scholarly journals Implementation and outcome of an electronic tool for detection of paracetamol overdose in a tertiary care hospital

2020 ◽  
Author(s):  
Francisco Cabrera-Diaz ◽  
Claudia Zaugg ◽  
Silke Lim ◽  
Kim Blum ◽  
Ali Reza Salili
Keyword(s):  
Information System ◽  
Medication Error ◽  
Clinical Information System ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Clinical Information ◽  
Paracetamol Overdose ◽  
Care Hospital ◽  
Electronic Tool ◽  
Process Failures

Abstract Background Paracetamol is a widely used analgesic and antipyretic drug in hospitals. The development and implementation of an electronic tool with algorithm-based alerts (e-agent) in a clinical information system could reduce the risk of overdose. Objective In this study, the performance of such an e-agent developed to detect paracetamol overdosing was analyzed. Setting Swiss tertiary care hospital. Method All patients ≥ 18 years old who had documented paracetamol administration in the used clinical information system during 2017 were retrospectively screened for an absolute and relative overdosing of paracetamol (> 4 g and > 60 mg/kg/24 h, respectively). This was compared with the patients for which the e-agent had, during the same period, prospectively made an alert for absolute or relative overdosing or for a dosing interval < 4 h (potentially leading to an absolute overdose). Main outcome measure E-agent performance defined as detection rate. Results of the 13,196 adult patients who received at least one dose of paracetamol, 2292 were exposed at least once to > 4 g/day (17.4%), 39 of these (0.3% of total) were given > 5 g paracetamol. None received more than 6 g. The e-agent detected 87.2% of cases with doses > 5 g. In most cases (87.9%), the cause of the absolute overdose was a switch from intravenous to oral paracetamol, resulting in an absolute overdose the day of the change. The maximal daily dose of 60 mg/kg was exceeded in 30.1% of patients weighing < 50 kg, as well as in 42.3% of patients weighing < 60 kg. The e-agent detected 73.4% and 75.5% of those cases. Multiple absolute overdoses were found in 204 patients. The e-agent detected 72.7% of those. 90 multiple overdoses occurred during the same hospital stay and 11 on consecutive days. Conclusion Paracetamol overdose is a common medication error in hospitalized patients, which may occur due to process failures such as wrong timing when changing administration route or when factors like comedication and low body weight are ignored. The e-agent detects cases of paracetamol overdose, and therefore, can help prevent this kind of medication error in the clinical setting.

scholarly journals Antibiotic-Related Adverse Drug Reactions at a Tertiary Care Hospital in South Korea

2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
In Young Jung ◽  
Jung Ju Kim ◽  
Se Ju Lee ◽  
Jinnam Kim ◽  
Hye Seong ◽  
...  
Keyword(s):  
South Korea ◽  
Adverse Drug Reactions ◽  
Antimicrobial Agents ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Clinical Information ◽  
World Health ◽  
Care Hospital ◽  
Drug Reactions ◽  
Skin Manifestations

Background. Adverse drug reactions (ADRs) are any unwanted/uncomfortable effects from medication resulting in physical, mental, and functional injuries. Antibiotics account for up to 40.9% of ADRs and are associated with several serious outcomes. However, few reports on ADRs have evaluated only antimicrobial agents. In this study, we investigated antibiotic-related ADRs at a tertiary care hospital in South Korea.Methods. This is a retrospective cohort study that evaluated ADRs to antibiotics that were reported at a 2400-bed tertiary care hospital in 2015. ADRs reported by physicians, pharmacists, and nurses were reviewed. Clinical information reported ADRs, type of antibiotic, causality assessment, and complications were evaluated.Results. 1,277 (62.8%) patients were considered antibiotic-related ADRs based on the World Health Organization-Uppsala Monitoring Center criteria (certain, 2.2%; probable, 35.7%; and possible, 62.1%). Totally, 44 (3.4%) patients experienced serious ADRs. Penicillin and quinolones were the most common drugs reported to induce ADRs (both 16.0%), followed by third-generation cephalosporins (14.9%). The most frequently experienced side effects were skin manifestations (45.1%) followed by gastrointestinal disorders (32.6%).Conclusion. Penicillin and quinolones are the most common causative antibiotics for ADRs and skin manifestations were the most frequently experienced symptom.

scholarly journals An analysis of occupation related mental health referrals of paramillitary forces to a tertiary care hospital

2017 ◽  
Vol 4 (4) ◽  
pp. 1131
Author(s):  
Sarada Prasanna Swain ◽  
Manoj Kumar Dash ◽  
Jigyansha Ipsita Pattnaik ◽  
Neelamadhab Rath
Keyword(s):  
Mental Health ◽  
Mental Health Professionals ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Psychiatric Morbidity ◽  
Clinical Information ◽  
Care Hospital ◽  
Health Burden ◽  
Security Personnel ◽  
Army Personnel

