Academic literature on the topic 'Medication Systems, Hospital'
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Journal articles on the topic "Medication Systems, Hospital"
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PAZOUR, JENNIFER A., SARAH E. ROOT, RUSSELL D. MELLER, LISA M. THOMAS, and SCOTT J. MASON. "SELECTING AND ALLOCATING REPACKAGING TECHNOLOGY FOR UNIT-DOSE MEDICATIONS IN HOSPITAL PHARMACIES." International Journal of Innovation and Technology Management 10, no. 03 (June 2013): 1340011. http://dx.doi.org/10.1142/s0219877013400117.
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To increase patient safety and support bedside-point-of-care medication administration, millions of unit-dose medications are dispensed in hospitals and health systems daily. Because not all medications are available in unit-dose form directly from the manufacturer, hospitals must repackage medications in unit-dose form themselves. We develop a mathematical model that simultaneously determines which level of technology is warranted and how each medication that is not delivered to the pharmacy in unit-dose form should be repackaged subject to multiple constraints. This model has been integrated into a free Excel-based tool available to pharmacy directors. We test our model with data based on small, medium, and large hospitals and conduct sensitivity analyses to gain further insight. We illustrate how the results from our model can aid in incorporating qualitative aspects into technology selection. Our results show that a semi-automated repackaging system is the most economical technology alternative for most hospital pharmacy in-house repackaging operations. This result, however, is sensitive to the number of unit-dose medications to repackage and the available labor.
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Zhang, Yichen, Haishaerjiang Wushouer, Sheng Han, Mengyuan Fu, Xiaodong Guan, Luwen Shi, and Anita Wagner. "The impacts of government reimbursement negotiation on targeted anticancer medication price, volume and spending in China." BMJ Global Health 6, no. 7 (July 2021): e006196. http://dx.doi.org/10.1136/bmjgh-2021-006196.
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IntroductionNew targeted therapies have changed cancer treatment in the past decades. However, high prices of targeted anticancer medications have increased economic burden for both patients and health insurance systems. In July 2017, China implemented combined medication price negotiation and mandatory reimbursement policies for 15 targeted anticancer medications. This study assesses effects of the policy on hospital procurement prices, volumes and spending.MethodsUsing a quasi-experimental interrupted time series design, we analysed procurement data from the Chinese Medical Economic Information of 789 public hospitals in 30 provinces between January 2016 and September 2018. The intervention group consisted of 15 targeted anticancer medications with negotiated prices in 2017. The comparison group consisted of six targeted anticancer medications without negotiated prices by 2018. The effective date of the policy was September 2017.ResultsAfter the implementation of the 2017 medication price negotiation and reimbursement policy, cost per defined daily dose (DDD) of the 15 targeted anticancer medications dropped US$71.21 on average from an average US$169.24/DDD before (p=0.000). Compared with what would have happened without the intervention, cost/DDD of price-negotiated medications decreased by 48.9% (p=0.000), procurement volumes increased by 143.0% (p=0.000) and hospital medication spending decreased by 6.9% (p=0.146).ConclusionsThe 2017 medication price negotiation and reimbursement policy decreased targeted medication procurement costs per DDD, increased volumes procured and at least temporarily contained spending. These changes should result in better access to and affordability of targeted anticancer medications in China.
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Pedersen, Craig A., Philip J. Schneider, Michael C. Ganio, and Douglas J. Scheckelhoff. "ASHP national survey of pharmacy practice in hospital settings: Dispensing and administration—2020." American Journal of Health-System Pharmacy 78, no. 12 (March 23, 2021): 1074–93. http://dx.doi.org/10.1093/ajhp/zxab120.
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Abstract Purpose Results of the 2020 ASHP national survey of pharmacy practice in hospital settings are presented. Methods Pharmacy directors at 1,437 general and children’s medical/surgical hospitals in the United States were surveyed using a mixed-mode method of contact by email and mail. Survey completion was online. IQVIA supplied data on hospital characteristics; the survey sample was drawn from the IQVIA hospital database. Results The response rate was 18.7%. Almost all hospitals (92.5%) have a method for pharmacists to review medication orders on demand. Most hospitals (74.5%) use automated dispensing cabinets (ADCs) as their primary method for drug distribution. A third of hospitals use barcodes to verify doses during dispensing in the pharmacy and to verify ingredients when intravenous medications are compounded. More than 80% scan barcodes when restocking ADCs. Sterile workflow management technology is used in 21.3% of hospitals. Almost three-quarters of hospitals outsource some sterile preparations. Pharmacists can independently prescribe in 21.1% of hospitals. Pharmacist practice in ambulatory clinics in 46.2% of health systems and provide telepharmacy services in 28.4% of health systems. Conclusion Pharmacists continue their responsibility in their traditional role in preparation and dispensing of medications. They have successfully employed technology to improve safety and efficiency in performance of these duties and have employed emerging technologies to improve the safety, timeliness, and efficiency of the administration of drugs to patients. As pharmacists continue to expand their role to all aspects of medication use, new opportunities highlighted in ASHP’s Practice Advancement Initiative 2030 have been identified.
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Badawoud, EM, E. Seoane-Vazquez, HS Alhamdan, and S. Jacobson. "Automation Of Hospital Medication Distribution Systems In The Us." Value in Health 19, no. 7 (November 2016): A485. http://dx.doi.org/10.1016/j.jval.2016.09.802.
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Cohen, Michael R., Susan M. Proulx, and Stephanie Y. Crawford. "Survey of hospital systems and common serious medication errors." Journal of Healthcare Risk Management 18, no. 1 (September 1998): 16–27. http://dx.doi.org/10.1002/jhrm.5600180104.
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Coppola, Sarah M., Patience Osei, Ayse P. Gurses, Myrtede Alfred, David M. Neyans, Ken R. Catchpole, Anjali Joseph, et al. "Process Risks in Perioperative Medication Delivery." Proceedings of the Human Factors and Ergonomics Society Annual Meeting 64, no. 1 (December 2020): 1100. http://dx.doi.org/10.1177/1071181320641265.
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One anesthesia provider is often responsible for prescribing, formulating, dispensing, administering, and documenting medications in the operating room. Unlike other hospital units, there are few safety interventions. Systems engineering approaches can provide important insights into improving patient safety during medication delivery processes (Kaplan et al., 2013; Reid et al., 2005). This study observed anesthesia medication delivery during 20 anesthetic cases in the OR and interviewed 10 anesthesia providers in a large midatlantic academic hospital using a Systems Engineering Initiative for Patient Safety (SEIPS) framework to identify process risk in perioperative medication delivery (Holden et al., 2013). Anesthesia attendings, fellows, residents, and certified resident nurse anesthetists (CRNAs) were sampled based on who was in the OR during observations and who volunteered for interviews. Interviews were transcribed and coded through a consensus procedure. The medication delivery process was described using a SEIPS-based process map. Tasks were separated based on the anesthesia phase, though the tasks and phases are not linear; e.g: a provider may prepare for the next case during the maintenance phase.
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Aseeri, Mohammed, Ghadeer Banasser, Omar Baduhduh, Sabirin Baksh, and Nasser Ghalibi. "Evaluation of Medication Error Incident Reports at a Tertiary Care Hospital." Pharmacy 8, no. 2 (April 19, 2020): 69. http://dx.doi.org/10.3390/pharmacy8020069.
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Background: Medications errors (MEs) have been a major concern of healthcare systems worldwide. Voluntary-based incident reporting is the mainstay system to detect such events in many institutions. However, the number of reports can be highly variable across institutions depending on their adoption of the safety culture. This study aimed to evaluate and analyze medication error incidents that were submitted through the hospital safety reporting system in 2015 at a tertiary care center in the western region of Saudi Arabia, and to explore the most common types of harmful MEs in addition to the risk factors that led to such harmful incidents. Methods: This is a descriptive study that was conducted utilizing 624 medication error reports extracted from the hospital safety reporting system. Reports were analyzed based on the medication name, event type, event description, nodes of the medication use process, harm score (adapted from the National Coordinating Council for Medication Error Reporting and Prevention harm index), patients’ age/gender, incident setting, and time of occurrence as documented in the Safety Reporting System (SRS). Furthermore, all errors that resulted in injury or harm to patients had a deeper review by two senior pharmacists to find contributing factors that led to these harmful incidents and recommend system-based preventive strategies. Results: This study showed that most reported incidents were near misses (69.3%). The pediatric population was involved in 28.4% of the incident reports. Most of the reported incidents were categorized as occurring in the inpatient setting (57.4%). Medication error incidents were more likely to be reported in the morning shift versus evening and night shift (77.4% vs. 22.6%). Most reported incidents involved the dispensing stage (36.7%). High-alert medications were reported in 281 out of 624 events (45%). Conclusions: The hospital medication safety reporting program is a great tool to identify system-based issues in the medication management system. This study identified many opportunities for improvement in the medication use system, especially in management of chemotherapy and anticoagulant agents.
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Linkens, A. E. M. J. H., V. Milosevic, P. H. M. van der Kuy, V. H. Damen-Hendriks, C. Mestres Gonzalvo, and K. P. G. M. Hurkens. "Medication-related hospital admissions and readmissions in older patients: an overview of literature." International Journal of Clinical Pharmacy 42, no. 5 (May 30, 2020): 1243–51. http://dx.doi.org/10.1007/s11096-020-01040-1.
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Abstract Background The number of medication related hospital admissions and readmissions are increasing over the years due to the ageing population. Medication related hospital admissions and readmissions lead to decreased quality of life and high healthcare costs. Aim of the review To assess what is currently known about medication related hospital admissions, medication related hospital readmissions, their risk factors, and possible interventions which reduce medication related hospital readmissions. Method We searched PubMed for articles about the topic medication related hospital admissions and readmissions. Overall 54 studies were selected for the overview of literature. Results Between the different selected studies there was much heterogeneity in definitions for medication related admission and readmissions, in study population and the way studies were performed. Multiple risk factors are found in the studies for example: polypharmacy, comorbidities, therapy non adherence, cognitive impairment, depending living situation, high risk medications and higher age. Different interventions are studied to reduce the number of medication related readmission, some of these interventions may reduce the readmissions like the participation of a pharmacist, education programmes and transition-of-care interventions and the use of digital assistance in the form of Clinical Decision Support Systems. However the methods and the results of these interventions show heterogeneity in the different researches. Conclusion There is much heterogeneity in incidence and definitions for both medication related hospital admissions and readmissions. Some risk factors are known for medication related admissions and readmissions such as polypharmacy, older age and additional diseases. Known interventions that could possibly lead to a decrease in medication related hospital readmissions are spare being the involvement of a pharmacist, education programs and transition-care interventions the most mentioned ones although controversial results have been reported. More research is needed to gather more information on this topic.
