Systemic analysis of medication administration omission errors in a tertiary-care hospital in Quebec

2018 ◽  
Vol 49 (2-3) ◽  
pp. 99-107 ◽  
Author(s):  
Thomas G Poder ◽  
Serge Maltais
Keyword(s):  
Failure Modes ◽  
Tertiary Care ◽  
Medication Administration ◽  
Fiscal Year ◽  
Care Hospital ◽  
Contributing Factors ◽  
Systemic Analysis ◽  
Patient Health ◽  
Criticality Analysis ◽  
Omission Errors

Objective: Medication administration omission errors (MAOEs) occur frequently in hospitals and can significantly affect patient health. An interdisciplinary committee was formed in summer 2012 to analyse incident/accident reports (AH-223-1 forms) of MAOEs for the 2011–2012 fiscal year in order to identify contributing factors and to propose preventive solutions. Special attention was paid to events with consequences for patients. Method: An aggregate data analysis involving four major steps was conducted: sampling, categorisation, identification of contributing factors, and seeking preventive solutions. One hundred omissions were randomly selected from the 889 reported for this period. All omissions categorised as having had consequences for patients were then added, making a final total of 145 omissions. The omissions were categorised using an Ishikawa diagram developed from an exploratory literature review and process mapping. Subsequent to failure modes, effects and criticality analysis, cause-and-effect diagrams were constructed with the main prioritised categories to differentiate the proximal causes from the root causes. Brainstorming was used to develop solutions, which were then prioritised with an impact/effort matrix. Results: This study identified 27 categories of MAOEs, of which the 7 most frequent and the most critical accounted for 79.3% of the reports. The event categories, in decreasing order of importance, were related to intravenous (IV) therapy (29.0%), failure in using the medication administration record (MAR; 23.4%), failure in creating/updating the MAR (10.3%), medications on the patient’s bedside (7.6%), and three types of MAOEs related to transcribing prescriptions (9.0%). Conclusion: The interdisciplinary committee formulated 10 main recommendations related to these 7 categories, including 3 for IV therapy and 4 for failure in using or creating/updating the MAR.

scholarly journals Maternal outcomes among emergency obstetric admissions at a tertiary care teaching hospital in Chitradurga, South India

2018 ◽  
Vol 7 (12) ◽  
pp. 4906 ◽  
Author(s):  
Anju Arpana ◽  
Rashmi B. M. ◽  
Latha V.
Keyword(s):  
Rural Areas ◽  
Health Care Services ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Contributing Factors ◽  
Cross Sectional ◽  
Emergency Admissions ◽  
Risk Pregnancy ◽  
Obstetric Emergencies

Background: The maternal mortality is a vital index of the quality and efficiency of obstetric services prevailing in a country. The obstetric emergencies are unexpected occurrences during pregnancy or puerperium requiring immediate attention. Obstetric emergencies can either happen suddenly or they can develop as a result of complications that are not properly identified, monitored or managed. These emergencies, to a large extent, are preventable. The purpose of this study was to understand the contributing factors of obstetric emergencies, their clinical presentation, management and maternal outcomes.Methods: A cross sectional study was conducted among obstetric emergency admissions during October 2016 to September 2017, at a tertiary care hospital in urban area of central Karnataka.Results: A total of 100 emergency admissions were observed in the study period. A 41% of were un-booked antenatal cases. A 13% of patients reached with the longest delay of 10-12 hours duration. A 31% of emergency admissions were in compromised condition. The majority of the cases were delivered by LSCS (55%).Conclusions: In the study, nearly half of the pregnancies were unbooked. There were teenage pregnancies reported in the study. More than half of obstetric emergencies were from rural areas. In nearly 50% of admissions a delay of more than 5 hours in reaching this hospital was noted. Ignorance was a major factor which impeded the access of antenatal health care services. Health education to pregnant women about importance of accessing maternal health services, early ANC booking and regular checkups, identification of high-risk pregnancy and timely referral, availability of fully functional first referral units and transport facilities for these emergency patients. Availability of skilled medical professionals round the clock in these FRU’s are the need of the hour.

scholarly journals A study on internet addiction among medical students in a tertiary care hospital in Bangalore, India

