scholarly journals Nature of dispensing errors in selected hospitals providing free healthcare: A multi-center study in Sri Lanka

2020 ◽  
Author(s):  
R.A.N. Dilsha ◽  
H.M.I.P. Kularathne ◽  
M.T.M. Mujammil ◽  
S.M.M. Irshad ◽  
Nithushi Samaranayake
Keyword(s):  
Sri Lanka ◽  
Tertiary Care ◽  
Sri Lankan ◽  
Patient Harm ◽  
Cross Sectional ◽  
Systematic Random Sampling ◽  
Surgical Diabetes ◽  
Free Healthcare ◽  
Multi Center Study ◽  
Dispensing Errors

Abstract Background Dispensing errors may result in patient harm. Dispensing errors are preventable if we knew its nature, but only very little information is available on these errors that occur in limited resourced settings where healthcare is provided free of charge. Therefore, the purpose of this study was to determine the types and prevalence of dispensing errors in selected hospitals in Sri Lanka. Methods A prospective, cross sectional and multi-centered study (in one tertiary care and two secondary care hospitals) was conducted among 420 patients attending medical, surgical, diabetes and pediatric clinics of study hospitals, proportioned according to population size, and selected through a systematic random sampling. A prescription audit was conducted. Dispensing errors were categorized as content, labelling, documentation, concomitant, and other errors based on definitions developed in-house. The total number of dispensing errors identified was used as the denominator for calculating percentages. Results A total of 420 prescriptions (1849 medicines) were analyzed (Hospital-01, 248 prescriptions with 1010 medicines; Hospital-02, 84 prescriptions with 400 medicines; Hospital-03, 88 prescriptions with 439 medicines), where 16,689 dispensing errors were detected. However, most frequent were labelling errors (63.1%). There were 4.9% content errors, 21% concomitant errors, 10.6% documentation errors, and 0.4% of other errors. No omissions or deteriorated medicines were detected. Conclusions Dispensing errors happen in Sri Lankan hospitals that operate with limited resources and provide free healthcare to citizens. However, most were labeling errors with little chance of immediate harm. Content errors were minimal. More emphasis on error-proofing the dispensing process could improve medication safety in these hospitals.

scholarly journals Nature of dispensing errors in selected hospitals providing free healthcare: a multi-center study in Sri Lanka

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
R. A. N. Dilsha ◽  
H. M. I. P. Kularathne ◽  
M. T. M. Mujammil ◽  
S. M. M. Irshad ◽  
N. R. Samaranayake
Keyword(s):  
Sri Lanka ◽  
Tertiary Care ◽  
Sri Lankan ◽  
Cross Sectional ◽  
Free Healthcare ◽  
Clinically Significant ◽  
Multi Center Study ◽  
Dispensing Error ◽  
Dispensing Errors ◽  
Center Study

Abstract Background Dispensing errors, known to result in significant patient harm, are preventable if their nature is known and recognized. However, there is a scarcity of such data on dispensing errors particularly in resource poor settings, where healthcare is provided free-of-charge. Therefore, the purpose of this study was to determine the types, and prevalence of dispensing errors in a selected group of hospitals in Sri Lanka. Methods A prospective, cross sectional, multi-center study on dispensing errors was conducted, in a single tertiary care, and two secondary care hospitals, in a cohort of 420 patients attending medical, surgical, diabetic and pediatric clinics. The patients were selected according to the population size, through consecutive sampling. The prescription audit was conducted in terms of dispensing errors which were categorized as i) content, ii) labelling, iii) documentation, iv) concomitant, and v) other errors based on in-house developed definitions. Results A total of 420 prescriptions (1849 medicines) were analyzed (Hospital-I, 248 prescriptions-1010 medicines; Hospital-II, 84 prescriptions-400 medicines; Hospital-III, 88 prescriptions-439 medicines), and a cumulative total of 16,689 dispensing errors (at least one dispensing error in a prescription) were detected. Labelling errors were the most frequent dispensing error (63.1%; N = 10,523; Mostly missing information on the dispensing label), followed by concomitant prescribing and dispensing errors (20.5%; N = 3425; Missing prescribing information overlooked by the pharmacist), documentation errors (10.6%; N = 1772 Missing identification of pharmacist on dispensing label), clinically significant medication interactions overlooked by pharmacists (0.5%; N = 82), content errors (4.9%; N = 812; Discrepancies between medication dispensed and prescription order), medications dispensed in unsuitable packaging (0.4%; N = 74), and lastly medication dispensed to the wrong patient (0.01%; N = 1). Conclusions Dispensing errors are frequent in Sri Lankan hospitals which operate with limited resources and provide free healthcare to all citizenry. Over one half of the errors were labeling errors with minimal content errors. Awareness on common types of dispensing errors and emphasis on detecting them could improve medication safety in Sri Lankan hospitals.