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&NA;. "US vs UK hospital drug distribution systems - medication errors compared." Inpharma Weekly &NA;, no. 1017 (December 1995): 21. http://dx.doi.org/10.2165/00128413-199510170-00046.
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&NA;. "US vs UK hospital drug distribution systems ??? medication errors compared." Reactions Weekly &NA;, no. 581 (December 1995): 2. http://dx.doi.org/10.2165/00128415-199505810-00003.
Full textDissertations / Theses on the topic "Medication Systems, Hospital"
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Thaibah, Hilal. "Managing a Hybrid Oral Medication Distribution System in a Pediatric Hospital: A Machine Learning Approach." University of Cincinnati / OhioLINK, 2021. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1626356839363113.
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Opitz, Simone Perufo. "Sistema de medicação: análise dos erros nos processos de preparo e administração de medicamentos em um hospital de ensino." Universidade de São Paulo, 2006. http://www.teses.usp.br/teses/disponiveis/22/22132/tde-11092008-163213/.
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Este estudo identificou, analisou e comparou os erros de medicação ocorridos nos processos de preparo e administração de medicamentos, em uma unidade de internação clínica de um hospital público de ensino, pertencente à Rede de Hospitais-Sentinela da Agência Nacional de Vigilância Sanitária (ANVISA) e localizado na cidade de Rio Branco-AC. Trata-se de um estudo observacional e transversal, realizado no período de julho a setembro de 2005. A amostra foi constituída de 1.129 doses de medicamentos. Esta investigação foi desenvolvida em duas fases: na primeira, os dados foram obtidos a partir da observação direta dos processos que compõem o sistema de medicação e de entrevistas com três profissionais: o responsável pelo setor de farmácia, o chefe do serviço médico e a supervisora do serviço de enfermagem. Na segunda fase, foram observados o preparo e a administração de 1.129 doses, e os erros de medicação foram identificados. Os resultados permitiram identificar 404 (35,8%) erros de medicação e um sistema de medicação com 56 ações. Verificou-se que 866 (76,7%) prescrições estavam manuscritas; 126 (11,2%) não continham o nome legível do medicamento; em 267 (23,6%) faltavam as doses; em 107 (9,5%) não constava a via; em 712 (63,1%) não havia a forma de apresentação; em 20 (1,8%) faltava a freqüência; e em 338 (29,9%) não constavam o tipo e volume do diluente para o preparo. No preparo de medicamentos, foi identificado que 976 (86,4%) doses estavam rotuladas incorretamente e 49 (4,3%) doses não possuíam rótulo. Em relação à administração, observou-se que apenas 31 (2,7%) doses foram administradas após conferência direta da prescrição; em 691 (61,2%) doses não ocorreu identificação do paciente e em 904 (80,1%) doses não houve orientação a respeito do medicamento. Constatouse que 179 (78,2%) doses infundidas não foram controladas, e 214 (18,9%) doses foram registradas imediatamente após a administração. Nas observações em que se desconhecia previamente a prescrição do medicamento, ocorreram os seguintes erros: 47 (4,2%) erros de dose, 2 (0,2%) erros de via, 130 (11,5%) erros de horário, 2 (0,2%) erros de pacientes, 11(1%) erros de medicamentos não autorizados e 71 (6,3%) erros de omissão. Nas observações em que se conhecia previamente a prescrição, identificaram-se 17 (1,5%) erros de dose, 85 (7,5%) erros de horário, 4 (0,4%) erros de medicamentos não autorizados e 35 (3,1%) erros de omissão. Nessa etapa, não ocorreram erros de via e de paciente. Propõe-se como medidas para a redução dos erros nessa instituição: formar um grupo multiprofissional com a finalidade de discutir e estabelecer estratégias que possam promover a segurança do paciente; elaborar protocolos de preparo e administração de medicamentos e promover a educação continuada e permanente para os profissionais. Sugere-se, ainda, que a instituição padronize a prescrição médica, normatizando os itens da prescrição dos medicamentos; desenvolvendo um sistema de distribuição de dose unitária e implementando a prescrição médica eletrônica.This study identified, analyzed and compared the medication errors that occurred in the medication preparation and administration processes at a clinical hospitalization unit of a public teaching hospital, which is part of the Sentinel Hospital Network of the Brazilian National Health Surveillance Agency (ANVISA) and located in Rio Branco-AC, Brazil. We carried out an observational and cross-sectional study between July and September 2005. The sample consisted of 1,129 medication doses. This study was developed in two phases: in the first, data were obtained through direct observation of the medication system processes and interviews with three professionals: the pharmacy sector responsible, the medical service head and the nursing service supervisor. In the second phase, we observed the preparation and administration of 1,129 doses and identified medication errors. The results revealed 404 (35.8%) medication errors and a medication system that consisted of 56 actions. We found 866 (76.7%) handwritten prescriptions; 126 (11.2%) did not contain the readable name of the drug; doses were missing in 267 (23.6%); route in 107 (9.5%); form in 712 (63.1%); frequency in 20 (1.8%); and the diluent type and volume for preparation in 338 (29.9%). In medication preparation, we identified that 976 (86.4%) doses were labeled incorrectly and that 49 (4.3%) doses did not have a label. With respect to administration, only 31 (2.7%) doses were administered after direct verification of the prescription; in 691 (61.2%) doses, the patient was not identified and, in 904 doses (80.1%), no orientation was provided about the drug. We found that 179 (78.2%) infused doses were not controlled, and that 214 (18.9%) were registered immediately after their administration. In those observations when the medication prescription was previously unknown, the following errors occurred: 47 (4.2%) dose errors, 2 (0.2%) route errors, 130 (11.5%) time errors, 2 (0.2%) patient errors, 11(1%) unauthorized medication errors and 71 (6.3%) omission errors. In those cases when the medication prescription was previously known, we identified 17 (1.5%) dose errors, 85 (7.5%) time errors, 4 (0.4%) unauthorized medication errors and 35 (3.1%) omission errors. In this phase, no route and patient errors occurred. To reduce errors at this institution, we propose the following measures: constitute a multiprofessional group to discuss and establish strategies with a view to promoting patient safety; elaborate medication preparation and administration protocols and promote continuing and permanent professional education. We also suggest that the institution should standardize medication prescriptions by normalizing medication prescription items; developing a unit dose distribution system and implementing electronic medical prescriptions.
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Reis, Marcos Aurélio Seixas dos. "Gerenciamento de risco para medicamentos potencialmente perigosos em serviços hospitalares." Universidade de São Paulo, 2015. http://www.teses.usp.br/teses/disponiveis/22/22134/tde-04032016-163240/.
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A administração de medicamentos se constitui num processo multidisciplinar e um multissistema e seus riscos podem ser reduzidos de forma significativa por meio da implantação de processos reconhecidos para melhoria da segurança. Medicamentos Potencialmente Perigosos (MPP) são medicamentos que possuem maior risco de provocar danos significativos aos pacientes. O gerenciamento de risco em saúde é um processo complexo que associa várias áreas do conhecimento e que tem como objetivo prevenir erros e eventos adversos advindos dos procedimentos e produtos utilizados na assistência, em relação aos MPP, é imprescindível implantar barreiras específicas para gerenciar os riscos envolvidos. O objetivo do estudo foi investigar o gerenciamento de risco de MPP em instituições hospitalares. Estudo transversal, quantitativo, não experimental, realizado em quatro unidades de Terapia Intensiva de hospitais gerais, sendo um público, dois privados com fins lucrativos e um privado beneficente. Foi utilizado um instrumento do tipo questionário, com questões fechadas, elaborado pelo pesquisador, validado para face e conteúdo por cinco juízes e quanto a aplicabilidade por meio de um piloto aplicado em uma unidade de terapia intensiva pediátrica. Os participantes foram todos os membros da equipe de enfermagem das unidades de terapia intensiva pesquisadas e todos os farmacêuticos das instituições pesquisadas. Os resultados apontaram que a participação total foi de 76% da população proposta para o estudo. Todos os medicamentos que compunham o instrumento eram considerados como MPP, entretanto, nenhum foi apontado por 100 % dos participantes como MPP, 17 deles foram apontados como utilizados por 95% ou mais dos entrevistados. Desses, o cloreto de potássio, foi o medicamento mais reconhecido como MPP (99%) e o tramadol o menos reconhecido como perigoso (46%). O medicamento apontado como menos utilizado nas unidades pesquisadas foi o hidrato de cloral (14%), reconhecido como MPP por 78%. O medicamento apontado como menos perigoso foi a água estéril em soluções superiores a 100 ml, reconhecida como MPP por 27% dos entrevistados e utilizada por 90%. Itens considerados rotineiros não foram considerados MPP, dentre eles a solução parenteral prolongada, lidocaína, glicose hipertônica de 25 ou 50%, cloreto de sódio e a enoxaparina, considerados como MPP por 61, 61, 69, 72 e 74% dos entrevistados, respectivamente. Os enfermeiros foram os que mais reconheceram a existência de barreiras de prevenção (96%), já os farmacêuticos os que menos reconheceram (78%). Em média, 84% dos profissionais reconheceram a existência de medidas de prevenção na administração de MPP. A barreira mais reconhecida pelos profissionais foi a de acesso restrito aos MPP (79%). Outra barreira foi a verificação dos certos da terapia medicamentosa, que mesmo sendo uma prática recomendada na administração de todos os medicamentos, foi reconhecida somente por 56% dos entrevistados. O reconhecimento dos MPP, assim como as medidas de prevenção de danos relacionados à esta classe de