Effectiveness of a pharmacist-led educational intervention to reduce the use of high-risk abbreviations in an acute care setting in Saudi Arabia: A quasi-experimental study

Objectives: To evaluate the effectiveness of a pharmacist-led educational intervention to reduce the use of high-risk abbreviations (HRAs) by healthcare professionals. Design: Quasi-experimental study consisting of a single group before-and-after study design. Setting: A public emergency hospital in Mecca, Saudi Arabia. Participants: 660 (preintervention) and then 498 (postintervention) handwritten physician orders, medication administration records (MRAs) and pharmacy dispensing sheets of 482 and 388 patients, respectively, from emergency wards, inpatient settings and the pharmacy department were reviewed. Intervention: The intervention consisted of a series of interactive lectures delivered by an experienced clinical pharmacist to all hospital staff members and dissemination of educational tools (flash cards, printed list of HRAs, awareness posters) designed in line with the recommendations of the Institute for Safe Medical Practices and the US Food and Drug Administration. The duration of intervention was from April to May 2011. Main outcome: Reduction in the incidence of HRAs use from the preintervention to postintervention study period. Findings: The five most common abbreviations recorded prior to the interventions were 'IJ for injection' (28.6%), 'SC for subcutaneous' (17.4%), drug name and dose running together (9.7%), 'OD for once daily' (5.8%) and 'D/C for discharge' (4.3%). The incidence of the use of HRAs was highest in discharge prescriptions and dispensing records (72.7%) followed by prescriptions from in-patient wards (47.3%). After the intervention, the overall incidence of HRA was significantly reduced by 52% (ie, 53.6% vs 25.5%; p=0.001). In addition, there was a statistically significant reduction in the incidence of HRAs across all three settings: the pharmacy department (72.7% vs 39.3%), inpatient settings (47.3% vs 23.3%) and emergency wards (40.9% vs 10.7%). Conclusions: Pharmacist-led educational interventions can significantly reduce the use of HRAs by healthcare providers. Future research should investigate the long-term effectiveness of such educational interventions through a randomised controlled trial

Comparison of the marginal adaptation of direct and indirect composite inlay restorations with optical coherence tomography

OBJECTIVE: The purpose of the study was to use the photonic imaging modality of optical coherence tomography (OCT) to compare the marginal adaptation of composite inlays fabricated by direct and indirect techniques. MATERIAL AND METHODS: Class II cavities were prepared on 34 extracted human molar teeth. The cavities were randomly divided into two groups according to the inlay fabrication technique. The first group was directly restored on cavities with a composite (Esthet X HD, Dentsply, Germany) after isolating. The second group was indirectly restored with the same composite material. Marginal adaptations were scanned before cementation with an invisible infrared light beam of OCT (Thorlabs), allowing measurement in 200 µm intervals. Restorations were cemented with a self-adhesive cement resin (SmartCem2, Dentsply), and then marginal adaptations were again measured with OCT. Mean values were statistically compared by using independent-samples t-test and paired samples t-test (p<0.05), before and after cementation. RESULTS: Direct inlays presented statistically smaller marginal discrepancy values than indirect inlays, before (p=0.00001442) and after (p=0.00001466) cementation. Marginal discrepancy values were increased for all restorations after cementation (p=0.00008839, p=0.000000952 for direct and indirect inlays, respectively). The mean marginal discrepancy value of the direct group increased from 56.88±20.04 µm to 91.88±31.7 µm, whereas the indirect group increased from 107.54±35.63 µm to 170.29±54.83 µm. Different techniques are available to detect marginal adaptation of restorations, but the OCT system can give quantitative information about resin cement thickness and its interaction between tooth and restoration in a nondestructive manner. CONCLUSIONS: Direct inlays presented smaller marginal discrepancy than indirect inlays. The marginal discrepancy values were increased for all restorations that refer to cement thickness after cementation