Background: The security personnel of our country including Army Personnel, C.I.S.F., Police and other security personnel bear a large amount of physical and psychological stress to maintain law and order situations at different corners of the country at different situations. To assess the Psychiatric Morbidity in C.I.S.F., the course of referrals of Para-military persons to a tertiary care hospital and to evaluate the Mental Health burden in the Para-military set up by virtue of their occupation. Methods: The study sample included all the consecutive patients referred by CISF Headquarters Hospital to the Mental Health Institute (MHI), S.C.B. Medical College, Cuttack, Odisha, from April 2015 to March 2016. The clinical information is collected from the patient and accompanying personnel from CISF or family members who accompanied the patient. The diagnosis is based on ICD-10 and the final opinion is given by the consultants of Psychiatry after final evaluation of all the reports. Results: Psychiatric assessment for job fitness (48%) was the dominant cause for referral of PMF staff to MHI. Substance abuse (alcohol) related disorders were the next common cause of referral (20%).Conclusions: Mental health burden in Para-military bases are substantial which should be taken care of in urgency basis. There is urgent need of posting of Psychiatrists with Clinical Psychologists and Psychiatric Social Worker or a team of the Mental Health Professionals should visit the paramilitary set ups regularly to look into improper diagnosis and review cases. 

scholarly journals Monitoring and Evaluation of Medication Error in a Tertiary Care Hospital

2020 ◽  
Vol 02 (02) ◽  
pp. 16-20
Author(s):  
Yadhukrishnan P U ◽  
Nolin Johncy ◽  
Shilpa R ◽  
Naveen Kumar P ◽  
Mohamed Thayub S ◽  
...  
Keyword(s):  
Medication Error ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Monitoring And Evaluation ◽  
Care Hospital

scholarly journals Efflux pump expression in MDR Acinetobacter baumannii strains from a tertiary care hospital in Lima, Peru

2020 ◽  
Author(s):  
Stefany Plasencia-Rebata ◽  
Saul Levy-Blitchtein ◽  
Isaac Peña-Tuesta ◽  
Miguel Angel Aguilar-Luis ◽  
William Vicente Taboada ◽  
...  
Keyword(s):  
Acinetobacter Baumannii ◽  
Efflux Pump ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Clinical Information ◽  
Care Hospital ◽  
Efflux System ◽  
Efflux Pump Inhibitor ◽  
Active Efflux ◽  
Different Sources

Abstract Objetive: To analyze the contribution of the active efflux system to quinolones and aminoglycosides resistance in selected outbreak A. baumannii clinical isolates using the efflux pump inhibitor PAβN.Results: A total of nineteen Acinetobacter baumannii strains were included in the study. All were positive for the blaOXA-51 gene by PCR and had clinical information associated. The samples were non-duplicate and collected from different sources. Non-susceptibility rates were as following: tobramycin 31.6% (6), ciprofloxacin 31.6% (6), levofloxacin 21.1% (4), nalidixic acid 26.3% (5) and amikacin 15.8% (3). A total of eight strains (42,1%) demonstrated an increase in the susceptibility rates and sixteen (84,2%) expressed efflux pumps.

scholarly journals A Study on the Utilization of Hospital Information System (Ward and Physician) Modules in a Tertiary Care Hospital

2016 ◽  
Vol 4 (2) ◽  
pp. 51-60
Author(s):  
AP Pandit ◽  
Meenal Kulkarni ◽  
Tanima Debmallik,
Keyword(s):  
Information System ◽  
Hospital Information System ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Discharge Summary ◽  
Handheld Devices ◽  
Work Culture ◽  
Care Hospital ◽  
Pareto Analysis ◽  
Hospital Operations

ABSTRACT Introduction Hospital information system (HIS) is a key managerial tool for any hospital administrator. It gives him all requisite information online, wherever he is and whatever he is doing, so that he can apply timely interventions and set the things right and thereby take care of patient safety, quality improvement, and also minimize litigation problems in the hospitals. After the initial introduction of HIS into the organization, the key findings were that the entire hospital operations are HIS driven. From the registration and admission of the patient, to the discharge summary generation of an inpatient, the entire process is guided by the HIS. It was found that the HIS is billing-centric, i.e., the HIS use pathway begins only when the registration fee is billed and the unique health identification number (UHID) of a patient is generated. The main HIS modules under study are the Ward module and the Physician module. After conducting a utilization study using a structured questionnaire, it is found that the level of utilization of the Ward module is 36.4% and that of the Physician module is 6.66%. Using a Fishbone analysis, the causes of reduced HIS utilization have been identified and using a Pareto analysis the main causes have been found to be Work culture and Lack of mobile handheld devices. Various recommendations have been made to increase the HIS usage. How to cite this article Pandit AP, Debmallik T, Kulkarni M. A Study on the Utilization of Hospital Information System (Ward and Physician) Modules in a Tertiary Care Hospital. Int J Res Foundation Hosp Healthc Adm 2016;4(2):51-60.

scholarly journals Medication Reconciliation and Medication Error Prevention in an Emergency Department of a Tertiary Care Hospital

2015 ◽  
Vol 7 (3) ◽  
pp. 241-249 ◽  
Author(s):  
Penumarthi Poornima ◽  
Pasala Reshma ◽  
Ramakrishnan TV ◽  
Nagasubramanian Vanitha Rani ◽  
Shree Devi G ◽  
...  
Keyword(s):  
Emergency Department ◽  
Medication Error ◽  
Medication Reconciliation ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Error Prevention ◽  
Medication Error Prevention
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