Ischemic Stroke Subtypes: Socio-demographic Factors, Risk Factors, and Outcomes in Southern Sri Lanka

2021 ◽  
Vol 31 (4) ◽  
pp. 509-518
Author(s):  
Sathyajith Buddhika Ambawatte ◽  
Dulmini Nadeesha Weerathunga ◽  
Athula Dissanayake ◽  
Surangi Chandhi Somaratne ◽  
Kanishka Athukorala ◽  
...  
Keyword(s):  
Risk Factors ◽  
Ischemic Stroke ◽  
Sri Lanka ◽  
Care Center ◽  
Tertiary Care ◽  
Clinical Analysis ◽  
Cross Sectional Study ◽  
Stroke Subtype ◽  
Anterior Circulation ◽  
Cross Sectional

Background: Stroke is a heterogeneous, catastrophic disease. A comprehensive clinical analysis of ischemic stroke (IS) risk factors and outcomes is crucial for optimum management in resource-poor settings.Methods: A prospective cross-sectional study of acute cerebrovascular disease (ACVD) involving 592 patients was con­ducted in a tertiary care center in Sri Lanka from November 2018 to May 2019. We aimed to describe the ACVD subtypes and the relationship of IS subtypes and subtype-categories (as defined by the Oxfordshire Community Stroke Project clinical clas­sification) with risk factors, severity, and outcome.Results: The majority (63.3%) had IS. Partial anterior circulation syndromes (PACS), total anterior circulation syndrome (TACS), posterior circulation syndromes (POCS), and lacunar syndromes (LACS) accounted for 102 (29.7%), 58 (16.9%), 88 (25.7%) and 95 (27.7%) of the cases, respectively. The most common PACS sub-category was higher-cerebral-dysfunction-with-homonymous-hemianopia (HCD+HH,39 cases;38.2%). Cerebellar-signs-without-long-tract-signs (CS-LTS) sub-category constituted the highest among POCS (47 cases; 53.4%). The leading sub-category within LACS was pure-motor (PM) strokes (43 cases; 45.3%).Patients aged ≥50 years (adjusted-OR [AOR]2.439; 95%CI,1.163-5.116;P=.018), IHD(AOR 2.520; 95%CI,1.347-4.713; P=.004) and BMI>23kg/m2(AOR 2.607; 95% CI,1.420-4.784; P=.002) were 2.5 times more likely to associate with TACS. Patients with a history of TIA (AOR 1.910; 95%CI,1.036-3.524; P=.038) and arrhyth­mias (AOR 5.933; 95%CI,3.294-10.684; P<.001) were 1.9 and 5.9 times more likely to be associated with POCS respectively. Those with hypertension were 2.3 times more likely to associate with LACS (AOR 2.233; 95%CI,1.270-3.926; P=.005).NIHSS(P<.001), mRS on admission (P=.001) and in 3 months (P<.001), deaths during hospital stay (P=.003) and within 28 days (P<.001) had a stronger relationship with individual stroke subtypes.Conclusion: The comparative risk of different IS subtypes depends on differ­ent risk factors. The findings of this study demonstrate that sub-categories within each stroke subtype may behave independently with regard to risk factors and outcomes, thus warranting the need for individual assessment. Ethn Dis. 2021;31(4):509-518; doi:10.18865/ed.31.4.509

