring and Tracking Medical Materials Lot Number].
[So] Source:Zhongguo Yi Liao Qi Xie Za Zhi;37(5):386-8, 2013 Sep.
[Is] ISSN:1671-7104
[Cp] País de publicação:China
[La] Idioma:chi
[Ab] Resumo:With various increasing health sector's demand of medical materials, monitoring and tracking medical materials lot number has become the most important thing of hospital's medical materials management. This paper discussed and researched deeply the actual operation problem through data analysis and charts comparison, put forward realizing barcodes wireless scanning, and synchronizing information in local area network, so to improve the barcode input accuracy. Achieve the ultimate goal of completing medical materials lot number traceability.
[Mh] Termos MeSH primário: Sistemas de Distribuição no Hospital/organização & administração
Administração de Materiais no Hospital
[Mh] Termos MeSH secundário: Controle de Qualidade
[Pt] Tipo de publicação:ENGLISH ABSTRACT; JOURNAL ARTICLE
[Em] Mês de entrada:1409
[Cu] Atualização por classe:140113
[Lr] Data última revisão:
140113
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:140114
[St] Status:MEDLINE



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