scholarly journals A Study on Design, Development, Implementation, and Evaluation of Severe Drug-Drug Interaction Alert System in ICU

2021 ◽  
Author(s):  
mehrdad Karajizadeh ◽  
Farid Zand ◽  
Roxana Sharifian ◽  
Afsaneh Vazin ◽  
Najmeh Bayati
Keyword(s):  
Drug Interaction ◽  
Cross Sectional Study ◽  
Teaching Hospitals ◽  
Design Development ◽  
Alert System ◽  
Cross Sectional ◽  
Computerized Provider Order Entry ◽  
System Usability Scale ◽  
The Mean ◽  
Drug Drug Interaction

Abstract Background and objective: The overridden rate of Drug-Drug Interaction Alerts (DDIAs) in the Intensive Care Unit (ICU) is very high. Therefore, this study aimed to design, develop, implement, and evaluate a severe Drug-Drug Alert System (DDIAS) in ICU and measure the override rate of DDIAs. Methods This is a cross-sectional study for the design, development, implementation, and evaluation of severe DDIAs into a Computerized Provider Order Entry(CPOE) system in the ICUs of Nemazee general teaching hospitals in 2021. The patients exposed to the volume of DDIAs, acceptance and overridden of DDIAs, and usability of DDIAS have been collected. Results The knowledge base of DDIAS contains 9,809 severe DDIs. A total of 2672 medications were prescribed in the population study. The volume and acceptance rate for severe DDIAs were 81 and 97.5%, respectively. However, the override rate was 2.5%. The mean System Usability Scale (SUS) score of the DDIAS was 75. Conclusion This study demonstrated that the implementation of high-risk DDIAs at point of prescribing in ICU improved adherence to alerts. In addition, the usability of DDIAS was reasonable. Further studies are need to investigate the establishment of severe DDIAS and measure the physician's response to DDIAS on a larger scale.

scholarly journals THE PREDICTORS OF POTENTIAL DRUG-DRUG INTERACTIONS AMONG DIABETIC HYPERTENSIVE ADULT OUTPATIENTS IN A KENYAN REFERRAL HOSPITAL

2020 ◽  
pp. 63-67
Author(s):  
MAKITE SIMON LATI ◽  
NYAMU GITONGA DAVID ◽  
ROSALINE NJERI KINUTHIA
Keyword(s):  
Drug Interaction ◽  
Drug Interactions ◽  
Cross Sectional Study ◽  
Potential Drug ◽  
National Hospital ◽  
Cross Sectional ◽  
Kenyatta National Hospital ◽  
Stage 4 ◽  
Drug Drug Interaction ◽  
Study Participants

Objective: To characterize the predictors of potential drug-drug interactions among adult diabetic hypertensive outpatients at Kenyatta National Hospital. Methods: This cross-sectional study collected and analyzed data on potential drug interactions from 104 diabetic hypertensive outpatients (aged ≥18 y) at the Department of Endocrinology Outpatient Clinic of Kenyatta National Hospital from 1st May 2019 to 31st August 2019. The main outcome measure was the prevalence of potential drug-drug interactions and their predictors among the study population. Results: There was a female preponderance (70.2%). The mean age of the study participants was 61.6 y (SD±10.8). The prevalence of potential drug interactions was high at 57.7%. The average number of drug interactions was one interacting pair per patient, with a majority of the prescriptions (81.0%) having moderate drug-drug interactions. Patients receiving>2 drugs were almost three times more likely to have drug-drug interaction compared to those prescribed ≤ 2 drugs (AOR=2.79; 95% CI: 1.11-7.28); p=0.029). Participants who were at stage 4 of hypertension were 2.5 times more likely to have a drug-drug interaction compared to the other stages of hypertension (AOR=2.52; 95% CI 1.31-4.89; p=0.007). Conclusion: Polypharmacy and stage 4 hypertension are independently associated with drug-drug interactions among patients with both diabetes and hypertension. Future studies should characterize the specific type of drug interactions and possible targets of minimization of drug-drug interactions.

scholarly journals Drug-drug Interactions between Hypoglycemic and Non-hypoglycemic Medication in Diabetic Patients with Comorbidities in a Tertiary Care Center: A Descriptive Cross-sectional Study