2021 ◽  
Author(s):  
Raj Lavadi ◽  
Mangala Subramanian ◽  
Meghana Panchaseelan ◽  
Lakshmi Chintala ◽  
Lalasa Reddy ◽  
...  
Keyword(s):  
Medical Students ◽  
Internet Addiction ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Internet Usage ◽  
The Internet ◽  
Care Hospital ◽  
Medical Sciences ◽  
Contributing Factors ◽  
Change Communication

Background: Internet usage is prevalent among medical students as they utilize it for both study purposes as well as for entertainment. Widespread usage of the internet may lead to its addiction. The objective of the study was to determine the prevalence of internet addiction and identify its contributing factors among medical students.Methods: 239 second and third year medical students completed the internet addiction test as well as the supplementary questionnaire at Vydehi institute of medical sciences and research center. The assessment of addiction was performed using Dr. Kimberley Young's internet addiction test.Results: It was found that 120 (50.2%) students were mildly addicted and 39 (16.3%) students were moderately addicted and 1 (0.42%) student was severely addicted.Conclusions: 66.9% of medical students had various levels of internet addiction from mild to severe. Therefore, behavior change communication is required to overcome addiction in these students. 

scholarly journals Prevalence of iron deficiency and thalassemia in patients presenting Tertiary Care Hospital.

2020 ◽  
Vol 27 (12) ◽  
pp. 2618-2621
Author(s):  
Nadia Taj ◽  
Saba Javed ◽  
Munazza Munir ◽  
Anam Naz ◽  
Asma Sajid ◽  
...  
Keyword(s):  
Iron Deficiency ◽  
Gestational Age ◽  
Tertiary Care ◽  
Tertiary Hospital ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Contributing Factors ◽  
Cross Sectional ◽  
Iron Deficient ◽  
Tertiary Care Hospitals

Objectives: To find the frequency of iron deficient anemia and thalassemia in anemic patient reporting in tertiary hospital in Multan. Study Design: Cross Sectional study. Setting: Department of Obstetrics and Gynecology in Nishtar Hospital, Multan. Period: 20th October 2018 to 20th April 2019. Material & Method: In this study total 260 females with anemia HB<10.5g/dl were incorporated. Blood of all the patients were collected following the septic measures in CBC vial for counting of hemoglobin and blood investigation serum ferritin [<11ng/ml] and HB electrophoresis HBA [>6]. Gestational age was predicted depending upon last period of menstruation. Results: Age of patients in this study was between 24 to 34 year with the average age of 29.9±2.3 year, average gestational age 33.2±2.11 week, average parity 1.46±1.3. Iron deficient anemia was observed in 88.4 percent patient. Thalassemia was observed in 5.7 percent patient. Conclusion: The results of our study revealed that iron deficiency and thalassemia are significant contributing factors of anemia in patients reporting tertiary care hospitals Multan. General screening for carriers of thalassemia should be provided to all pregnant females attending prenatal care.

EVALUATION OF DRUG-DRUG INTERACTIONS IN HOSPITALISED GERIATRIC PATIENTS AT TERTIARY CARE HOSPITAL

INDIAN DRUGS ◽  
2021 ◽  
Vol 58 (03) ◽  
pp. 62-66
Author(s):  
Jalpa Suthar ◽  
Avni Tandel ◽  
Varsha Patel ◽  
◽  
◽  
...  
Keyword(s):  
Drug Interaction ◽  
Drug Interactions ◽  
Prospective Observational Study ◽  
Geriatric Patients ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
The Elderly ◽  
Care Hospital ◽  
Contributing Factors ◽  
Associated Conditions

A study was planned to evaluate the prevalence, nature, and severity of drug-drug interactions (DDI) in geriatrics. A prospective observational study was carried out in hospitalized patients. DDIs were evaluated using a medscape drug interaction checker. Data of 300 patients were collected who were followed up for 3 days and analyzed over a period of 7 months. The prevalence rate of DDI was 90.3 %, as 271 out of 300 prescriptions showed drug-drug interaction. Out of 300 patients, 4797 possible DDIs were identified, of which 39 (0.81 %) were contraindicated, 290 (6.04 %) serious drug interactions, 3312 (68.85 %) significant interactions and 1156 (24.09 %) minor interactions. Out of 4797 possible DDIs, 2962 (62.91 %) were pharmacodynamics. 1835 (37.08 %) were pharmacokinetic type. Antihypertensive class of drug showed potential for DDIs. Total 244 (81.33 %) cases were found with potentially inappropriate medicines(PIM). The prevalence of DDIs in geriatric patients was 90.3 %. Poly pharmacy and multiple associated conditions in the elderly were the major contributing factors for DDIs.