scholarly journals Susceptibility for varicella and factors associated with immunity among pregnant women in a tertiary care hospital in Sri Lanka- a cross-sectional study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Ishara P. Premathilake ◽  
Praveena Aluthbaduge ◽  
Channa P. Senanayake ◽  
Renuka Jayalatharachchi ◽  
Sirithilak Gamage ◽  
...  
Keyword(s):  
Sri Lanka ◽  
Pregnant Women ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Sectional Study ◽  
Cross Sectional ◽  
Factors Associated

scholarly journals Adequacy of equipment available for the insertion of chest drains in tertiary care units in Sri Lanka: a multi center study

2018 ◽  
Vol 36 (1) ◽  
pp. 1 ◽  
Author(s):  
D.V.T. Harischandra ◽  
H.V.G. Hewage ◽  
L. Amarashriyan ◽  
K. Indrapala ◽  
N. Perera ◽  
...  
Keyword(s):  
Sri Lanka ◽  
Tertiary Care ◽  
Multi Center Study ◽  
Center Study

scholarly journals Study on Online Behavioural Add Avoidance in Sri Lankan Online Advertising

2018 ◽  
Vol 2 (3) ◽  
pp. 159-163
Author(s):  
Shanika Wijenayake ◽  
Imesha Ruwan Pathirana
Keyword(s):  
Sri Lanka ◽  
Avoidance Behavior ◽  
Structural Equation ◽  
Online Advertising ◽  
Cross Sectional Study ◽  
Sri Lankan ◽  
Privacy Concern ◽  
Sectional Study ◽  
Cross Sectional ◽  
Negative Experience

This paper aims to investigate the effect of goal impediment, privacy concern, perceived personalization on the online behavioral add (OBA) avoidance behavior in Sri Lankan online advertising. This is done through the negative experience faced by the viwer. For this purpose, four hypothesis were used. Study is designed as a cross sectional study where data was collected using a questionnaire and the sample size is 384. Collected data was analyzed through structural equation method in AMOS 22.  All the hypotheses were supported by data. Therefore, it was concluded that goal impediment, privacy concern, perceived personalization has a significant impact on negative experience and negative experience has a significant impact on the online add avoidance behavior. Based on the findings recommendations were proposed to improve the performance of online advertising in Sri Lanka and to control online behavioral add avoidance.

scholarly journals Infant and Young Child Feeding Practices among Mothers in Lahore, Pakistan: A Cross-Sectional Study

2021 ◽  
Vol 2 (1) ◽  
pp. 29-38
Author(s):  
Faisal Farooq ◽  
Mohsin Raza ◽  
Zoofishan Imran ◽  
Fatima Zulfiqar ◽  
Fareeha Gul ◽  
...  
Keyword(s):  
Exclusive Breastfeeding ◽  
Urban Areas ◽  
Tertiary Care ◽  
Feeding Practices ◽  
High Rate ◽  
Military Hospital ◽  
Child Feeding ◽  
Cross Sectional ◽  
Child Feeding Practices ◽  
Free Healthcare