2021 ◽  
Vol 59 (243) ◽  
pp. 1125-1130
Author(s):  
Lujaw Ratna Tuladhar ◽  
Shirish Lal Shrestha ◽  
Sneha Bimali ◽  
Srijana Bhusal ◽  
Pingala Khadka
Keyword(s):  
Drug Interaction ◽  
Confidence Interval ◽  
Drug Interactions ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Outpatient Department ◽  
Diabetic Patients ◽  
Sectional Study ◽  
Cross Sectional ◽  
Drug Drug Interaction

Introduction: Drug-drug interaction is one of the causes of adverse drug reactions. Generally, drug-drug interaction is common in multidrug therapy. Diabetic patients, particularly due to associated comorbidities tend to have various drug-drug interactions due to the effect of multiple drugs. The objective of this study was to find out the prevalence of drug-drug interactions in diabetic patients. Methods: It was a descriptive cross-sectional study that was conducted among previously diagnosed diabetic patients visiting the outpatient department of medicine at a tertiary care hospital between March 2021 and August 2021. Ethical approval was taken from the institutional review committee (Ref no: 030-076/077). Data was collected from diabetic patients presenting to the outpatient department of medicine using a preformed self-constructed questionnaire. Convenient sampling was done. Statistical Package for Social Sciences version 21 and Microsoft Excel were used for data analysis. Point estimate at 95% confidence interval was calculated along with frequency and proportion for binary data. Results: The prevalence of drug-drug interaction between hypoglycemic and non-hypoglycemic medication was 56 (44.1%) (35.5-52.7 at 95% Confidence Interval) of the patients out of which at least one drug-drug interaction was seen in 48 (37.8%) of the patients. Conclusions: Our study showed the prevalence of drug-drug interactions in diabetic patients to be higher than other studies done in similar settings. Based on the severity, we observed two types of drug-drug interactions; close monitoring drug-drug interactions and minor drug-drug interactions.

scholarly journals Potential Drug–Drug Interactions among Hospitalized COVID-19 Patients Admitted to Medical Wards of a Referral Hospital, North-East of Iran: A Cross Sectional Study

2021 ◽  
Author(s):  
Niloofar Saber-Moghaddam ◽  
Sepideh Hejazi ◽  
Sepideh Elyasi
Keyword(s):  
Drug Interaction ◽  
Virus Disease ◽  
Median Number ◽  
Cross Sectional Study ◽  
Referral Hospital ◽  
Sectional Study ◽  
Cross Sectional ◽  
North East ◽  
East Of Iran ◽  
Drug Drug Interaction

Background: Hospitalized corona virus disease 2019 (COVID-19) patients are special population in term of drug-drug interaction (DDI), as they receive various experimental novel medications and also most of them are elderly with various comorbidities and consequently numerous medications. The aim of present study was to assess the prevalence and determinants of potential DDIs in hospitalized COVID-19 patients admitted to the medical ward of a Referral Hospital in North-East of Iran. Methods: A cross-sectional study was conducted among COVID-19 inpatients between March 2020 and April 2020. Prescribed medication being taken concurrently for at least 24 h were included and checked for DDI using Lexicomp® online drug reference. Data were analyzed using SPSS19. Results: A total of 88 patients were evaluated. The cardiovascular disease was the most common comorbidity (30.68%). The median number of medications prescribed for each patient was 5. Hydroxychloroquine was the most common prescribed medication for COVID-19 management (92.05%). About two-third (62.5 %) of patients were exposed to at least one potential C (84.09 %) or D (52.27%) DDI and no X DDIs were found. Patients with at least five prescribed medications were at higher risk of having DDI (P = 0.001). Conclusion: Drug–drug interaction in COVID-19 inpatients was common. Considering these DDIs, clinical pharmacist involvement can be helpful in minimizing the risk of these potentially harmful drug combinations.

