Impact of Internally Developed Electronic Prescription on Prescribing Errors at Discharge from the Emergency Department

Introduction: Medication errors are common, with studies reporting at least one error per patient encounter. At hospital discharge, medication errors vary from 15%-38%. However, studies assessing the effect of an internally developed electronic (E)-prescription system at discharge from an emergency department (ED) are comparatively minimal. Additionally, commercially available electronic solutions are cost-prohibitive in many resource-limited settings. We assessed the impact of introducing an internally developed, low-cost E-prescription system, with a list of commonly prescribed medications, on prescription error rates at discharge from the ED, compared to handwritten prescriptions.Methods: We conducted a pre- and post-intervention study comparing error rates in a randomly selected sample of discharge prescriptions (handwritten versus electronic) five months pre and four months post the introduction of the E-prescription. The internally developed, E-prescription system included a list of 166 commonly prescribed medications with the generic name, strength, dose, frequency and duration. We included a total of 2,883 prescriptions in this study: 1,475 in the pre-intervention phase were handwritten (HW) and 1,408 in the post-intervention phase were electronic. We calculated rates of 14 different errors and compared them between the pre- and post-intervention period.Results: Overall, E-prescriptions included fewer prescription errors as compared to HW- prescriptions. Specifically, E-prescriptions reduced missing dose (11.3% to 4.3%, p <0.0001), missing frequency (3.5% to 2.2%, p=0.04), missing strength errors (32.4% to 10.2%, p <0.0001) and legibility (0.7% to 0.2%, p=0.005). E-prescriptions, however, were associated with a significant increase in duplication errors, specifically with home medication (1.7% to 3%, p=0.02).Conclusion: A basic, internally developed E-prescription system, featuring commonly used medications, effectively reduced medication errors in a low-resource setting where the costs of sophisticated commercial electronic solutions are prohibitive

Impact of Internally Developed Electronic Prescription on Prescribing Errors at Discharge from the Emergency Department

Introduction: Medication errors are common, with studies reporting at least one error per patient encounter. At hospital discharge, medication errors vary from 15%–38%. However, studies assessing the effect of an internally developed electronic (E)-prescription system at discharge from an emergency department (ED) are comparatively minimal. Additionally, commercially available electronic solutions are cost-prohibitive in many resource-limited settings. We assessed the impact of introducing an internally developed, low-cost E-prescription system, with a list of commonly prescribed medications, on prescription error rates at discharge from the ED, compared to handwritten prescriptions. Methods: We conducted a pre- and post-intervention study comparing error rates in a randomly selected sample of discharge prescriptions (handwritten versus electronic) five months pre and four months post the introduction of the E-prescription. The internally developed, E-prescription system included a list of 166 commonly prescribed medications with the generic name, strength, dose, frequency and duration. We included a total of 2,883 prescriptions in this study: 1,475 in the pre-intervention phase were handwritten (HW) and 1,408 in the post-intervention phase were electronic. We calculated rates of 14 different errors and compared them between the pre- and post-intervention period. Results: Overall, E-prescriptions included fewer prescription errors as compared to HW-prescriptions. Specifically, E-prescriptions reduced missing dose (11.3% to 4.3%, p <0.0001), missing frequency (3.5% to 2.2%, p=0.04), missing strength errors (32.4% to 10.2%, p <0.0001) and legibility (0.7% to 0.2%, p=0.005). E-prescriptions, however, were associated with a significant increase in duplication errors, specifically with home medication (1.7% to 3%, p=0.02). Conclusion: A basic, internally developed E-prescription system, featuring commonly used medications, effectively reduced medication errors in a low-resource setting where the costs of sophisticated commercial electronic solutions are prohibitive

Impact of Internally Developed Electronic Prescription on Prescribing Errors at Discharge from the Emergency Department