Background: Inadequate child feeding practices lead to malnutrition, higher under-five mortality rates and adverse effects on quality of life. This study aimed to assess the breastfeeding and complementary feeding practices of mothers as well as the influence of various sociodemographic factors on them in local families of Lahore. Methods: This is a cross-sectional, descriptive study. It was conducted in CMH (Combined Military Hospital), Lahore in 2018. It comprises a sample of 203 mothers with children of at least two years of age, from various urban areas of Lahore. The subjects were selected on the basis of the inclusion criteria. Mothers with psychiatric illnesses and children with congenital anomalies were excluded from the study. Mothers were approached in the paediatric outpatient departments of four tertiary care hospitals of Lahore. Responses were recorded using a modified version of the Action Contre La Faim (ACF) questionnaire. Independent sample t-test and chi-square test were applied for analysis of the data. Results: Early initiation of breastfeeding within one hour from birth was observed in 83.3% children. Most children were administered colostrum (69.5%). The rate of exclusive breastfeeding for the first six months was 45.3%.  A child was being breastfed 8.21 ± 6.67 (mean ± SD) times a day. Maternal educational status, total number of adults in a household, and access to free healthcare were identified as important factors influencing the practice of breastfeeding. Porridge, khichdi, eggs, fruit and yoghurt were the most frequently used complementary foods. Conclusions: A high rate of an early start of breastfeeding and a low rate of exclusive breastfeeding for at least six months were predominant in our population. Administration of colostrum was observed in approximately two-thirds of the study participants. Education of the mother, type of the family system (nuclear or combined), and access to free healthcare strongly influence the breastfeeding practices.

scholarly journals 1677. Prevalence and Patterns of Outpatient Antibiotic Prescription at a Public Tertiary Medical Center in Southern Province, Sri Lanka

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S614-S614
Author(s):  
Helen L Zhang ◽  
Gaya B Wijayaratne ◽  
Pasangi Jayatissa ◽  
Bhagya Piyasiri ◽  
Tianchen Sheng ◽  
...  
Keyword(s):  
Sri Lanka ◽  
Antibiotic Prescription ◽  
Medical Center ◽  
Care Center ◽  
Tertiary Care ◽  
Electronic Prescribing ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Southern Province ◽  
Duration Of Illness

Abstract Background The global emergence of antimicrobial resistance poses a major public health threat. However, there are little data regarding antimicrobial use from many low- or middle-income countries. In this study, we determined the prevalence and patterns of antibiotic prescription among outpatients at a tertiary healthcare facility in Sri Lanka. Methods The study was conducted at the Outpatient Department (OPD) of the largest public tertiary care center in Southern Province, Sri Lanka. This is a free walk-in clinic serving upwards of 1,000 patients per day. Adult and pediatric OPD patients were recruited for a cross-sectional survey in February–April 2019. Pre-visit and post-visit questionnaires were verbally administered to obtain information regarding participants’ demographics and presenting illness. The OPD pharmacy’s electronic prescribing system was queried to calculate the prevalence of antibiotic prescriptions among enrolled patients. Logistic regression was performed to identify features associated with antibiotic prescription. Results Of 408 patients surveyed, 246 (62.9%) were female and 88 (21.7%) were children <18 years. Median age was 38 (IQR 19–54) years, and median duration of illness at enrollment was 7 (IQR 3–30) days. Medications were prescribed for 291 (72.4%) patients during the OPD visit, with 146 (35.8% of all patients) receiving an antibiotic. The most frequently prescribed antibiotics were amoxicillin (41, 28.1%), first-generation cephalosporins (38, 26.0%), and amoxicillin/clavulanate (30, 20.5%). The most frequent chief complaints among antibiotic recipients were cough (35, 24.0%), rhinorrhea/congestion (26, 17.8%), and fever (18, 12.3%). Diagnostic investigations were ordered for 38 (26.0%) antibiotic recipients. On bivariable analysis, younger age (P = 0.01), shorter duration of illness (P < 0.001), and lack of prior evaluation (P = 0.001) were positively associated with antibiotic prescription. Conclusion We show a high prevalence of outpatient antibiotic prescription despite limited diagnostic evaluation at a tertiary medical facility in Southern Province, Sri Lanka. Antibiotic stewardship efforts, especially targeting respiratory illness, may help improve antibiotic use in this setting. Disclosures All authors: No reported disclosures.

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