Nurses’ knowledge and performance of the patients’ bill of rights

2016 ◽  
Vol 23 (8) ◽  
pp. 866-876 ◽  
Author(s):  
Abbas Sheikhtaheri ◽  
Monireh Sadeqi Jabali ◽  
Zahra Hashemi Dehaghi
Keyword(s):  
Ethics Committees ◽  
Cross Sectional Study ◽  
Teaching Hospitals ◽  
Bill Of Rights ◽  
Cross Sectional ◽  
Patients Rights ◽  
Long Time ◽  
The Mean ◽  
And Performance ◽  
Nurses Knowledge

Background: Observance of the patients’ bill of rights is one of the main features of moral codes in hospitals. In this regard, nurses bear great responsibility because they spend a long time with patients. Therefore, the continuous evaluation of the nurses’ performance and assessing their knowledge about the patients’ bill of rights are a need. Objectives: We aimed to determine the nurses’ awareness of the patients’ rights and measure their performance in this regard. Research design and participants: This cross-sectional study was carried out in 2013. To measure the nurses’ knowledge and performance, 250 nurses and 300 patients were surveyed. The participants were selected randomly from five teaching hospitals in Tehran, Iran. Two questionnaires, one for nurses (17 questions) and the other for patients (11 questions), were applied. The data were analyzed in SPSS software using descriptive and inferential statistics. Ethical consideration: The research protocol was submitted and approved by the research and ethics committees of the participating hospitals. Additionally, the consent of all of the participants was obtained before the study. Findings: The mean score of the nurses’ knowledge regarding the patients’ rights was acceptable (69.85 ± 11.7 of 85). Furthermore, the mean score of nurses’ performance in observing the patients’ rights was relatively acceptable (11.2 ± 4.6 of 22). More experienced and educated nurses had higher knowledge regarding the patients’ rights, and patients with higher education level or experience of being hospitalized were less satisfied with the nurses’ performance. Conclusion: Nurses’ knowledge of the patients’ bill of rights was acceptable; however, observance of the patients’ rights was not. It seems that notification of the patients’ bill of rights has increased the nurses’ awareness of the patients’ rights, although improvement of the nurses’ performance needs more extensive measures.

EVALUATING RISK FACTORS, CLINICAL AND THERAPEUTIC PROFILE OF STROKE PATIENTS PRESENTING TO A TERTIARY CARE HOSPITAL

2021 ◽  
pp. 128-133
Author(s):  
LAKSHMI P ◽  
SUCHITHA S ◽  
SAI ASWANI V ◽  
DHANYA SREE V ◽  
ZAFEER SK
Keyword(s):  
Risk Factors ◽  
Drug Interaction ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
World Health ◽  
Care Hospital ◽  
Cross Sectional ◽  
Therapeutic Guidelines ◽  
Drug Drug Interaction ◽  
Health Organization

Objective: According to the World Health Organization, stroke is the second leading cause of death for people above the age of 60 years, and the fifth leading cause in people aged 15–59 years old. This study mainly aims to evaluate the prevalence of risk factors, clinical features, pattern of drugs prescribed, and severity of stroke among patients. Methods: A cross-sectional study was carried out in a tertiary care teaching hospital on 210 patients for a period of 6 months. Patients aged 18 years and above were included in the study. The severity of stroke was assessed using National Institute of Health Stroke Scale (NIHSS). Results: The majority of the patients were under the age group of 61–70 years (31%). The incidence of ischemic stroke (81%) was more common compared to hemorrhagic stroke (19%). Males (66%) are prone to stroke compared to females (34%). The most common risk factor was hyperlipidemia (29%) followed by hypertension (17%). Antihypertensives (28%) were most commonly used drugs followed by antihyperlipidemics (23%). Most of the prescriptions were prescribed with 4–6 drugs per prescription (62%). Moderate stroke (69%) was most commonly observed in patients. A total of 147 drug-drug interactions were observed. Among 147 drug-drug interaction, the most commonly observed drug-drug interaction was aspirin with metformin (15%). Conclusion: The present study emphasizes on the need to identify risk factors and providing awareness among the patients by a pharmacist in minimizing the disease burden. Early identification of risk factors and pattern of therapy based on therapeutic guidelines plays a crucial role in qualitative patient care.

scholarly journals The Association of Work Environments and Nurse-Nurse Collaboration: A Multicenter Cross-Sectional Study