scholarly journals Study Of Prevalence Of Anxiety And its Contributing Factors Among Patients Undergoing Surgery In a Tertiary Care Hospital

2019 ◽  
Vol 8 (2) ◽  
pp. 59-65
Author(s):  
S. Subedi ◽  
K. Paudel ◽  
M. Koirala ◽  
P. Chhetri
Keyword(s):  
Health Care Providers ◽  
Family Income ◽  
Elective Surgery ◽  
Operative Procedure ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Care Providers ◽  
Contributing Factors ◽  
Cross Sectional

Introduction: Anxiety is a vague, uneasy feeling, the source of which is often non-specific but known to cause abnormal hemodynamic changes as a consequence of sympathetic, parasympathetic and endocrine stimulation. Most patients awaiting elective surgery experience anxiety. The degree, to which patient develops anxiety depends on many factors like age, gender, type and extent of the proposed surgery, previous surgical experience, and personal susceptibility to stressful situations. This study was conducted to find out the prevalence of preoperative anxiety and factors contributing to it. Material and Method: This is a cross-sectional study done among 74 pre-operative patients admitted the day before elective surgery in Department Of Surgery Universal College Of Medical Sciences Teaching Hospital, Bhairahawa. Socio-demographic as well contributing factor questionnaire, semi structured pro forma by interview method and Beck Anxiety Inventory Scale (BAI) Nepali Version were used to collect the data. Results: The findings of the study revealed that 90.54%, had very low level of anxiety and 2.70% of patients had severe pre-operative anxiety. The bivariate logistic regression analysis showed statistically significant association between family income (p= 0.004, AOR=2.03, CI= 0.009-2.567), family support (p< 0.001, AOR= 2.34, CI= 0.003-3.368), expected duration of hospital stay (p= 0.049, AOR=8.889, CI= 78.051-78.051), clarity on given information by health care providers (p< 0.001, AOR= 53.33, CI=7.165-396.99), staffs friendliness (p< 0.001, AOR= 21.01, CI= 3.450-127.82), fear of nil per oral (p= 0.015, AOR= 2.32, CI= 0.26-3.67) and level of pre-operative anxiety. Conclusion: It is concluded that varying degree of pre-operative anxiety were found in patients undergoing surgery. Providing adequate information about Peri-Operative procedure can help in reducing these anxiety.

scholarly journals Comparative Study on Effectiveness and Safety of Atorvastatin with Rosuvastatin in Hyperlipidemic Patients at a Tertiary Care Hospital in Nepal

2020 ◽  
Vol 42 (3) ◽  
pp. 32-37
Author(s):  
Binod Raut ◽  
Nimesh Paudel ◽  
Deepti Shrestha ◽  
Anant Bhosekar
Keyword(s):  
Heart Diseases ◽  
Low Density Lipoprotein ◽  
Tertiary Care ◽  
Density Lipoprotein ◽  
Care Hospital ◽  
Contributing Factors ◽  
Female Ratio ◽  
Group I ◽  
The Mean ◽  
Group Ii

Introduction Hyperlipidemia is one of the most contributing factors to coronary heart diseases. Statins have become standard medicine in clinical practice to reduce total cholesterol, low density lipoprotein and to increase high density lipoprotein cholesterol. This study is conducted to compare the effectiveness and safety of atorvastatin with rosuvastatin in hyperlipidemic patients. MethodsThis is a prospective observational study involving 150 patients conducted in the Department of Internal Medicine of Kathmandu Medical College and Teaching Hospital from July 2019 to March 2020. Patients newly diagnosed with hyperlipidemia were enrolled. Patients that were prescribed with 10 mg of atorvastatin and 5 mg of rosuvastatin by the treating physician once daily for 6 weeks were divided into two groups. Data was recorded in the customized proforma and the SPSS package version 20 was used for analysis. ResultsPatients that were prescribed with atorvastatin were put in group I and those prescribed with rosuvastatin were included in group II with 75 participants in each group. The mean age of the patients were 50.56± 10.08 years in group I and 52.45±10.20 years in group II with male to female ratio of 3:1. The mean BMI of group I was 25.36±1.74 and that of group II was 26.48±2.21 before therapy. There was a significant main effect of duration (F1,74=401.02, p<0.001) on the TG and TC levels (F1,74=1134.23, p<0.001) as well as (F1,74=614.99, p<0.001) on the LDL and HDL levels (F1,74=146.38, p<0.001). ConclusionRosuvastatin was significantly more effective than atorvastatin in reducing levels of TG, TC and LDL-C. Rosuvastatin also significantly increased the level of HDL.