Introduction: Medication errors are common, with studies reporting at least one error per patient encounter. At hospital discharge, medication errors vary from 15%–38%. However, studies assessing the effect of an internally developed electronic (E)-prescription system at discharge from an emergency department (ED) are comparatively minimal. Additionally, commercially available electronic solutions are cost-prohibitive in many resource-limited settings. We assessed the impact of introducing an internally developed, low-cost E-prescription system, with a list of commonly prescribed medications, on prescription error rates at discharge from the ED, compared to handwritten prescriptions. Methods: We conducted a pre- and post-intervention study comparing error rates in a randomly selected sample of discharge prescriptions (handwritten versus electronic) five months pre and four months post the introduction of the E-prescription. The internally developed, E-prescription system included a list of 166 commonly prescribed medications with the generic name, strength, dose, frequency and duration. We included a total of 2,883 prescriptions in this study: 1,475 in the pre-intervention phase were handwritten (HW) and 1,408 in the post-intervention phase were electronic. We calculated rates of 14 different errors and compared them between the pre- and post-intervention period. Results: Overall, E-prescriptions included fewer prescription errors as compared to HW-prescriptions. Specifically, E-prescriptions reduced missing dose (11.3% to 4.3%, p <0.0001), missing frequency (3.5% to 2.2%, p=0.04), missing strength errors (32.4% to 10.2%, p <0.0001) and legibility (0.7% to 0.2%, p=0.005). E-prescriptions, however, were associated with a significant increase in duplication errors, specifically with home medication (1.7% to 3%, p=0.02). Conclusion: A basic, internally developed E-prescription system, featuring commonly used medications, effectively reduced medication errors in a low-resource setting where the costs of sophisticated commercial electronic solutions are prohibitive

Impact of Internally Developed Electronic Prescription on Prescribing Errors at Discharge from the Emergency Department

Introduction: Medication errors are common, with studies reporting at least one error perpatient encounter. At hospital discharge, medication errors vary from 15%-38%. However,studies assessing the effect of an internally developed electronic (E)-prescription systemat discharge from an emergency department (ED) are comparatively minimal. Additionally,commercially available electronic solutions are cost-prohibitive in many resource-limitedsettings. We assessed the impact of introducing an internally developed, low-cost E-prescriptionsystem, with a list of commonly prescribed medications, on prescription error rates at dischargefrom the ED, compared to handwritten prescriptions.Methods: We conducted a pre- and post-intervention study comparing error rates in a randomlyselected sample of discharge prescriptions (handwritten versus electronic) five months pre andfour months post the introduction of the E-prescription. The internally developed, E-prescriptionsystem included a list of 166 commonly prescribed medications with the generic name, strength,dose, frequency and duration. We included a total of 2,883 prescriptions in this study: 1,475 inthe pre-intervention phase were handwritten (HW) and 1,408 in the post-intervention phase wereelectronic. We calculated rates of 14 different errors and compared them between the pre- andpost-intervention period.Results: Overall, E-prescriptions included fewer prescription errors as compared to HWprescriptions.Specifically, E-prescriptions reduced missing dose (11.3% to 4.3%, p &lt;0.0001),missing frequency (3.5% to 2.2%, p=0.04), missing strength errors (32.4% to 10.2%, p &lt;0.0001)and legibility (0.7% to 0.2%, p=0.005). E-prescriptions, however, were associated with a significantincrease in duplication errors, specifically with home medication (1.7% to 3%, p=0.02).Conclusion: A basic, internally developed E-prescription system, featuring commonly usedmedications, effectively reduced medication errors in a low-resource setting where the costs ofsophisticated commercial electronic solutions are prohibitive. [West J Emerg Med. 2017;18(5)943-950.]