2021 ◽  
Vol 11 (3) ◽  
pp. 370-379
Author(s):  
Roya Ghasemi ◽  
Mansour Ghafourifard ◽  
Hadi Hassankhani ◽  
Javad Dehghannezhad
Keyword(s):  
Work Environment ◽  
Pearson Correlation ◽  
Cross Sectional Study ◽  
Teaching Hospitals ◽  
Practice Environment ◽  
Sectional Study ◽  
Cross Sectional ◽  
Nursing Work Environment ◽  
The Mean ◽  
Intraprofessional Collaboration

Background: Along with the recent healthcare reform, intraprofessional collaboration in nursing is considered an essential factor for managing the challenges related to diverse roles and tasks of nurses in providing high quality care. There is lack of knowledge on how the nursing work environment could influence nurse-nurse collaboration.   Purpose: The study aimed to assess the relationship between nursing work environment and nurses’ intraprofessional collaboration.Methods: A total of 300 nurses working in four teaching hospitals participated in this multicenter cross-sectional study. Data were collected using the Nurse-Nurse Collaboration Scale (NNCS) and the Practice Environment Scale of the Nursing Work Index (PES–NWI). The Pearson correlation test was used to analyze the data.Results: The results showed that the mean score of the PES–NWI was 2.65±0.32 out of 4. The highest and lowest scores belonged to the subscales of the nursing foundations for quality of care (2.86±0.31) and staffing and resource adequacy (2.24±0.49), respectively. The mean total score of nurse-nurse collaboration was 2.94±0.21 out of a score of 4. The results showed a significant positive relationship between nursing work environment and nurses’ intraprofessional collaboration (r=0.49, p<0.05).Conclusion: The nursing practice environment has a positive and significant relationship with nurse-nurse collaboration. Therefore, improving nurses’ practice environment and providing healthy workplaces could improve the intraprofessional nurse’s collaboration. Moreover, nurse managers should improve nurses’ skills in some areas of collaboration such as conflict management.

Brief Overview and Experience of Visual Evoked Potential of First 67 cases at Referral Neuroscience Hospital in Bangladesh

2020 ◽  
Vol 6 (2) ◽  
pp. 74-77
Author(s):  
Mohammad Enayet Hussain ◽  
Bithi Debnath ◽  
AFM Al Masum Khan ◽  
Md Ferdous Mian ◽  
Md Nahidul Islam ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Optic Neuritis ◽  
Clinical Diagnosis ◽  
Optic Neuropathy ◽  
Cross Sectional Study ◽  
P Value ◽  
Pattern Reversal ◽  
Cross Sectional ◽  
The Mean ◽  
Visual Evoked

Background: The visual evoked potentials (VEP) is a valuable tool to document occult lesions of the central visual channels especially within the optic nerve. Objectives: The purpose of the present study was to observe the findings of first few cases of VEP done in the neurophysiology department of the National Institute of Neurosciences (NINS), Dhaka, Bangladesh. Methodology: This cross-sectional study was conducted in the Department of Neurophysiology at the National Institute of Neurosciences and Hospital, Dhaka, Bangladesh from September 2017 to March 2020. All patients referred to the Neurophysiology Department of NINS for VEP were included. Pattern reversal VEPs were done using standard protocol set by International Federation of Clinical Neurophysiology (IFCN). Results: The mean age of the study population was 30.70 (±12.11) years (6-68 years) with 31 (46.3%) male and 36 (53.7%) female patients. The mean duration of illness was 8.71 (±1.78) months (3 days- 120 months). Most common presenting symptom was blurring of vision (37.3%) and dimness of vision (32.8%). Patterned VEP revealed mixed type (both demyelinating and axonal) of abnormality in most cases [29(43.35)]. The most common clinical diagnosis was multiple sclerosis (29.85%) and optic neuropathy (26.87%). In the clinically suspected cases of multiple sclerosis, optic neuropathy and optic neuritis most of the cases of VEP were abnormal and the p value is 0.04 in optic neuropathy and optic neuritis. Conclusion: The commonest presentation of the patients in this series were blurring of vision and dimness of vision. The most common clinical diagnosis for which VEP was asked for, was optic neuritis and multiple sclerosis. Most abnormalities were of mixed pattern (demyelinating and axonal). Journal of National Institute of Neurosciences Bangladesh, 2020;6(2): 74-77

Sonographic Assessment of Amniotic Fluid Volume using Single Deepest Pocket (SDP) among Igbo Women with Uncomplicated Singleton Pregnancies.