medicamentos ainda é frágil nas instituições de saúde. A adoção de medidas isoladas ou agrupadas de prevenção de riscos não constituem um sistema de gerenciamento de risco institucional, tampouco em relação aos MPP. A constituição dos comitês de segurança do paciente, além de ser uma obrigação legal pode ser um caminho importante para a efetivação do gerenciamento de risco nas instituições. Diante deste contexto, cabe às instituições de ensino melhorar a qualidade da formação profissional em relação à farmacologia, abordando o tema dos MPP, e aos serviços de saúde implementar programas de educação permanente robustos nos ambientes de trabalho, aplicar barreiras de prevenção baseadas em evidencia de forma sistemática e, finalmente, instituir uma política de incentivo à cultura de segurança do paciente por meio de estratégias educativas, estimulando ações não punitivas ao lidar com os errosThe administration of drugs constitutes a multidisciplinary and multi-system process and its risks can be reduced significantly by implementing recognized processes to improve security. High-Alert Medications (HAM) are drugs that bear a heightened risk of causing harm to the patients. The risk management in healthcare is a complex process that associates several areas of knowledge and aims to prevent errors and events that may come from procedures and products used in assistances. Regarding HAM, it is essential to implement specific barriers in order to manage the risks involved. The objective of this study was to investigate the risk management for HAM in hospital institutions. This study is transversal, quantitative, non-experimental and it was performed in four Intensive Care Units from general hospitals, one of them being public, two of them private for-profit, and one of them a charitable hospital. A questionnaire type instrument containing closed questions made by the researcher was used. Its face and content validation were performed by five judges and its applicability validated by a pilot applied in a pediatric intensive care unit. The participants were the entire nursing staff of the researched intensive care units and the entire pharmacists staff of the researched institutions. The results show that the participants were 76% of the proposed populations for the study. All drugs that formed part of the instrument were HAM, however, none of them were pointed out as HAM by 100% of participants and 17 of them were pointed out as being used by at least 95% of the interviewed. Of these, the potassium chloride was the drug that was most recognized as HAM (99%) and the tramadol was the least recognized as being hazardous (46%). The least used drug in the researched units was the chloral hydrate (14%), it was recognized as HAM by 78% of the participants. The drug pointed out as being the least hazardous was the sterile water in solutions superior to 100mL, recognized as HAM by 27% of the interviewed and used by 90% of them. Routine items were not considered HAM; among them, long-term parenteral, lidocaine, hypertonic glucose 25% or 50%, sodium chloride and enoxaparin were considered HAM by 61, 61, 69, 72 and 74% of the interviewed respectively. The nurses were the ones that most recognized the existence of prevention barriers (96%), whereas the pharmacists were the ones that least recognized them (78%). On average, 84% of the professionals recognized the existence of prevention measures in the administration of HAM. The barrier most recognized by the professionals was the restrict access to HAM. Checking the rights of medication administration was another barrier, recognized only by 56% of the interviewed despite the fact that it is recommended when administering all types of drugs. Recognizing HAM as well as the harm prevention measures regarding this type of medicine is still feeble in healthcare institutions. The adoptions of risk prevention measures, isolated or in group, do not constitute an institutional risk management system, let alone regarding HAM. The constitution of patient security committees, besides being a legal obligation, can be an important path to implement risk management in institutions. In face of this, educational institutions need to improve professional training quality in relation to pharmacology, addressing the HAM theme, and, in relation to healthcare services, they need to implement solid permanent educational programs, apply prevention barriers based on systematic evidence and, finally, institute a patient security culture incentive policy through educational strategies, stimulating non-punitive actions when dealing with errors
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Hogan-Murphy, Diana. "Exploring the facilitators and barriers towards implementation of electronic prescribing, dispensing, and administration of medicines in hospitals in Ireland." Thesis, Robert Gordon University, 2017. http://hdl.handle.net/10059/2710.
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Limited data exist on the facilitators and barriers to implementing electronic systems for medicines management in hospitals. Whilst numerous studies advocate system use in improved patient safety and efficiency within the health service, their rate of adoption in practice has been slow. The aim of this doctoral research was to explore this under-researched area in three phases. Phase one: - Phase one focused on critically appraising and synthesising the available evidence on healthcare professionals’ perceptions, attitudes, and views of the facilitators and barriers to implementing electronic prescribing, electronic dispensing, and/or electronic administration of medicines in the hospital setting. The review protocol was registered with the Centre for Reviews and Dissemination and conducted according to best practice. Key facilitators included systems improved patient safety and provided better access to patients’ drug records and that team leadership and hardware/software availability and reliability were essential for successful implementation. Key barriers consisted of hardware and network problems, altered work practices, and weakened interpersonal communication between healthcare professionals and with patients. Phase two: - This phase employed a qualitative phenomenological design to gain original insight into the perceptions of local key stakeholders towards the facilitators and barriers to implementing prescribing, robotic pharmacy systems, and automated medication storage and retrieval systems in public hospitals in Ireland using Normalization Process Theory as a theoretical framework. Individual face-to-face semi-structured interviews were conducted in three public hospitals in Ireland with 23 consenting participants: nine nurses; four pharmacists; two pharmacy technicians; six doctors; and two hospital Information Technology managers. Enhanced patient safety and efficiency in healthcare delivery emerged as key facilitators to system implementation, as well as the need to have clinical champions and a multidisciplinary implementation team to promote engagement and cognitive participation. Key barriers included inadequate training and organisational support, and the need for ease and confidence in system use to achieve collective action. Phase three: - A similar qualitative methodology was employed in phase three of this research in order to explore the perceptions of national key stakeholders and eHealth leads towards the facilitators and barriers to system implementation. Sixteen consenting invitees participated: eight hospital leads, four government leads, two regulatory leads, and two academics. Key facilitators included enhanced patient safety, workflow efficiencies, improvements in governance, and financial gains. Perceived barriers included the introduction of new drug errors, loss of patient contact, initial time inefficiencies, and issues with the complexity of integration and standardisation of work processes. Overall, adequate technology, stakeholder involvement, and organisational leadership and support are required at a national and local level to drive the eHealth agenda forward. Testing at scale, contingency plans, and ongoing evaluations will assist in determining success or otherwise of system implementation. This research has generated novel findings with many potentially transferable themes identified which extend the evidence base. This will assist organisations to better plan for implementation of medication-related eHealth systems.
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Solti, Imre. "Influence of Organizational, Operational, Financial AndEnvironmental Factors on Hospitals' Adoption of Computerized Physician Order Entry Systems for Improving Patient Safety: A Resource Dependence Approach." VCU Scholars Compass, 2006. https://scholarscompass.vcu.edu/etd/1283.
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This study examines specific organizational, operational, financial and environmental characteristics to identify factors that are associated with increased likelihood of hospitals' CPOE adoption decision in six rollout regions of the Leapfrog initiatives.Resource dependence theory provides theoretical basis for the study. The study is retrospective observational in design. Individual hospitals are the unit of analysis. The Leapfrog Group's 2002-survey collection serves the primary data source. Univariate statistical methods along with bivariate and ordinal logistic regression models are used to analyze the data. The models provided support for multiple hypotheses for both the adoption and early adoption decisions of study hospitals. The operational characteristics of ownership, in-house physician staff, case mix index and the environmental characteristic of HMO penetration rate had a positive effect on management's adoption decisions. The operational characteristic excess capacity, the organizational characteristic community orientation, the financial characteristic of operating income per admission, and the environmental characteristic of number of HMO contracts had a significant negative effect on CPOE adoption decisions.
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Mattos, Elisangela Maria Santos. "Impacto farmacoeconômico da implantação do método de dispensação de drogas em forma de kit em procedimentos cirúrgicos e anestésicos." Universidade de São Paulo, 2006. http://www.teses.usp.br/teses/disponiveis/5/5154/tde-20032007-135530/.