Impact of Internally Developed Electronic Prescription on Prescribing Errors at Discharge from the Emergency Department

Introduction: Medication errors are common, with studies reporting at least one error per patient encounter. At hospital discharge, medication errors vary from 15%-38%. However, studies assessing the effect of an internally developed electronic (E)-prescription system at discharge from an emergency department (ED) are comparatively minimal. Additionally, commercially available electronic solutions are cost-prohibitive in many resource-limited settings. We assessed the impact of introducing an internally developed, low-cost E-prescription system, with a list of commonly prescribed medications, on prescription error rates at discharge from the ED, compared to handwritten prescriptions.Methods: We conducted a pre- and post-intervention study comparing error rates in a randomly selected sample of discharge prescriptions (handwritten versus electronic) five months pre and four months post the introduction of the E-prescription. The internally developed, E-prescription system included a list of 166 commonly prescribed medications with the generic name, strength, dose, frequency and duration. We included a total of 2,883 prescriptions in this study: 1,475 in the pre-intervention phase were handwritten (HW) and 1,408 in the post-intervention phase were electronic. We calculated rates of 14 different errors and compared them between the pre- and post-intervention period.Results: Overall, E-prescriptions included fewer prescription errors as compared to HW- prescriptions. Specifically, E-prescriptions reduced missing dose (11.3% to 4.3%, p &lt;0.0001), missing frequency (3.5% to 2.2%, p=0.04), missing strength errors (32.4% to 10.2%, p &lt;0.0001) and legibility (0.7% to 0.2%, p=0.005). E-prescriptions, however, were associated with a significant increase in duplication errors, specifically with home medication (1.7% to 3%, p=0.02).Conclusion: A basic, internally developed E-prescription system, featuring commonly used medications, effectively reduced medication errors in a low-resource setting where the costs of sophisticated commercial electronic solutions are prohibitive

Sepsis in hemodialysis patients.

BACKGROUND: Bacterial infections are very common in End Stage Renal Disease (ESRD) patients. The diagnosis of sepsis in such patients is often challenging and requires a high index of suspicion. The aim of this study is to report on a series of patient with ESRD on hemodialysis (HD) diagnosed with sepsis. METHODS: Single center retrospective study looking at ESRD on HD who presented to our tertiary hospital were retrieved. Inclusion criteria included a discharge diagnosis of sepsis, septic shock or bacteremia. RESULTS: Our sample was composed of 41 females and 49 males, with a mean age of 70 ± 15 years. Infections from the HD catheters followed by lower respiratory tract infections were the most common cause of bacteremia. IV fluid replacement for the first 6 and 24 h were 0.58 and 1.27 l respectively. Vasopressors were used in 30 patients with norepinephrine, dopamine and dobutamine used in 22, nine and one patients respectively. Out of 90 subjects, 24 (26.6 %) were dead within the same hospital visit. the 28 days out of hospital mortality was 25.6 %. There was no significant difference in mortality in patients who presented with less than two SIRS or two or more SIRS criteria. CONCLUSION: This is the first study looking at an in depth analysis of sepsis in the specific dialysis population and examining the influence of fluid resuscitation, role of SIRS criteria and vasopressor use on their mortality

Propuesta de implementación de sistema de costos abc para los procesos de captación de clientes y prestación de servicios y su efecto en la rentabilidad de la empresa Inicia, Fútbol y Valores Asociación Civil, Lima 2017

Trabajo de Suficiencia ProfesionalEl presente proyecto está orientado a proporcionar información relevante sobre la elaboración e implementación de un sistema de costos ABC en los procesos de captación de clientes y prestación de servicios en la empresa Inicia, Fútbol y Valores Asociación Civil. El sistema de costos ABC, es una herramienta muy útil para la determinación y el control de los costos de una empresa y la gestión de ellos, debido a que proporciona información importante sobre el costo de cada proceso y actividad de la misma, contribuyendo en la toma de decisiones, reducir costos y en muchos casos mejora la prestación de servicios, permitiendo generar valor y mejorar la rentabilidad, generando el éxito desde una pequeña bodega en nuestra comunidad, hasta una multinacional

Additional file 2: of Cynicism and other attitudes towards patients in an emergency department in a middle eastern tertiary care center

COREQ questionnaire guidelines. (XLSX 11 kb