2019 ◽  
Vol 2 (1) ◽  
pp. 1-18
Author(s):  
Chijioke Okeudo ◽  
B.U. Ezem
Keyword(s):  
Amniotic Fluid ◽  
Gestational Age ◽  
Cross Sectional Study ◽  
Fluid Volume ◽  
Singleton Pregnancy ◽  
Cross Sectional ◽  
South Eastern ◽  
Amniotic Fluid Volume ◽  
The Mean ◽  
Singleton Pregnancies

Background: The amniotic fluid is fundamental for proper fetal development and growth. Ultrasound visualization of the amniotic fluid permits both subjective and objective estimates of the amniotic fluid. Objective: The objective of this study was to determine the reference values of normal single deepest pocket (SDP) – upper and lower limits, mean SDP and variation of the SDP with gestational age among Igbo women of South-Eastern Nigeria extraction carrying uncomplicated singleton pregnancy. Methodology: This was a prospective cross sectional study involving 400 women carrying uncomplicated singleton pregnancies and who were sure of the date of the first day of their last menstrual period. The single deepest pocket / maximum vertical pool were determined once at presentation at the hospital.. The study was conducted from January 1st to December 31st 2015. The second author carried out all the scanning. The SDP was obtained. Results: The womens’ mean and median ages were the same at 28 years. The gestational age range of the pregnancies was 14-41 weeks. The mean SDP was 5.8cm, while the 5th and 95th percentiles were 3.3cm and 8.5cm respectively. There was no difference in the mean SDP in both term and preterm. There was irregular but continuous rise of mean SDP to a peak of 6.8cm at gestational age of 39 weeks. In conclusion, the participants had a mean SDP of 5.8cm. There was also a positive correlation between SDP and Gestational age. We therefore recommend a longitudinal study to assess perinatal outcome and abnormal amniotic fluid volume among Igbo women of South-Eastern Nigeria. Key words: Single Deepest Pocket, Uncomplicated Singleton Pregnancy, Igbo Women.

Advantages and limitations of the endoscopic tympanoscopy a prospective study

2020 ◽  
Vol 1 (1) ◽  
pp. 012-017
Author(s):  
Najib Zouhair ◽  
Anass Chaouki ◽  
Amine M’khatri ◽  
Youssef Oukessou ◽  
Sami Rouadi ◽  
...  
Keyword(s):  
Middle Ear ◽  
Operating Time ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Invasive Approach ◽  
Intraoperative Bleeding ◽  
Advantages And Disadvantages ◽  
Early Return ◽  
The Mean ◽  
Endoscopic Tympanoplasty

Tympanoplasty is one of the most performed procedures in ENT. The aggressiveness of its microscopic approach has led otologists to adopt the endoscopic approach as a less invasive alternative. The purpose of this work is to appreciate the advantages and disadvantages of this surgical technique. We conducted a prospective descriptive cross-sectional study on 20 interventions within the ENT department of August the 20th 1953 Hospital of Casablanca from April 2019 to June 2019. The average age of operated patients was 36.3 years. Perforations were unilateral in (71%) of the cases with a predominance of the anterior (29%) and subtotal (36%) locations. The tympanoplasties were performed by 3 different senior otologic surgeons, and were left in (57%). The mean operating time was (59.5 min) and the mean anesthesia duration was 75.1 min. Intraoperative vision allowed us to fully visualize the margins of all perforations (100%) and anatomical structures of the middle ear in almost all interventions. The first procedures carried out were filled with difficulties whose management of intraoperative bleeding was the main one in (42.8%) of the cases. (57%) procedures were described as easy. No complication was detected intraoperatively or immediately postoperatively. Endoscopic tympanoplasty has several advantages, including: Minimally invasive approach to the middle ear; panoramic perioperative vision; Gain of operating time; decrease in the duration of anesthesia; Valuable educational tool; postoperative comfort; Decrease in hospital stay and early return to daily activities; Better aesthetic rendering; cost and transportability. However, we also note a number of disadvantages of endoscopic tympanoplasty, particularly: performing the procedure with one hand; difficulty passing through the EAC; 2D vision that alters the perception of depth; management of intraoperative bleeding; fogging; learning curve.

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