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 ◽  
...  
2021 ◽  
pp. 53-55
Author(s):  
Harsimran Singh Das

Introduction:qCSI (Quick COVID severity index) is a clinical tool established recently post pandemic to predict respiratory failure within 24 hours of admission in COVID-19 patients; respiratory failure being explain as increased oxygen requirement greater than 6L/min by low ow device, high ow device, noninvasive or invasive ventilation to maintain spO2 of greater than or equal to 94%, or death. Aim:To verify and validate the application of the qCSI in Emergency Department in Indian demographic for evidence-based guidance to aid physician decision making in safely dispositioning adult patients with COVID-19 with oxygen requirement less than or equal to 6L/min via low ow devices including nasal cannula and oxygen mask Materials and methods:This is an observational, retrospective study from Emergency Department in a private tertiary care hospital of admitted adult patients with COVID-19 disease. Clinical parameters in qCSI and disposition of 210 patients admitted through Emergency Department included in this study selected randomly was sought on admission and clinical status with level of care 24 hours following admission was recorded and compared with prediction based on qCSI from a period of 1 May 2020 to 31 October 2020. Result:We found that19(9.0%) patients Initial qCSI Score was Low, 80(38.1%) patients Initial qCSI Score was Low-intermediate, 84(40.0%) patients Initial qCSI Score was High-intermediate and 27(12.9%)patients Initial qCSI Score was High.qCSI Score after 24 hours 16(11.4%) patients were Low, 43(30.7%) patients were Low-intermediate, 63(45.0%) patients was High-intermediate and 18(12.9%) patients was High.Out of 210(100.0%) patients, 70 (33.3%) patients were critically ill. Conclusion:In conclusion these data show that the quick COVID-19 Severity Index provides easily accessed risk stratication relevant to Emergency Department provider.


2021 ◽  
Vol 38 (ICON-2022) ◽  
Author(s):  
Syed Ghazanfar Saleem ◽  
Saima Ali ◽  
Nida Ghouri ◽  
Quratulain Maroof ◽  
Muhammad Imran Jamal ◽  
...  

Background and Objective: Maintaining privacy and ensuring confidentiality with patients is paramount to developing an effective patient-provider relationship. This is often challenging in over-crowded Emergency Departments (EDs). This survey was designed to explore patients’ perceptions on maintenance of privacy and confidentiality and their subsequent interactions with providers in a busy tertiary care hospital in Karachi. Methods: Trained nursing staff conducted structured interviews with 571 patients who presented to The Indus Hospital (TIH) ED from January to December 2020. All patients were 14 years of age or older, could speak and understand Urdu, and provide informed consent. Patients were asked about their perceptions of privacy and confidentiality in the ED and whether this affected their interactions with providers. Results: Respondents were primarily men (64%) under the age of 45 (62%) presenting for the first time (49%). The majority of patients felt that privacy and confidentiality were maintained, however 10% of patients reported that they had rejected examination due to privacy concerns and 15% of patients reported that they had changed or omitted information provided to a provider due to confidentiality concerns. There was correlation between privacy and confidentiality concerns and patient-provider interactions (p<0.0001). Conclusions: Despite the often over-crowded and busy environment of the ED, patients generally felt that privacy and confidentiality were maintained. Given the correlation between perception and behavior and the importance of an effective patient-provider relationship, particularly in the acute setting when morbidity and mortality is high, initiatives that focus on maintaining privacy and confidentiality should be pursued. doi: https://doi.org/10.12669/pjms.38.ICON-2022.5785 How to cite this:Saleem SG, Ali S, Ghouri N, Maroof Q, Jamal MI, Aziz T, et al. Patient perception regarding privacy and confidentiality: A study from the emergency department of a tertiary care hospital in Karachi, Pakistan. Pak J Med Sci. 2022;38(2):351-355.  doi: https://doi.org/10.12669/pjms.38.ICON-2022.5785 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Author(s):  
Francisco Cabrera-Diaz ◽  
Claudia Zaugg ◽  
Silke Lim ◽  
Kim Blum ◽  
Ali Reza Salili

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.


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