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Proposta: O hospital é parte integrante de um sistema coordenado de saúde, cuja função é a prestação de serviços. Os administradores hospitalares preocupam-se em obter o menor custo possível e maximizar a qualidade. Como o custo hospitalar tem uma parcela importante representada pelo consumo de materiais e medicamentos, sendo a farmácia o setor responsável pelo controle, estoque e dispensação, o profissional farmacêutico tem-se aprimorado profissionalmente e desenvolvido pesquisas e estudos, para reformular suas atividades básicas e retomar algumas funções primárias como a farmacoeconomia, a fim de adequar-se as novas exigências. É relevante neste contexto o sistema de distribuição de medicamentos, que se iniciou com a dose coletiva, cujos principais problemas era o aumento do potencial de erros de medicação, as perdas econômicas decorrentes da falta de controles, e o tempo excessivo gasto pela enfermagem para separar a medicação, em vez de dar assistência aos pacientes. Depois avançou para dose individualizada, que além de minimizar e/ou extinguir todas as desvantagens da dose coletiva, apresentava um controle mais efetivo do consumo dos medicamentos, aumentando a integração do farmacêutico com a equipe de saúde, sendo sua principal desvantagem, o aumento das necessidades de recursos humanos e infra-estrutura da Farmácia Hospitalar. E por último a dose unitária, originada da dose individualizada, que tem como principais objetivos racionalizar a terapêutica, diminuir custos sem reduzir a qualidade da dispensação; e garantir que os medicamentos prescritos cheguem ao paciente de forma segura e higiênica, assegurando a eficácia do esquema terapêutico prescrito. Após associar os conceitos descritos acima, a farmácia do Centro Cirúrgico do Instituto Central do Hospital das Clínicas da Faculdade de Medicina da USP propôs-se a identificar o elenco representativo de produtos, e utilizar estes grupos de medicamentos, na elaboração, ampliação, e experimentação do sistema de dispensação de kit. Esta nova alternativa pretende atingir como os dois principais benefícios a melhor utilização de recursos econômicos e a elevação da qualidade de assistência prestada ao paciente e equipe multiprofissional. Método: O método de pesquisa utilizado foi um estudo de caso qualitativo/quantitativo, sendo o mesmo realizado no Centro Cirúrgico do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, no período de 12/05/2002 a 22/07/2002. Foram escolhidas como amostra as dez salas do bloco III, onde pudemos acompanhar procedimentos de médio e grande porte de determinadas especialidades médicocirúrgicas. O estudo foi dividido em três etapas, sendo as duas primeiras experimentais, e a terceira apenas de análise e interpretação dos achados. Foi realizado o mapeamento do elenco de medicamentos disponibilizado (seja nos carrinhos de drogas, nos kits e nas solicitações extra) e o levantamento do consumo de três dias de funcionamento de cada sala cirúrgica do Bloco III, nas duas etapas experimentais. Na primeira etapa - pré kit - o levantamento foi realizado através da verificação do elenco e das quantidades contidas nos carros de parada e anestesia de cada uma das salas, às 06h30min da manhã antes do início das cirurgias e no final da tarde após o término da última, assim, delimitando o consumo/dia/sala. Estes levantamentos eram feitos em dias aleatórios para não induzir a equipe médica ou a enfermagem em modificar seu consumo. Na segunda etapa - pós kit - realizou-se o levantamento dentro da unidade farmacêutica através da análise dos documentos de dispensação do kit e notas de débito, onde estavam relacionadas as quantidades de medicamentos utilizadas e solicitadas pela auxiliar de enfermagem durante a cirurgia. A confirmação desta documentação era feita através da conferencia do kit e devolução de medicamentos extra. Os carros de medicamentos não estavam mais sendo utilizados, apenas os kits e os medicamentos extra, que pela rotina estabelecida deviam ser devolvidos após o término de cada cirurgia, não permanecendo nada em sala entre uma cirurgia e outra. Após o fechamento dos dois levantamentos pré e pósimplantação do kit procedeu-se às seguintes análises dos resultados: Comparação do consumo de medicamentos por sala/dia; Relação de preço de cada medicamento utilizado; Cálculo do valor total gasto por sala/dia; Comparação do valor gasto por sala/dia. Vale assinalar que: Os anestésicos inalatórios não entraram no levantamento dos medicamentos utilizados nas cirurgias, pois comportam frações diferentes para cada paciente; No primeiro dia de mapeamento (pré e pós) das salas cirúrgicas, os medicamentos vencidos encontrados foram recolhidos e considerados como consumidos. Resultados: Não houve críticas nem reclamações em relação ao novo sistema implantado. Quantitativamente, houve uma redução de aproximadamente 47% no estoque inicial, 54% nas solicitações extras e 30,4% no consumo de medicamentos, com impacto muito relevante sobre os custos. Conclusões: Foi viável e benéfica a prática de implantação dos kits, pois houve redução de aproximadamente 60% nos gastos, estimados pelo preço de medicamentos, traduzindo menores perdas e desperdícios.Purpose: The hospital a integrant of a health coordinated system, which duty is offer services. The hospital administrators\' worry is get the lowest cost as possible and increasing the quality. As the hospital cost has an important installment represented by the medicine and materials consumed, and the pharmacy being the control responsible section, storage and dispensation, the pharmacist has improving professionally and developing researches and studies, in order to reformulate ones basics activities and recover some primary functions such as pharmaco economy, in order to adequate the new demands. The medicine distribution system is relevant in this context, which has started with a collective dose, which the main problems were the medicine error increased, the economic losses because of the lack of control, and the excessive expenses by the nurse ring in order to sort out the medicine, instead of patient care. Then it upgrade to the individual dose, which has not only decrease and /or extinguishes all the disadvantage of collective dose, presented a more effective control of the medicine consume, increasing the pharmacist integration along with health group, being the main disadvantage, the increase of Hospital Pharmacy infrastructure and human recourse need. And the one dose being the last one, being a derivation from the individual dose, which has as the main targets rationalize the therapy, decrease the costs without reducing the dispensation quality; and guaranty that the prescribed medicine reach the patient in a hygienic and safe fashion, guarantying the efficacy of the prescribed therapeutic scheme. After having connect the above described concepts, the Surgery Room of Instituto Central do Hospital das Clínicas da Faculdade de Medicina da USP purpose identify a representative product group, and use these medicine group, on the kit dispensation system elaboration, increase , and experiment. This new alternative intend to hit as the two main benefits which are the better use of economic resources and increasing the assistance quality giving to the patient and to the multi professional team. Method: The used research method applied was a qualitative/quantitative study case, where it was applied at the Centro Cirúrgico do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, from 12/05/2002 to 22/07/2002. Were chosen as samples the ten surgey rooms of Block III, where we could follow big and medium port procedures of specific medical surgery specialties. The study was divided into three steps, where the first two experiments, and the third one was only analyses and comprehension of found. From the available medicine group mapping was taken (which means ones in the drug trolleys, at the kits and the extra solicitations) and the inventory of three day consumptions of each surgery room at the Block III, at the two experimental steps. At the first step - pre kit - the inventory was taken through a verification of the group the quantities which were in the drug emergency trolley and anesthesia of each room, at 06:30 min a.m. before the surgeries starting and at the late afternoon after the last surgery happened, so, determining the consumption/ day/room. These inventories were chosen in random days way in order not to prompt the medical or the nursing group to modify their consumption. At the second step - post kit - the inventory was taken in the pharmacy unit through out of a kit dispensation documents analyses and debit note, which were listed the medicine amount used and from the nurse asked for during the surgery. This document confirmation was done through out of the kit checking and the extra medicine return. The medicine trolley were not use any more, only the kits and the extra medicine, which through the established routine should be returned after each surgery ended, and nothing was left in the surgery room between surgeries. The analyses of the results were taken right after the closing of the two research pre and post kit implementation: Medicine consume comparison by room/day; Listing the price of each medicine used; Total expenses calculated by room/day; Comparison of expenses by room/day. Is worthwhile note that: The inhale ting anesthetic are not considered on the used medicine inventory used at the surgery, because it holds different fractions for each patient; At the first surgery room mapping day (pre and post) the out of day medicine were took away and considered as used. Results: There were no criticism nor complaints related to implemented new system. Quantitatively, there was a decrease of 47% on the initial stock, 54% at the extra solicitations and 30,4% at the medicine consumption, with a very related impact on the costs. Conclusions: The implementation of the kits was totally viable because there was about 60% costs reduction, estimated by the medicine price, presenting less losses and wastings.
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Pereira, Camila Dannyelle Fernandes Dutra. "Seguran?a do paciente no sistema de medica??o: an?lise de enfermeiros de um hospital de ensino." Universidade Federal do Rio Grande do Norte, 2013. http://repositorio.ufrn.br:8080/jspui/handle/123456789/14805.
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Previous issue date: 2013-11-29This study aimed to identify and describe the factors related to Patient Safety in a medication system according to the nurses analysis in a teaching hospital from the photographic analysis method. This was a cross-sectional, descriptive study with mixed approach in a teaching hospital in Rio Grande do Norte. The population consisted of 42 nurses from inpatient units, of which 34 composed the study sample. As eligibility criteria, we defined nurses from public service and nurses who agreed to participate. Ethical determinations were observed, the study was submitted to the Ethics and Research of the University Hospital Onofre Lopes, obtaining the assent with ethical assessment certificate (CAAE 0098.0.051.294-11). For data collection, we used the photographic method (Photographic Analysis Technique) by Patricia Marck (Canada). It was developed in two phases: at first, we randomly captured photos from the medication system, resulting in 282 images; then we selected/processed the photographs, which were reduced to 10 images in Microsoft Excel 2010; in the second phase, the nurses answered the questionnaire divided into socio-professional profile and Digital Photography Scoring Tool (questions a and b ). For analysis of the question a , we used the content analysis technique, and for b , we used the Statistical Package for the Social Sciences 20.0 (temporary license). The socio-professional profile revealed the predominance of females; age group 34-43 years; professionals with specialization; 10-18 years of length of service; and nurses working exclusively in the hospital and who know the Patient Safety. The photographic analysis in relation to Patient Safety resulted in specific categories for each stage of the medication system. Regarding disposal, we identified Proper verification ; Improper verification ; Correct identification ; Disposal in single doses ; and Improper Environment , with predominance of that last category. As for storage: Proper storage ; Improper storage ; Risk of exchange/disappearance ; and Poor hygiene , with special reference to improper storage. In preparation: Risk of exchanging medication/patient ; Inappropriate physical space ; and Inadequate 9 preparation of controlled drugs , highlighting the first category. In drug administration: Lack of Personal Protective Equipment ; Use of Personal Protective Equipment ; Improper administration technique ; Proper administration technique ; Correct drug identification ; Incorrect drug identification ; and Peripheral venous access without identification . From the safety assessment of 10 photographs, by adapting the scores (1-10) to the Likert Scale, we identified three Totally Unsafe (Level 1), three Unsafe (Level 2), three Partially Safe (Level 3), one Safe (Level 4), and no photograph considered Totally Safe. This study identified the prevalence of unsafety in the medication system in the nurses opinion. We were also able to understand that, although nurses identify safety aspects, the most prevalent categories characterize an unsafe assessment. Nursing needs to reflect on its practice, identifying gaps in the medication system in order to achieve a proper and safe care
O estudo teve como objetivo identificar e descrever os fatores relacionados ? Seguran?a do Paciente em um sistema de medica??o de acordo com a an?lise de enfermeiros de um Hospital de Ensino a partir do m?todo de an?lise fotogr?fica. Tratou-se de um estudo transversal, descritivo, com abordagem mista em um hospital de ensino no Rio Grande do Norte. A popula??o foi composta por 42 enfermeiros das unidades de interna??o, dos quais 34 compuseram a amostra. Como crit?rios de elegibilidade definiu-se enfermeiros servidores p?blicos e que aceitaram participar do estudo. As determina??es ?ticas foram respeitadas, o estudo foi submetido ao Comit? de ?tica e Pesquisa do Hospital Universit?rio Onofre Lopes, obtendo o parecer favor?vel com certificado de aprecia??o ?tica (CAAE n? 0098.0.051.294-11). A coleta dos dados utilizou o m?todo fotogr?fico (T?cnica de An?lise Fotogr?fica) de Patr?cia Marck (Canad?), desenvolvido em duas fases: inicialmente foi realizada captura aleat?ria das fotografias do sistema de medica??o, resultando em 282 imagens; em seguida, realizou-se sele??o/tratamento das fotografias, que foram reduzidas a 10 imagens no Microsoft Excel 2010; na segunda fase, os enfermeiros responderam ao question?rio dividido em perfil s?cioprofissional e Digital Photography Scoring Tool (quest?es a e b ). Para an?lise da quest?o a utilizou-se a t?cnica de an?lise de conte?do e da b o Statistical Package for the Social Scienses-20.0 (licen?a tempor?ria). O perfil s?cioprofissional caracterizou-se pelo predom?nio: do sexo feminino; da faixa et?ria 34-43 anos; de profissionais com especializa??o; do tempo de servi?o de 10 a 18 anos; de enfermeiros que atuam exclusivamente no hospital e que conhecem a Seguran?a do Paciente. A avalia??o da fotografia em rela??o ? Seguran?a do Paciente resultou em categorias espec?ficas para cada etapa do sistema de medica??o. Da dispensa??o, identificou-se: Confer?ncia adequada ; Confer?ncia inadequada ; Identifica??o correta ; Dispensa??o em dose unit?ria e Ambiente impr?prio , com predomin?ncia desta ?ltima categoria. No armazenamento: Armazenamento adequado ; Armazenamento inadequado ; 7 Risco de troca/desaparecimento e Higiene prec?ria , com destaque para o armazenamento inadequado. No preparo: Risco de troca de medicamento/paciente ; Espa?o f?sico inapropriado e Preparo inadequado de medicamentos de uso controlado ; destacando-se a primeira categoria. Na administra??o dos medicamentos: Aus?ncia de Equipamento de Prote??o Individual ; Uso de Equipamento de Prote??o Individual ; T?cnica incorreta de administra??o ; T?cnica correta de administra??o ; Identifica??o correta do medicamento ; Identifica??o incorreta do medicamento e Acesso venoso perif?rico sem identifica??o . Da avalia??o da seguran?a das 10 fotografias, adaptando os escores (1 a 10) ? Escala de Likert, identificou-se: tr?s Totalmente Inseguras (Grau 1), tr?s Inseguras (Grau 2), tr?s Seguras Parcialmente (Grau 3), uma Segura (Grau 4), n?o havendo fotografia considerada Segura Totalmente. Este estudo identificou o predom?nio da inseguran?a no sistema de medica??o na opini?o dos enfermeiros. Ainda, possibilitou compreender que, apesar dos enfermeiros perceberem aspectos seguros, as categorias de maior preval?ncia caracterizam uma avalia??o insegura. A enfermagem precisa refletir acerca da pr?tica, identificando falhas no sistema de medica??o para alcan?ar um cuidado adequado e seguro
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Salles, Roseluci Santos de. "Educação permanente: potencialidades para a cultura da qualidade em uma instituição pública de saúde." Universidade Federal Fluminense, 2013. https://app.uff.br/riuff/handle/1/1235.
