Qual Saf Health Care
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Qual Saf Health Care · Aug 2007
Pneumothorax after insertion of central venous catheters in the intensive care unit: association with month of year and week of month.
One of the complications associated with insertion of central venous catheters (CVCs) is pneumothorax (PTX). Because of housestaff inexperience, it was hypothesised that rates of PTX after insertion of CVCs in teaching hospitals would be highest in July and August and in the first week of the month (beginning of intensive care unit (ICU) rotation). ⋯ The rate of PTX after insertion of CVCs is greatest in the last week of the month. If this effect can be verified in other centres, increased supervision of residents at the end of ICU rotations when placing CVCs should be considered. Whether this effect applies to other patient safety outcomes in the ICU also needs further study.
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In clinical practice guidelines, the quality of the available evidence is graded according to its reliability and quality. This study aimed to evaluate the quality of the available research evidence, using the levels of evidence, in the evidence summaries of 64 Finnish national evidence-based Current Care guidelines. ⋯ There is adequate high-quality evidence (level A) to support only a fifth of the main statements of the 64 guidelines. This is most likely an optimistic estimate, since level D evidence often does not have an evidence summary. The guideline development groups find it easier to agree on recommendations based on level A and level B evidence.
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Qual Saf Health Care · Aug 2007
Preventing medication errors in community pharmacy: frequency and seriousness of medication errors.
Medication errors are a widespread problem which can, in the worst case, cause harm to patients. Errors can be corrected if documented and evaluated as a part of quality improvement. The Danish community pharmacies are committed to recording prescription corrections, dispensing errors and dispensing near misses. This study investigated the frequency and seriousness of these errors. ⋯ Prescribing errors were the most frequent type of error reported. Errors that reached the patients were not frequent, but most of them were potentially harmful, and the absolute number of medication errors was high, as provision of medicine is a frequent event in primary care in Denmark. Patient safety could be further improved by optimising the opportunity to learn from the incidents described.
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Qual Saf Health Care · Aug 2007
The impact of a closed-loop electronic prescribing and administration system on prescribing errors, administration errors and staff time: a before-and-after study.
To assess the impact of a closed-loop electronic prescribing, automated dispensing, barcode patient identification and electronic medication administration record (EMAR) system on prescribing and administration errors, confirmation of patient identity before administration, and staff time. ⋯ A closed-loop electronic prescribing, dispensing and barcode patient identification system reduced prescribing errors and MAEs, and increased confirmation of patient identity before administration. Time spent on medication-related tasks increased.
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Qual Saf Health Care · Aug 2007
Mature rapid response system and potentially avoidable cardiopulmonary arrests in hospital.
To study the incidence, outcome and potentially avoidable causes of inpatient cardiopulmonary arrests in a hospital with a "mature" rapid response system (RRS). ⋯ In spite of the high crisis event rate and a low rate of cardiac arrests, potentially avoidable cardiopulmonary arrests still occurred. According to the present study more cardiopulmonary arrest events might be avoided by better adherence to hospital patient care policies, by closer monitoring on floors and by preventing delays in addressing deterioration in patient condition.