scholarly journals Study of different surgical management approach in lower limb varicose veins at tertiary care hospital

2017 ◽  
Vol 4 (8) ◽  
pp. 2520
Author(s):  
Mohd Shafiuddin ◽  
T. P. Bhavanishankar
Keyword(s):  
Wound Infection ◽  
Lower Limb ◽  
Varicose Veins ◽  
Tertiary Care ◽  
Management Approach ◽  
Care Hospital ◽  
Contributing Factors ◽  
College Hospital ◽  
Male Predominance ◽  
Medical College

Background: The present study was conducted with the aim to evaluate the clinical features and management of varicose veins in terms of recurrence and symptoms improvement.Methods: This clinical study was conducted for a period of two years during January 1990 to February 1992. A total of 21 patients who presented with symptoms of varicose veins in lower extremities to Karnataka Medical College Hospital Hubli were involved in the study. After thorough clinical examination and investigation all the patients are subjected to relevant treatment.Results: Long saphenous system is the most common venous system affected by varicosity in 18 (85.7%) cases. Incompetence of perforator veins was seen in about 20 (95.3%) cases. Trendelenburg’s operation was done in all cases of long saphenous involvement. Sub fascial ligation of perforators was done in 2 patients. Wound infection is the common postoperative complication observed in 5 patients. Preoperative stay in hospital was longer in patients with ulcer (13 days), whereas patients with postoperative wound infection (14 days) had longer postoperative stay.Conclusions: This study showed that the prevalence of lower limb varicose veins has a male predominance and is more common in younger age group. Occupation involving standing for longer periods of time is one of the important contributing factors in the development of varicosities. There is no single method of appropriate treatment for all cases. Multiple ligations of saphenous vein and excision of varicosed tributaries were done in 9 patients. If cases are selected properly with good operative technique the complications are negligible.

scholarly journals Locked in: psychiatric impact on COVID-19 patients isolated in a tertiary care hospital in Lahore, Pakistan

2021 ◽  
Author(s):  
Nazish Imran ◽  
Irum Aamer ◽  
Hadia Afzal ◽  
Ali Hashmi ◽  
Bilquis Shabbir ◽  
...  
Keyword(s):  
Sleep Disturbances ◽  
Acute Stress ◽  
Psychiatric Symptoms ◽  
Tertiary Care ◽  
Adjustment Disorder ◽  
Severity Index ◽  
Care Hospital ◽  
Stress Reactions ◽  
Psychological Consequences ◽  
Patient Health

Background: Adverse psychological effects have been associated with COVID-19-related disease containment measures, but little is known about the psychiatric symptoms and distress. Aim: This study aimed to explore and understand the psychiatric symptoms and distress in suspected or confirmed COVID-19 patients isolated and quarantined in hospital. Methods: A mixed methods study was conducted in the COVID-19 units of Mayo Hospital, Lahore, Pakistan; 114 out of 160 adult patients were assessed by telephone using validated scales (Stress Reactions and Adjustment Disorder Checklist, 9-item Patient Health Questionnaire, 7-item Generalized Anxiety Disorder Scale and Insomnia Severity Index) and a few open-ended questions about expectations and anticipated areas of need during hospitalization, including experiences with isolation. Results: The prevalence of adjustment disorder, acute stress disorder, anxiety, depressive symptoms and insomnia was 67.5%, 3.5%, 16.7%, 18.4%, and 29.8% respectively. One male patient tried to commit suicide during the study period. Fear, anger, low mood, anxiety and sleep disturbances were the most notable psychological consequences in qualitative the responses. Inadequate communication, poor ward facilities, concerns about the health of family members and financial problems were the most commonly identified factors leading to distress. Conclusion: Our results show alarmingly high levels of stress-related symptoms – insomnia, depression and anxiety – among COVID-19 confirmed or suspected hospitalized patients. There is a need to incorporate psychological services in the acute phase of illness for prompt recognition and management of psychiatric problems.

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