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Mestrado Profissional em Ensino na Saúde
Os processos de Educação Permanente surgem para os serviços em geral e seus setores de treinamento ou capacitação com a necessidade da adoção da concepção pedagógica problematizadora, com o propósito de estimular a reflexão da prática e a construção do conhecimento. Nas instituições de saúde não é diferente, porquanto seus trabalhadores cotidianamente precisam também aplicar adequadamente seus conhecimentos à realidade, o que frequentemente ocorre em um cenário complexo, onde a habilidade técnica deve-se aliar à de realizar ações que assegurem a continuidade do processo de trabalho. Nesse contexto, a segurança do paciente internado em um hospital está ligada ao desenvolvimento de algumas ações preventivas, que devem estar baseadas em princípios universais e na realidade específica da unidade de saúde. O gerenciamento do uso seguro de medicamentos é uma prioridade quando se trata de minimizar riscos para o paciente. Nesse cenário, foi delimitado como objetivo principal descrever sobre uma educação permanente fundada na cultura institucional da qualidade, a partir do cotidiano de profissionais envolvidos no processo de medicação do paciente internado; como objetivos secundários: relacionar as principais questões/problemas ligadas ao processo de educação permanente; conhecer possíveis estratégias adotadas pelos profissionais envolvidos com a saúde dos pacientes internados, no enfrentamento de questões ligadas ao processo de medicação e sua efetividade e; identificar estratégias educacionais com potencial de promover a interação/discussão e a solução multiprofissional de questões e problemas ligados ao processo de medicação dos pacientes internados. Metodologia: estudo descritivo de abordagem qualitativa, desenvolvido no Instituto Nacional de Traumatologia e Ortopedia (INTO), instituição pública de saúde, acreditada há seis anos, de referência nacional no atendimento de alta complexidade, localizado no município do Rio de Janeiro. Utilizaram-se como técnicas de coleta de dados: entrevistas em profundidade e grupo focal, em amostra intencional composta por 15 profissionais de saúde. Os dados foram tratados por análise de conteúdo conforme Bardin. Resultados: Da análise dos dados emergiram três categorias, a saber: A Educação Permanente para o compromisso; A Educação Permanente para o convívio e; A Educação Permanente para a mudança. As categorias emergidas mostraram as perspectivas do fenômeno estudado no que compete às dificuldades, ações multiprofissionais para resolução de problemas e para geração da mudança do processo de trabalho no que se relaciona ao processo de medicação do paciente internado. Conclusão: A concepção de Educação Permanente em um serviço de saúde no cumprimento de seu objetivo transformador de ações cotidianas prevê o conhecimento contínuo sobre seus trabalhadores e os aspectos que os tornam participantes do processo na construção de mudanças. A reflexão sobre educação em serviços de saúde dialoga com a que se dá sobre a qualidade da assistência em tais serviços. Assim, o desenvolvimento dos processos de trabalho de uma unidade hospitalar que prima pela qualidade na assistência prestada ao seu cliente, vai além de implementar uma metodologia de gestão que garanta a realização das tarefas conforme os padrões pré-estabelecidos em manuais, rotinas e protocolos.
The processes of Permanent Education for services in general and their training sectors or capacity with the need to adopt the questionable instructional design, in order to stimulate reflection on practice and knowledge construction. In health institutions is no different, because its workers daily need also appropriately apply their knowledge to reality, which often occurs in a complex scenario, where technical skill should be combined with actions to ensure continuity of the work process. In this context, the safety of the patient at hospital is linked to the development of some preventive actions, which must be based on universal principles and the specific reality of the health unit. Manage the safe use of medicines is a priority when it comes to minimizing risks to the patient. Main aim: to describe about one permanent education founded on institutional quality culture, from the everyday lives of professionals involved in medication process of the in-patient. Secondary aims: relate the main issues related to the process of education permanent; know possible strategies adopted by professionals involved with the health of hospitalized patients, in coping of issues related to the medication process and its effectiveness and; identify educational strategies with potential to promote interaction / discussion and multidisciplinary solution of issues and problems related to medication process of inpatients. Methodology: A descriptive qualitative study, developed at the National Institute of Traumatology and Orthopaedics (INTO), public health institution, accredited for six years, national reference in high-complexity care, located in the municipality of Rio de Janeiro. Were used as techniques of data collection: in-depth interviews and focus groups in intentional sample of 15 health professionals. Data were treated by content analysis according to Bardin. Results: Data analysis revealed three categories, namely: Permanent Education for commitment; Permanent Education for socializing and; Permanent Education for change. The categories that emerged showed the prospects of the studied phenomenon related to difficulties, multidisciplinary actions for problem solving and generation change in the working process as it relates to the process of inpatient medication. Conclusion: The concept of Permanent Education in a health service in fulfilling its goal of transforming everyday actions provides the continued knowledge about its employees and the aspects that make them participants in the construction process of change. The reflection about education in health services dialogues with a reflection that occurs about the quality of care in such services. Thus, the development of work processes within a hospital unit that excels in quality of care provided to your customer goes beyond implementing a management methodology that ensures the tasks according to pre-established standards in manuals, routines and protocols.
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Santos, Márcia Farias de Oliveira dos. "Incidentes críticos dos processos de medicação em uma unidade neonatal: contribuição para a gerência do cuidado de enfermagem." Universidade Federal Fluminense, 2014. https://app.uff.br/riuff/handle/1/1081.
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Mestrado Acadêmico em Ciências do Cuidado em Saúde
Estudo realizado para obtenção do grau de Mestre em Ciências do Cuidado em Saúde da Universidade Federal Fluminense. Objeto: os processos de medicação realizados pela equipe de enfermagem da Unidade Neonatal do Hospital Universitário Pedro Ernesto. Objetivos: Descrever os processos de preparo e administração de medicamentos, executados pela equipe de enfermagem da unidade, através da construção de fluxogramas; Analisar por meio de incidentes críticos as situações, comportamentos e consequências, positivos e negativos, identificados nos processos de preparo e administração de medicamentos, a partir do relato da equipe de enfermagem. Método: Pesquisa descritiva, qualitativa, utilizando a Técnica do Incidente Crítico (TIC). Para coleta de dados a proposta foi de realização de entrevistas individuais, semiestruturadas com profissionais de enfermagem lotados no cenário do estudo pelo menos desde março de 2012, realizando atividades de assistência direta de enfermagem, sendo esta a amostragem proposital. Foi considerada atingida a saturação dos dados com 39 entrevistas realizadas, sendo 20 com enfermeiros e 19 com técnicos de enfermagem. Para realização das entrevistas contou-se com uma auxiliar de pesquisa. O material foi gravado e posteriormente transcrito. O conteúdo das entrevistas foi lido exaustivamente e pré-analisado nos moldes da TIC tendo como base a separação, nos textos de cada entrevista, dos elementos situação, comportamento e consequência e polaridades positiva e negativa. Por escolha metodológica de unir a análise de conteúdo preconizada por Flanagan àquela descrita por Bardin, os dados foram lançados em quadros, gerando unidades de registro. A seguir foi realizado o agrupamento dos incidentes críticos positivos e negativos em subcategorias, nomeadas por palavras-chave que emergiram dos conteúdos (unidades de significância), Oito categorias foram obtidas, quatro por polaridade: time de medicação, divisão de tarefas, atividades técnicas e atuação da gerência. Leituras das normas e rotinas de medicação da Unidade serviram de base para elaboração de fluxogramas dos processos de trabalho estudados. Como conclusão do estudo foi apresentado que a fluxogramação dos processos indicou a necessidade de reavaliação na divisão de tarefas durante o processos de preparo de medicamentos e necessidade de inclusão de atividades de monitoramento do sistema de medicação. Quanto a análise dos incidentes críticos, as subcategorias de incidentes negativos com mais relatos agrupados foram as denominadas divisão de tarefas e atividades técnicas. Nessas subcategorias os relatos apontaram uma preocupação com a persistência dos erros, com questões éticas e com atividades desenvolvidas em outras fases do sistema de medicação, pontos considerados prioritários nos estudos produzidos na área. Em relação à persistência dos erros, as duas metodologias utilizadas apontam para o mesmo caminho: a necessidade de monitoramento dos eventos adversos e de adoção de estratégias que diminuam a ocorrência e persistência desses eventos. Espera-se que os resultados obtidos e o produto do trabalho possam colaborar com o contínuo desenvolvimento do processo de medicação adotado na Unidade Neonatal, com o desenvolvimento de pesquisas na Instituição e com a melhoria da assistência de enfermagem em geral, já que apresenta metodologias aplicáveis à análise de processos de trabalho em qualquer realidade de cuidado.
