scholarly journals An Effective Tool to Enhance a Culture of Patient Safety and Assess the Risks of Medication Use Systems

2005 ◽  
Vol 8 (sp) ◽  
pp. 53-58 ◽  
Author(s):  
Julie Greenall ◽  
David U ◽  
Robert Lam
Keyword(s):  
Patient Safety ◽  
Medication Use

Abstract 17166: Comparison Between Use of Vasoactive Medications in Patients Undergoing PVC and VT Ablation

Circulation ◽  
2018 ◽  
Vol 138 (Suppl_1) ◽  
Author(s):  
Amneet Sandhu ◽  
Jeffrey Graham ◽  
Alexis Tumolo ◽  
Blake Fleeman ◽  
Nicholas Mantini ◽  
...  
Keyword(s):  
Patient Safety ◽  
Medication Use ◽  
Structural Heart Disease ◽  
Lv Function ◽  
Vasoactive Medication ◽  
Case Type ◽  
Vt Ablation ◽  
The Impact ◽  
Vasoactive Medications ◽  
Continuous Drip

Background: Societal guidelines have set prerequisites regarding procedures conducted in the EP lab. Despite metrics for management of EP cases, no clear guidelines exist for use of hemodynamic drugs to support complex ablations, particularly in setting of structural heart disease. Objectives: We sought to understand the variety and range of vasoactive medication use in patients undergoing PVC/VT ablation. Methods: Patients undergoing PVC or VT ablation, from January 2015 to December 2016, at our institution were analyzed. Demographics, echocardiography, and procedural details, including vasoactive medication use, were analyzed. Results: Sequential patients undergoing PVC or VT ablation (70 in each arm) were studied. Those undergoing PVC ablation (56 +/- 14 years, 30% female) had an average EF of 58% in comparison to 44% (p<0.01 for EF difference) in VT ablation patients (60 +/- 13 years, 20% female); more VT patients (62%) were under general anesthesia. Pressors were administered in 86% of cases with the significant majority (63%) consisting of alpha-agonists (phenylephrine, ephedrine, epinephrine). Importantly, 48% of cases required continuous drip initiation (Figure). Regardless of case type or abnormal EF, drip initiation with or administration of multiple bolus doses of alpha-agonists was much more frequent compared to inotropes (Figure). In a subset of patients with EF ≤ 35%, 96% received vasoactive medications with 73% receiving a continuous drip or multiple bolus doses of phenylephrine. Conclusions: Vasoactive medication use during ventricular EP cases is common. Regardless of baseline EF, a propensity for use of alpha-agonists exists that may affect the treatment of patients with abnormal LV function. More studies are needed to assess the impact of pressor use on patient safety and procedural endpoints in the EP lab. Figure:

Safe Medication Use for Guaranteeing Patient Safety

Yakhak Hoeji ◽  
2020 ◽  
Vol 64 (3) ◽  
pp. 185-190
Author(s):  
Ju-Young Shin ◽  
Yunha Noh ◽  
Byung-Joo Park
Keyword(s):  
Patient Safety ◽  
Medication Use ◽  
Safe Medication

Does applying technology throughout the medication use process improve patient safety with antineoplastics?

2013 ◽  
Vol 20 (6) ◽  
pp. 445-460 ◽  
Author(s):  
Joseph Bubalo ◽  
Bruce A Warden ◽  
Joshua J Wiegel ◽  
Tess Nishida ◽  
Evelyn Handel ◽  
...  
Keyword(s):  
Patient Safety ◽  
Improve Patient Safety ◽  
Medication Use ◽  
Improve Patient

scholarly journals Population-scale patient safety data reveal inequalities in adverse events before and during COVID-19 pandemic

2021 ◽  
Author(s):  
Xiang Zhang ◽  
Marissa Sumathipala ◽  
Marinka Zitnik
Keyword(s):  
Public Health ◽  
Patient Safety ◽  
Adverse Events ◽  
Drug Safety ◽  
Gender Gap ◽  
Safety Data ◽  
Medication Use ◽  
Incidence Rates ◽  
Drug Interference ◽  
Demographic Groups

