Chronology of prescribing error during the hospital stay and prediction of pharmacist's alerts overriding: a prospective analysis

<p>Abstract</p> <p>Background</p> <p>Drug prescribing errors are frequent in the hospital setting and pharmacists play an important role in detection of these errors. The objectives of this study are (1) to describe the drug prescribing errors rate during the patient's stay, (2) to find which characteristics for a prescribing error are the most predictive of their reproduction the next day despite pharmacist's alert (<it>i.e</it>. override the alert).</p> <p>Methods</p> <p>We prospectively collected all medication order lines and prescribing errors during 18 days in 7 medical wards' using computerized physician order entry. We described and modelled the errors rate according to the chronology of hospital stay. We performed a classification and regression tree analysis to find which characteristics of alerts were predictive of their overriding (<it>i.e</it>. prescribing error repeated).</p> <p>Results</p> <p>12 533 order lines were reviewed, 117 errors (errors rate 0.9%) were observed and 51% of these errors occurred on the first day of the hospital stay. The risk of a prescribing error decreased over time. 52% of the alerts were overridden (<it>i.e </it>error uncorrected by prescribers on the following day. Drug omissions were the most frequently taken into account by prescribers. The classification and regression tree analysis showed that overriding pharmacist's alerts is first related to the ward of the prescriber and then to either Anatomical Therapeutic Chemical class of the drug or the type of error.</p> <p>Conclusions</p> <p>Since 51% of prescribing errors occurred on the first day of stay, pharmacist should concentrate his analysis of drug prescriptions on this day. The difference of overriding behavior between wards and according drug Anatomical Therapeutic Chemical class or type of error could also guide the validation tasks and programming of electronic alerts.</p

Influence de la maturation des sols de mangrove sur la déflation éolienne et la formation des dunes argileuses dans le delta du fleuve Sénégal

L'étude des dunes argileuses est largement employée pour la reconstitution des paléo-environnements. L'arrêt de la sédimentation éolienne est généralement attribuée à des modifications climatiques ou hydrologiques. Notre étude, menée dans le delta du fleuve Sénégal, montre que des transformations internes de la couverture pédologique peuvent induire des modifications de la partie superficielle des sols et arrêter la déflation éolienne, sans modifications des conditions environnementales. (Résumé d'auteur

Évaluation de la pollution chimique par le zinc et le fer de la nappe profonde des graviers d'Annaba (Nord-Est d'Algérie)

La maîtrise de la gestion des ressources en eau souterraine relève de la bonne connaissance des équilibres hydrauliques, hydrochimiques et biologiques qui conditionnent l'avenir socio-économique régional. A l'exemple du bassin hydrologique de la Seybouse (Nord-Est de l'Algérie), les activités humaines déployées dans les vallées et les plaines adjacentes ont évidemment d'importantes répercussions sur ces équilibres. La région d'étude constitue un pôle important d'industrie lourde et de transformation. La pollution industrielle est provoquée par les rejets thermiques, chimiques et organiques par voie aquatique terrestre ou atmosphérique. Les unités industrielles qui sont des points potentiels ou réels de pollution sont nombreuses (plus d'une dizaine) notamment les usines sidérurgiques, métalliques et pétrochimiques. Une analyse piézométrique et hydrochimique a été réalisée en 15 stations s'étendant du Nord vers le Sud entre Annaba et Bouchegouf dans le Nord-Est de l'Algérie. Ces analyses ont concerné les concentrations en chlorures et en sulfates dans les eaux des aquifères ainsi que celles de fer et de zinc. La période d'échantillonnage en avril 2002 a été celle des hautes eaux

Geochemistry of clay dunes and associated pan in the Senegal Delta, Mauritania

Since the construction of the anti-salting Diama dam, a resumption of aeolian deflation has been observed in the Senegal delta and particularly in Diawling National Park. It results in the formation of many clay dunes with high salt concentrations. The soft powdery structure observed on the soil surface, affected by aeolian deflation is due to rapid salt crystallization. In order to identify the mineralogy of the salt involved in this environment, the chemistry of soil and groundwater was studied along a transect from a pan to the associated clay dune. Equilibria computation and field and scanning electron microscope (SEM) observations indicated that the changes observed in the chemical facies of the solution were due to the following precipitation sequence : calcite to gypsum to halite. A progressive but significant fixing of Na+ onto the clay particles was observed. The calcite deposition in the soil was limited by exhibition of the potential acidity arising from the former mangrove site soils. It resulted in high equilibrating pCO2. This study intended to test a new extension to the Debye-Hückel law for concentrated chlorurated sodic waters. The relationship between chloride amounts and the residual alkalinity concept confirmed that calcite and gypsum formation and the exchanges between Na and Ca are the main phenomena responsible for the changes observed in the soil solution (r2 = 0.99). (Résumé d'auteur

Geochemistry of clay dunes and associated pan in the Senegal Delta (Mauritania)

Aeolian deflation is very active in the Senegal delta and results in the formation of many clay dunes with high salt concentration. The chemistry of soil and groundwater was studied along a sequence from a pan to the associated clay dune in the Diawling park. Equilibria computation and field and SEM observations indicates that the changes observed in the chemical facies of the solution are due to the following precipitation sequence : calcite&gt;gypsum&gt;halite. A progressive but significant fixing of sodium onto the clay particles is observed. However, the calcite deposite in the soil is limited by exhibition of the potentiel acidity arising from the former mangrove. It locally results in high equilibrating CO2 pressure. This study provided an opportunity to test succesfully a new extension to the Debye-Hückel law for concentrated chlorurated sodic waters. (Résumé d'auteur

Détermination de la qualité des eaux du littoral mauritanien par la mesure des métaux traces chez les mollusques

Les variations des concentrations en Cd, Cu, Fe, Mn et Zn ont été analysées chez deux Mollusques prélevés l'un le long de la côte mauritanienne (Donax rugosus) et l'autre dans deux baies du nord de la Mauritanie (Venus verrucosa). Pour D. rugosus, les poids variant, nous avons examiné les relations C = a Pb, C = concentration en métal, P = poids sec et b = coefficient de régression. Dans tous les cas, le coefficient b est négatif. Pour V verrucosa, les poids varient peu, V. verrucosa, animal le plus gros, a les concentrations les plus faibles en métaux, à l'exception du cadmium. Ce travail a été réalisé dans le cadre d'un accord inter-universitaire : Université de Nice,Institut Supérieur des Sciences de Nouakchott