This is a research project for the Academic Master’s Degree in the Sciences of Health Care, of the Fluminense Federal University. Object: medication processes executed by the nursing team in the Neonatal Unit of the University Hospital Pedro Ernesto.. Objectives: To describe the process of preparing and administrating the medication, which are performed by the nursing team, byusing flowcharts created to represent this work process. To analyze the situations, behavior and consequences - both positive and negative - identified in the process, based on the reports of the professionals involved. Method: This is a descriptive, qualitative research, using the Critical Incident Technique (CIT) approach. The data was collected through individual, semi-structured, recorded interviews with nursing professionals from the University Hospital. Those workers should be part of the hospital staff at least since march 201, and be involved in activities of direct care, thus being an stratified sample.The data was saturated after interviewing 39 employees: 20 nurses e 19 nurse technicians. A research assistant helped collect the interviews. The data was recorded and later transcribed. The material was then extensively read and preanalyzed following the CIT precepts. ,by separating the following elements: situation, behavior and consequence, and its respective positive and/or negative polarities. It was decided that the methodology of this research would unite the content analysis as it was defined by Flanagan to that of Bardin; this resulted in the creating of data tables from which registration unities were extracted. Afterwards, the positive and negative critical incidents were grouped in subcategories, named after key-words noted from the content of the interviews. Eight categories were obtained, four per polarity: the medication team, task division, implanted technical activities and the actions of the management. The rules and routines of the medication unit served as the base for the elaboration of flowcharts of the studied work processes. The resulting flowchart indicated the need to reevaluate the task division in the process of preparing and administrating the medications, as well as the inclusion of monitoring activities in the medication system. The analysis of the critical incidents showed that the subcategory of negative critical incidents with the most reports were task division and implanted technical activities, in which reports indicated concerns about the persistence of errors, ethical matters and with the activities performed in other stages of the medication process; points that are consistently approached in studies in the field. In relation to error persistence, both of the methodologies applied point out to the same path: the need to monitor the adverse events, and the implementation of strategies to reduce its persistency and occurrences. The author hopes that the results obtained might assist with the continuous development of the medication system adopted by the Neonatal Unit and with the development of researches in the institution, as well as helping improve the nursing assistance in general, since this research works with a methodology which can be applied in the analyzes of work processes in any care-related context.
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Sousa, Fernanda Raphael Escobar Gimenes de. "A segurança de pacientes na administração de medicamentos em uma unidade de terapia intensiva de um hospital geral do interior paulista: a abordagem restaurativa em saúde." Universidade de São Paulo, 2011. http://www.teses.usp.br/teses/disponiveis/22/22132/tde-29082011-144409/.
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Os atuais serviços de saúde tornaram-se ambientes complexos e vulneráveis, fazendo-nos repensar acerca da necessidade de simplificar os processos de trabalho de modo a torná-los mais éticos e seguros. Os objetivos do estudo foram analisar o sistema de medicação e os processos de preparo e de administração de medicamentos de uma UTI, à luz da abordagem restaurativa em saúde. Tratou-se de pesquisa multimétodos, com delineamento embutido, a qual aplicou técnicas de coleta de dados embasadas na perspectiva sócio-ecológica: grupos focais, narração fotográfica e foto elicitation. A pesquisa foi realizada em uma UTI de um hospital geral do interior paulista e envolveu a participação de 23 profissionais da enfermagem e um médico intensivista. A investigação ocorreu em quatro fases. Na primeira, grupos focais foram formados com o objetivo de fazer emergir as opiniões dos participantes em relação aos aspectos de segurança, bem como identificar situações no ambiente e nos processos de trabalho que poderiam comprometer a segurança do paciente no preparo e na administração de medicamentos. Na segunda, a pesquisadora, junto à gerente de enfermagem, realizou narrativas visuais com os propósitos de refletir sobre o ambiente assistencial onde os medicamentos são preparados e administrados, de observar condições passadas e de identificar possibilidades de melhorias futuras, no que diz respeito aos aspectos de segurança. Na terceira fase, as imagens foram expostas ao segundo grupo focal com a finalidade de identificar potenciais mudanças a serem implantadas no sistema de medicação, bem como nos processos, nas práticas, nas políticas e no ambiente de trabalho da UTI. Na quarta, novos registros fotográficos foram feitos com o propósito de captar as mudanças ocorridas no sistema de medicação e no ambiente assistencial da UTI, por meio da comparação destes com as fotografias obtidas durante a segunda fase da pesquisa. A coleta e a análise dos dados ocorreram de maneira interativa em todas as fases da investigação, segundo a orientação teórica da abordagem restaurativa em saúde. Os achados auxiliaram na compreensão das barreiras e das medidas facilitadoras voltadas para a segurança no preparo e na administração de medicamentos, a partir da obtenção de seis temas: Identificando o ambiente assistencial como contribuinte para a segurança no preparo e na administração de medicamentos; Identificando riscos no ambiente assistencial; Percebendo o ambiente assistencial como fator de risco para os acidentes ocupacionais; Tendo que conviver com o sentimento de \"impotência\" diante da cultura organizacional vigente; Convivendo com os improvisos no dia-a-dia do trabalho e Vislumbrando possibilidades de mudanças no ambiente assistencial. A partir da construção conjunta do conhecimento entre pesquisadora e pesquisados, os resultados forneceram subsídios para pesquisas futuras e revelaram que os problemas existentes no sistema interferem na segurança, tanto do paciente como do profissional, devendo a instituição rever a forma de gerenciar os riscos existentes no ambiente assistencial.The current health services have become vulnerable and complex environments. This has made us rethink about the need of simplifying the work processes so that they are more ethical and safer. The goals of the study were the analysis of the medication system and the processes of preparing and administering the medications at an ICU, in the light of the restorative approach in healthcare. It was a multi-method research, with an embedded delineation, which applied collecting techniques of data having a social ecological perspective: focus groups, photo narration and photo elicitation. The research was performed at an ICU of a general hospital in a city in the São Paulo state and it involved the participation of 23 nursing professionals and an intensivist physician. The investigation occurred in four phases. First, focus groups were formed with the goal of getting the participants\' opinions related to the safety aspects to emerge, as well as identifying situations in the work environment and in the processes that could compromise the patient\'s safety in the preparation and in the administration of medications. Next, the researcher, along with the nursing manager, performed several visual narratives with the purpose of reflecting about the healthcare environment where the medications are prepared and administrated, observing past conditions and identifying possibilities of future improvements, when it comes to the safety aspects. After that, the images were exposed to the second focus group with the aim to identify potential changes to be implemented in the medication system, as well as in the processes, in the practices, in the politics and in the workplace environment at the ICU. At the last phase, new photographic registrations were done with the aim to get the changes occurred in the medication system and in the care environment at the ICU, by comparing these ones with the pictures obtained during the second phase of the research. Collecting and analyzing data was performed in an interactive way at all the phases of the investigation, according to the theoretical orientations of the restorative approach in healthcare. The findings helped in understanding the barriers and the facilitating measures directed to the safety in the preparation and administration of medications, after obtaining six themes: Identifying the healthcare environment as a contributor for the safety in the preparation and administration of medications; Identifying risks in the healthcare environment; Realizing the healthcare environment as a risk factor for the occupational accidents; Having to live with an \"impotence\" feeling before the current organizational culture; Living with the everyday workarounds; and Envisioning possible changes in the healthcare environment. From the joint construction of the knowledge among the researcher and the investigated ones, the results provided subsidies for future investigations and revealed that the problems in the system interfere in the safety, both the patient and the professional, having the institution a necessity to revise the way it manages the risks in the healthcare environment.
Books on the topic "Medication Systems, Hospital"
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A, Patton Kurt, and Potter Maureen Connors, eds. Medication management and reconciliation. Marblehead, MA: HCPro, 2007.
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Gibbs, Maureen. Medication management and reconciliation. Marblehead, MA: HCPro, 2007.
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American Society of Health-System Pharmacists, ed. Safe and effective medication use in the emergency department. Bethesda, MD: American Society of Health-System Pharmacists, 2009.
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Hoffmann, Richard P. Drug death: A danger of hospitalization : an expose of life-threatening adverse drug reactions and medication errors in hospitals. Springfield, Ill., U.S.A: Thomas, 1989.
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Inc, Joint Commission Resources, ed. A guide to the Joint Commission's medication management standards. 2nd ed. Oakbrook Terrace, Ill: Joint Commission Resources, 2009.
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Gulseth, Michael. Managing anticoagulation patients in the hospital: The inpatient anticoagulation service. Bethesda, Md: American Society of Health-System Pharmacists, 2007.
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Posey, L. Michael. Complete review for the pharmacy technician. 2nd ed. Washington, D.C: American Pharmacists Association, 2007.
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Posey, L. Michael. APhA's complete review for the pharmacy technician. Washington, D.C: American Pharmaceutical Association, 2001.
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author, Weitzel Kristin W., and American Pharmacists Association, eds. Complete review for the pharmacy technician. Washington, D.C: American Pharmacists Association, 2014.
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Detection and prevention of adverse drug events: Information technologies and human factors. Amsterdam: IOS Press, 2009.
Find full textBook chapters on the topic "Medication Systems, Hospital"
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Bjørnstad, Camilla, and Gunnar Ellingsen. "Integration and Medication in Hospitals." In Advances in Intelligent Systems and Computing, 815–24. Cham: Springer International Publishing, 2017. http://dx.doi.org/10.1007/978-3-319-56538-5_82.
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Sales, Leila, Bárbara Rodrigues, Catarina Santos, Maria Ferreira, and Isabel Lucas. "Medication Errors Prevention in Hospitals: Barcode Point of Care System." In Health and Social Care Systems of the Future: Demographic Changes, Digital Age and Human Factors, 152–62. Cham: Springer International Publishing, 2019. http://dx.doi.org/10.1007/978-3-030-24067-7_18.