Adverse patient safety events were associated with 110 thousand deaths in the U.S. alone in 2019. The COVID-19 pandemic has further challenged the ability of healthcare systems to ensure medication safety, and its effects on patient safety remain unknown. Here, we investigate negative outcomes associated with medication use before and during the pandemic. Using a dataset of 10,443,476 reports involving 3,624 drugs and 19,193 adverse events, we develop an algorithmic approach to analyze the pandemic's impact on incidence of drug safety events by evaluating disproportional reporting relative to the pre-pandemic time, quantifying unexpected trends in clinical outcomes, and adjusting for drug interference. Among 64 adverse events identified by our analyses, we find 54 have increased incidence rates during the pandemic, even though reporting of adverse events has decreased by 4.4% overall. We find clinically relevant differences in drug safety outcomes between demographic groups. Comparing to male patients, women report 47.0% more distinct adverse events whose occurrence significantly increased during the pandemic relative to pre-pandemic levels. Out of 53 adverse events with the pre-pandemic gender gap, 33 have increased gap during the pandemic more than would have been expected had the pandemic not occurred. While musculoskeletal and metabolic side effects are disproportionately enriched in women during the pandemic, immune-related adverse events are enriched only in men. We also find the number of adverse events with a higher reporting ratio during the pandemic in adults is higher (16.8%) than in older patients (adjusted for population size). Our findings have implications for safe medication use and public health policy and highlight the role of variation in adverse events for improving patient safety during a public health emergency.

Impact of an electronic health record transition on chemotherapy error reporting

2019 ◽  
Vol 26 (4) ◽  
pp. 787-793
Author(s):  
Elizabeth Hess ◽  
Shannon E Palmer ◽  
Andrew Stivers ◽  
Lindsey B Amerine
Keyword(s):  
Patient Safety ◽  
Electronic Health Record ◽  
Medication Error ◽  
Medication Use ◽  
Incident Reporting ◽  
Error Reporting ◽  
Health Record ◽  
Incident Reporting Systems ◽  
Reporting Systems ◽  
Electronic Health

Background Incident reporting systems allow for frontline employees to report errors and are a critical component of healthcare patient safety programs. Although incident reporting systems cannot quantify total errors, organizations can utilize incident reporting systems to help identify risks and trends to act upon. The objective of this article is to utilize incident reporting systems to evaluate trends in medication error reporting before and after implementation of a new electronic health record system. Methods A five-month pre- and post-analysis was completed in a cancer hospital following electronic health record conversion by reviewing medication errors reported via the institution’s voluntary incident reporting systems. Error reports included medication error category, date error was reported/occurred, patient location at time of error, harm severity score, medication(s) involved, medication use system node error originated/discovered in, medication source, narrative summary, and contributing factors. Data were analyzed using descriptive statistics within Office Excel. Results Oncology medication error reports submitted pre- and post-electronic health record were 68 vs. 57, respectively. During the pre- and post-electronic health record conversion, a majority of errors had a harm severity index of 0 or 1; 12 (18%) in pre-electronic health record and 3 (5%) in post-electronic health record were level 2, and one (1%) in pre-electronic health record vs. 0 in post-electronic health record were level 3. Reported medication errors originated most commonly during the prescribing, administration, and preparation/dispensing phase and were primarily identified in the administration phase of the medication use process. The most frequently reported error category was ‘wrong dose’ followed by ‘other’ and ‘overdose’ in the pre-electronic health record phase and ‘missing dose/delayed delivery’ and ‘order incorrect’ in the post-electronic health record phase. The most frequently reported medications included methotrexate, chemotherapy (unspecified), and cisplatin. Conclusion Analyzing data from incident reporting system reports allowed our institution to understand different trends of reporting in the cancer hospital following electronic health record adoption. Utilization of incident reporting systems must be combined with proactive risk identification approaches to enable systems-focused improvements to improve patient safety.

Sign in / Sign up

Export Citation Format

Share Document