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Ker, Jun-Ing, Yichuan Wang, and Cappi W. Ker. "Reducing Medication Dispensing Process Time in a Multi-Hospital Health System." In Proceedings of the Institute of Industrial Engineers Asian Conference 2013, 1109–16. Singapore: Springer Singapore, 2013. http://dx.doi.org/10.1007/978-981-4451-98-7_132.
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El Abkari, Safae, Soufiane Kaissari, Jamal El Mhamdi, Abdelilah Jilbab, and El Hassan El Abkari. "RFID System for Hospital Monitoring and Medication Tracking Using Digital Signature." In Digital Technologies and Applications, 1051–60. Cham: Springer International Publishing, 2021. http://dx.doi.org/10.1007/978-3-030-73882-2_96.
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Albolino, Sara, Marco De Luca, and Antonino Morabito. "Patient Safety in Pediatrics." In Textbook of Patient Safety and Clinical Risk Management, 299–308. Cham: Springer International Publishing, 2020. http://dx.doi.org/10.1007/978-3-030-59403-9_21.
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AbstractSince the publication of the 1999 IOM report “To Err Is Human: Building a Safer Health System,” much has been learned about pediatric patient safety. However, adverse events still affect one-third of all hospitalized children [1]. The main areas of adverse events are hospital-acquired infections, intravenous line complications, surgical complications, and medication errors [2].
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Hunt, Sevgin, and Joyram Chakraborty. "Electronic Health Records in Hospitals: Preventing Dosing Errors in the Medication Administration Context." In Advances in Intelligent Systems and Computing, 65–76. Cham: Springer International Publishing, 2019. http://dx.doi.org/10.1007/978-3-030-20451-8_7.
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Akiyama, Masanori, Atsushi Koshio, and Nobuyuki Kaihotsu. "Analysis on Data Captured by the Barcode Medication Administration System with PDA for Reducing Medical Error at Point of Care in Japanese Red Cross Kochi Hospital." In IFIP Advances in Information and Communication Technology, 122–29. Berlin, Heidelberg: Springer Berlin Heidelberg, 2010. http://dx.doi.org/10.1007/978-3-642-15515-4_13.
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Chan, Stephen L. "End-User Directed Requirements - A Case in Medication Ordering." In Advances in End User Computing, 72–82. IGI Global, 2002. http://dx.doi.org/10.4018/978-1-930708-42-6.ch005.
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This paper presents a physician ordering entry system in the ward (for medication prescriptions) by using scanning and image processing. Important design and operational issues that need to be considered by developers of similar end-user computer systems are presented. Then the scanning and imaging processing system (SIPS) is described. SIPS was developed for the Hong Kong Baptist Hospital (HKBH), Kowloon, Hong Kong and has been in successful operation for over three years in the hospital. The development of SIPS was based on end-user directed requirements. SIPS makes use of and integrates different information technologies, including scanning, bar code and other marks recognition, intelligent image capturing, server database access and retrieval, and network communication and printing. We observe that the end-user context has directed the design and development of the system. On the other hand, the use of SIPS led to the implementation of new operational procedures, resulting in improved quality healthcare delivery in the ward and increased productivity of the medical personel.
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Lara-Millán, Armando. "Building a Public Hospital That Everyone Knows Is Too Small." In Redistributing the Poor, 120–48. Oxford University Press, 2021. http://dx.doi.org/10.1093/oso/9780197507896.003.0005.
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This chapter presents the historical transformation of the Los Angeles County hospital system in order to understand the restriction of medicine in large public hospitals. In contrast to a simple story of underfunding, the chapter details how legal demand and austerity pushed local government to reinvest in public healthcare but downsize inpatient capacity. Officials re-emphasized their patients less as local residents in need of urgent care and more as non-urgent patients, homeless, and immigrants in need of early intervention. Doing so allowed them to draw in funds from the federal government to reconfigure their healthcare systems away from inpatient care. In the process, however, legal and regulatory agencies began threatening public hospitals for dangerous overcrowding. Such pressure led directly to the development of waiting line management techniques—such as policing, closer observation of waiting patients, and opiate medication—that, in practice, worked to restrict care.
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Relíquias, Tânia Patrícia Cabo, Carmen Dolores Roque Agostinho, and Maria do Céu Marques. "Falls in Elderly." In Handbook of Research on Health Systems and Organizations for an Aging Society, 196–207. IGI Global, 2020. http://dx.doi.org/10.4018/978-1-5225-9818-3.ch015.
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The objective of this chapter is to identify the risk factors and preponderant causes of falls in the hospital elderly inpatients. A survey on the search engines B-on, EBSCO, and Pubmed, followed by an analysis of the title and abstract is done. Afterwards, the authors analyze all the articles with full text available in Portuguese, Spanish, and English. The most common risk factor for falls in the analyzed articles was being aged above 65 years old. More than half of the articles also mentioned intrinsic factors such as mental disorder, mobility disorder, and use of medication. As for extrinsic factors associated with risk of falls, most of the articles mentioned the characteristics of bed/chair and the obstacles associated with the physical/environmental infrastructures. The prevention strategies for this phenomenon must consider each country and care unit specifically as well as the specific characteristics of its patients, aiming to promote the care quality.
Conference papers on the topic "Medication Systems, Hospital"
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Coles, Garill A. "Prospective System Assessments Used to Enhance Patient Safety: Case Studies From a Collaboration of Engineers and Hospitals in Southwest Washington State." In ASME 2007 International Mechanical Engineering Congress and Exposition. ASMEDC, 2007. http://dx.doi.org/10.1115/imece2007-42740.
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It is no secret that healthcare, in general, has become an increasingly complicated mixture of technical systems, complex processes and intricate skilled human interactions. Patient care processes have followed this same trend. The healthcare industry, itself, has acknowledged that it is fraught with high-risk and error prone processes and cite medication management systems, invasive procedures and diagnostic methods. Complexity represents opportunity for unanticipated events, process failures and undesirable outcomes. Traditionally when a patient care process fails, accountability was focused on the individual clinician error. However, increasing, healthcare is following the lead of other high-risk industries (e.g. chemical, aerospace, nuclear, etc.) that give attention to the characteristics the overall system that contribute to the failure. The focus has shifted to identification of systemic weaknesses and vulnerabilities. Increasing the healthcare industry is using prospective system assessment methods to evaluate the high-risk systems and processes. This paper describes results of collaboration between engineers and community hospitals in Southwest Washington State between 2002 and 2007 in applying prospective system assessment methods to a range of the high-risk healthcare systems and processes. The methods used are Failure Mode Effects and Criticality Analysis and Probabilistic Risk Assessment. The two case studies presented are: 1) an interhospital FMEA on patient transfer and 2) a risk assessment of mental health patients who present themselves in a hospital Emergency Department.
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Mustafa, Fadhil Ilham, Nurfitri Bustamam, and Andri Pramesyanti. "Association between Compliance Level on Fixed-Dose Combination Antiretroviral Drug and CD4 Level among HIV Patients." In The 7th International Conference on Public Health 2020. Masters Program in Public Health, Universitas Sebelas Maret, 2020. http://dx.doi.org/10.26911/the7thicph.02.03.
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Background: People living with HIV / AIDS (PLWHA) have weak immune systems and are prone to infection. Therefore, PLWHA must take antiretroviral (ARV) to maintain their immunity. This study aimed to determine the relationship between the level of adherence to taking ARV fixed-dose combination (FDC) drugs and CD4 levels of HIV patients. Subjects and Method: This was a cross-sectional study conducted at Pengayoman Cipinang Hospital, Indonesia, in 2018. Total of 91 HIV patient over 17 years of age, had or had received FDC ARV therapy for at least 1 year, and did not experience drug-induced hepatitis were enrolled in this study. The dependent variable was CD4 level. The independent variable was level of adherence to taking ARV fixed-dose combination (FDC). The data were taken from the Voluntary Counseling and Testing Poli Pengayoman Cipinang Hospital. This study used secondary data from the Overview of HIV Care and ARV Therapy. The data were analyzed using Chi-square. Results: A total of 65.93% HIV patients had a good level of medication adherence and 79.12% had an increase of CD4 levels. There was a significant relationship between adherence to taking FDC ARV drugs and CD4 levels (OR = 6.50; 95% CI = 2.15 to 19.62; p<0.001), and it was statistically significant. Conclusion: There is a significant relationship between the level of adherence to taking FDC ARV drugs and CD4 levels. Therefore, patients must receive education and support to improve adherence to taking ARV drugs. Keywords: antiretroviral, CD4, fixed-dose combination, adherence to taking medication, people with HIV / AIDS Correspondence: Fadhil Ilham Mustafa. Faculty of Medicine, Universitas Pembangunan Nasional Veteran, Jakarta. Jl. RS Fatmawati, Pondok Labu, South Jakarta. Email: fadhilimn@gmail.com. Mobile: 081283681755. DOI: https://doi.org/10.26911/the7thicph.02.03
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Pop, Petru A., Liviu Lazar, and Florin M. Marcu. "Significance of Kinetotherapy in Rehabilitation Treatment of Osteoporosis." In ASME 2013 International Mechanical Engineering Congress and Exposition. American Society of Mechanical Engineers, 2013. http://dx.doi.org/10.1115/imece2013-64784.
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Osteoporosis is a systemic skeleton disease, characterized by a low bone mass and micro-architectural deterioration of bone tissue with consecutive increasing of fragile bones and susceptibility of fractures. Risk facture, advanced ages, family history, rheumatoid arthritis, low calcium intake, physical inactivity, and low body weight can lead to this condition. The aim of treatment in osteoporosis is to grow-up the bone mineral density of the skeleton and to increase resorption of formed bone, used diverse methods as medications, conservative measures, weight reduction, physical and occupational therapy, mechanical support devices and surgery. This paper presents a balneal-conservative treatment applied to 82 patients diagnosed with osteoporosis from Rehabilitation Clinical Hospital of Felix Spa in 2011–2012, which has combined with a kinetotherapy and medication treatment. The complex rehabilitation treatment involves balneal-physical-kinetic recovery treatment that must be periodical repeated every six months, while the subjects themselves at home followed the kinetotherapy with drugs between balneal-treatments at hospital. The significance of rehabilitation treatment for the osteoporosis patients is to rise both functional and independence level, and improving their quality life. DEXA, Qualeffo-41 Test, fragility fractures, difference of height patients, using the statistical analysis have performed the evaluation of trial. These results emphasized the efficiency of balneal-rehabilitation treatment with main accent on respect the kinetotherapy applied the osteoporosis patients. The future research will be focused upon the implementation of vibration therapy with balneal-conservative treatment on patients with osteoporosis to reduce the therapy time and improving the quality patients life.
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Chircu, Alina M., Janis L. Gogan, Ryan J. Baxter, and Scott R. Boss. "Handoffs and Medication Errors: A Community Hospital Case Study." In 2011 44th Hawaii International Conference on System Sciences (HICSS 2011). IEEE, 2011. http://dx.doi.org/10.1109/hicss.2011.218.
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Naseralallah, Lina Mohammad, Tarteel Ali Hussain, Shane Pawluk, and Myriam Eljaam. "The Impact of Pharmacist Interventions on Reducing Medication Errors in Pediatric Patients: A Systematic Review and Meta-analysis." In Qatar University Annual Research Forum & Exhibition. Qatar University Press, 2020. http://dx.doi.org/10.29117/quarfe.2020.0153.
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Background: Medication errors are avoidable events that could occur at any stage of the medication use process. They are widespread in the healthcare system and are associated with increased risk of morbidity and mortality. Implementing a clinical pharmacist is one strategy that is believed to reduce medication errors in the general population including pediatric patients who are more vulnerable to medication errors due to several contributing factors including the challenges of weight-based dosing. Aim: The aim of this study is to qualitatively and quantitatively evaluate the impact of clinical pharmacist interventions on medication error rates for hospitalized pediatric patients. Methodology: PubMed, Embase, Cochrane and Google Scholar search engines were searched from database inception to February 2019. Study selection, data extraction and quality assessment was conducted by two independent reviewers. Observational and interventional studies were included. Data extraction was done manually and the Crowe Critical Appraisal Tool (CCAT) was used to critically appraise eligible articles. Summary odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using a random-effects model for rates of medication errors. Results: A total of 19 studies were systematically reviewed and 6 studies (29 291 patients) were included in the meta-analysis. Pharmacist interventions involved delivering educational sessions, reviewing prescriptions, attending rounds and implementing a unit-based clinical pharmacist. The systematic review showed that the most common trigger for pharmacist interventions was inappropriate dosing. Pharmacist involvement was associated with significant reductions in the overall rate of medication errors occurrence (OR, 0.27; 95% CI, 0.15 to 0.49). Conclusion: The most common cause for pharmacist interventions in pediatric patients at hospital settings was inappropriate dosing. Overall, pharmacist interventions are effective at reducing medication error rates.
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Litster, Shawn, Byunghang Ha, Daejoong Kim, and Juan G. Santiago. "A Two-Liquid Electroosmotic Pump for Portable Drug Delivery Systems." In ASME 2007 International Mechanical Engineering Congress and Exposition. ASMEDC, 2007. http://dx.doi.org/10.1115/imece2007-42583.
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Portable drug delivery systems present an opportunity to improve patient mobility and reduce drug dosage. Infusion pumps for drug delivery are heavily used in hospital and home care settings to administer a variety of therapies such as chemotherapy, antimicrobials, analgesia, anesthesia, and post-operative and chronic pain management. We are developing electroosmotic (EO) pumps for drug delivery applications. EO pumps offer active dosage control, are compact, use low power, and have no moving parts. We here explore a two-liquid EO pump that decouples the drug from the working electrolyte with a series of collapsible membranes and enables EO pumping of a wide variety of medications.
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Dobson, Gregory, Vera Tilson, Sandy Sullivan, and Dave Webster. "Reducing Costs of Managing Medication Inventory in Automated Dispensing System in Hospital Units." In Hawaii International Conference on System Sciences. Hawaii International Conference on System Sciences, 2019. http://dx.doi.org/10.24251/hicss.2019.812.
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Dwiyani, Fitri, and Amal C. Sjaaf. "Analysis of Pharmaceutical Installations Management at Kambang Hospital, Jambi." In The 7th International Conference on Public Health 2020. Masters Program in Public Health, Universitas Sebelas Maret, 2020. http://dx.doi.org/10.26911/the7thicph.04.20.
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ABSTRACT Background: Hospital Pharmacy Installation (IFRS) was one of 5 revenue centres as well as being the primary support for the hospital which has full authority in managing various pharmaceutical preparations. Therefore, pharmaceutical supplies require careful and precise management through a one-door system. This study aimed to determine the management system and identify the various problems that exist in the pharmacy installation at Kambang Jambi Hospital. Subjects and Method: This study was a qualitative study conducted on IFRS at Kambang Jambi Hospital from August to September 2020. The data were obtained from primary data in the form of in-depth interviews with stakeholders related to IFRS and field observations, as well as secondary data in the form of document review. The data were collected by in-depth interview guide. The data was reported by 5 Whys Analysis diagram. Results: Based on field observations at IFRS Kambang Jambi Hospital, it was found that there were still many problems at almost every stage of pharmaceutical supply management starting from planning, procurement, receiving, storage, distribution, control, deletion, recording and reporting, as well as monitoring and evaluation. When the problem is identified more deeply using 5 Whys Analysis, the roots of these various problems are obtained, namely: 1) There has not been an adequate Pharmacy and Therapy Committee (KFT) in the management of the pharmaceutical installation at Kambang Jambi Hospital, 2) The majority of KFT members have assumed structural positions at Kambang Jambi Hospital so that it does not focus on KFT duties, 3) KFT does not regularly hold monthly meetings and evaluations, 4) The ineffective role of SPI at Kambang Jambi Hospital in monitoring and evaluating IFRS performance, 5) SIMRS still depends on outsiders not always standby at the hospital when there are problems. Conclusion: Re-organized the pharmacy and therapy committee to carry out a continuous review of the hospital formularies to be more effective and minimize medication errors. Keywords: IFRS, IFRS management, drug procurement, KFT. Correspondence: Fitri Dwiyani. Postgraduate Student for Hospital Administration Studies, Faculty of Public Health, University of Indonesia, Depok City, West Java. Email: fitridwiyani14@gmail.com. Mobile: 081221005831/081221005831 DOI: https://doi.org/10.26911/the7thicph.04.20
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Darianian, Mohsen, and Martin Peter Michael. "A low power pervasive RFID identification system for medication safety in hospital or home tele-care." In 2008 3rd International Symposium on Wireless Pervasive Computing (ISWPC). IEEE, 2008. http://dx.doi.org/10.1109/iswpc.2008.4556184.
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San, C., G. Bianconi, JF Meyer, A. Minetti, Y. De Oliveira Granja, L. De Pontual, JE Fontan, and S. Kabiche. "5PSQ-138 Review of medication errors in a paediatric hospital based on an institutional reporting system." In 24th EAHP Congress, 27th–29th March 2019, Barcelona, Spain. British Medical Journal Publishing Group, 2019. http://dx.doi.org/10.1136/ejhpharm-2019-eahpconf.571.
Full textReports on the topic "Medication Systems, Hospital"
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Tipton, Kelley, Brian F. Leas, Nikhil K. Mull, Shazia M. Siddique, S. Ryan Greysen, Meghan B. Lane-Fall, and Amy Y. Tsou. Interventions To Decrease Hospital Length of Stay. Agency for Healthcare Research and Quality (AHRQ), September 2021. http://dx.doi.org/10.23970/ahrqepctb40.
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Background. Timely discharge of hospitalized patients can prevent patient harm, improve patient satisfaction and quality of life, and reduce costs. Numerous strategies have been tested to improve the efficiency and safety of patient recovery and discharge, but hospitals continue to face challenges. Purpose. This Technical Brief aimed to identify and synthesize current knowledge and emerging concepts regarding systematic strategies that hospitals and health systems can implement to reduce length of stay (LOS), with emphasis on medically complex or vulnerable patients at high risk for prolonged LOS due to clinical, social, or economic barriers to timely discharge. Methods. We conducted a structured search for published and unpublished studies and conducted interviews with Key Informants representing vulnerable patients, hospitals, health systems, and clinicians. The interviews provided guidance on our research protocol, search strategy, and analysis. Due to the large and diverse evidence base, we limited our evaluation to systematic reviews of interventions to decrease hospital LOS for patients at potentially higher risk for delayed discharge; primary research studies were not included, and searches were restricted to reviews published since 2010. We cataloged the characteristics of relevant interventions and assessed evidence of their effectiveness. Findings. Our searches yielded 4,364 potential studies. After screening, we included 19 systematic reviews reported in 20 articles. The reviews described eight strategies for reducing LOS: discharge planning; geriatric assessment or consultation; medication management; clinical pathways; inter- or multidisciplinary care; case management; hospitalist services; and telehealth. All reviews included adult patients, and two reviews also included children. Interventions were frequently designed for older (often frail) patients or patients with chronic illness. One review included pregnant women at high risk for premature delivery. No reviews focused on factors linking patient vulnerability with social determinants of health. The reviews reported few details about hospital setting, context, or resources associated with the interventions studied. Evidence for effectiveness of interventions was generally not robust and often inconsistent—for example, we identified six reviews of discharge planning; three found no effect on LOS, two found LOS decreased, and one reported an increase. Many reviews also reported patient readmission rates and mortality but with similarly inconsistent results. Conclusions. A broad range of strategies have been employed to reduce LOS, but rigorous systematic reviews have not consistently demonstrated effectiveness within medically complex, high-risk, and vulnerable populations. Health system leaders, researchers, and policymakers must collaborate to address these needs.
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Integration of reproductive health services for men in health and family welfare centers in Bangladesh. Population Council, 2004. http://dx.doi.org/10.31899/rh17.1006.
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Since the mid-1970s, the Bangladesh national family planning program primarily focused on motivating women to use modern contraceptive methods and encouraging them to seek services from clinics. In addition, female field workers were recruited to deliver contraceptive methods at homes. The program design facilitated women’s access to information and medical care through clinics and home visits. In the process, however, the medical needs of males were marginalized. Men generally seek services from pharmacies, private practitioners, and district hospitals, and often ignore preventive steps and postpone seeking medical care for chronic health conditions. In cases of acute illness, they often resort to self-medication. As noted in this report, the study’s aim was to integrate male reproductive health services within the existing government female-focused health-care delivery system. The study concluded that reproductive health services for men could easily be integrated into the health and family welfare centers without affecting the clinics’ focus on serving women and children.