Correlation between workplace culture, learning and medication errors

The occurrence of medication errors in intensivecare units can bring about irreparable damageand even lead to death in hospitalized patients.In this respect, numerous investigations have suggestedthat many factors including workplace culture and learningfrom error can affect the incidence rates of such errorsin these units. Accordingly, the present study was to shedlight on the correlation between workplace culture, learningfrom error, and reporting rate of medication errorsamong nurses in intensive care units affiliated to teachinghospitals of Shahid Beheshti University of Medical Sciencesin Iran.Methods: A descriptive-analytical study was conductedamong 120 nurses working in intensive care units in fourteaching hospitals in the city of Tehran. Then, the questionnairesdeveloped by Gulley et al., Rybowiak et al., andWakefield et al. were used to collect the data related toworkplace culture, learning climate, and medication errors.Results: The findings of this study indicated that increasedlearning from error in nurses working in intensivecare units could lower reporting rate of medication errors(r=-0.312, p-value=0.001); there was also a significantrelationship between workplace culture and reportingrate of medication errors, so that enhancing workplaceculture could reduce reporting rate of medication errors(r=-0.239, p-value=0.012).Conclusion: Improving workplace culture via supportingemployee creativity and innovation as well as promotinglearning environment through an employee reward systemalong with avoidance of punishments and reprimands fornurses during the occurrence of errors could be effective inmitigating the incidence rates of medication errors

Two Methods of Discharge Care Program Follow-up on Drug Treatment Adherence of Patients with Heart Failure

Background: Heart failure is a potentially life-threatening condition that disrupts the normal flow of blood throughout the body. Patients with heart failure lack sufficient knowledge regarding drug treatment adherence. An effective discharge plan and its continuity can improve treatment adherence.Aim: This study was performed with aim to compare two methods of discharge care program follow-up on drug treatment adherence of patients with heart failure.Method: This quasi-experimental was conducted in 2022-2023 on 126 patients with heart failure in Iran. Participants were divided into the two intervention groups via telephone call (group A), and via video message (group B) and a control group (group C). The required data were collected through Morisky Medication Adherence Scale (MMAS-8) before and 12 weeks after the start of the intervention. In the intervention groups, the care plan was presented to the patients every two weeks.Results: The mean drug treatment adherence scores increased to 2.47±1.68 in group A, 1.51±2.11 in group B, and 0.83±1.60 in group C,  which was significantly different in each group and among the three groups (p<0.001). The Mean changes in the patient’s drug treatment adherence in group A were statistically significant only compared to group C (p<0.001). After adjusting confounding variables (age, gender and cause of heart failure), there was a significant difference among the three groups in the patient’s drug treatment adherence and quality of life (p=0.002).Implications for Practice: According to the obtained results, the nurses are recommended to continue the care program after discharge and use technologies to improve treatment adherence

Drug utilization evaluation of Rivaroxaban in both inpatient and outpatient settings: Using standard guidelines

Stroke-related atrial fibrillation (AF), deep vein thrombosis (DVT), and pulmonary thromboembolism (PE) are among the most common thromboembolic events. recently, direct oral anticoagulants (DOACs) have been slowly replacing warfarin. Rivaroxaban is a DOAC frequently prescribes to control thrombotic events. The safety and efficacy of Rivaroxaban are dependent on appropriate prescription, dosage, and other factors. This study is aimed to evaluate the Rivaroxaban utilization based on the standard protocol in both inpatient and outpatient settings. This cross-sectional/observational study was conducted for six months from 1st August 2018 to 1st February 2019 at a private hospital and also an outpatient clinic in Shiraz, Iran. First, a clinical pharmacist defined a standard protocol for Rivaroxaban utilization and several indexes (9 indexes for Non-valvular AF (NVAF) patients and 10 indexes for DVT/PE patients). Second, participants were classified into three groups (NVAF inpatients, NVAF outpatients, and DVT/PE patients). Finally, the adherence of Rivaroxaban utilization indexes in each group to was evaluated accordingly. Two hundred and forty one eligible patients were recruited into this study. Most patients (N=208), were NVAF. Rivaroxaban utilization was appropriate in 71.9%, 65.8%, and 50.6% of patients within groups 1, 2, and 3, respectively. Although medication interaction, administration regarding time/meal, and dose adjustment based on renal function showed the lowest compliance, the monitoring laboratory data and considering the underlying disorders were completely matched with the protocol. This study showed some critical errors in both settings, especially in DVT/PE patients (49.4% no match). Hence, the most productive collaboration must be developed between clinical pharmacists and clinical practitioners

PROTECTIVE EFFECT OF IRIS GERMANICA L. IN Β-AMYLOID-INDUCED ANIMAL MODEL OF ALZHEIMER’S DISEASE

Background: Alzheimer's disease (AD) is the most common cause of dementia that is an irretrievable chronic neurodegenerative disease. In the current study, we have examined the therapeutic effects of Iris germanica extract on Amyloid β (Aβ) induced memory impairment. Materials and Methods: Wistar rats were divided into five groups of 8 per each. Groups were as followed: control group which were normal rats without induction of AD, Aβ group which received Aβ (50 ng/side), iris 100 group which received Aβ + Iris (100 mg/kg), iris 200 group which received Aβ + Iris (200 mg/kg), and iris 400 group which received Aβ + Iris (400 mg/kg). AD was established by intrahippocampal injection of 50 ng/μl/side Aβ1-42. The day after surgery, animals in treatment groups received different doses of the aqueous extract of Iris by gavage for 30 days. Morris water maze test (MWM) was performed to assess the effects of I. germanica on learning and memory of rats with Aβ induced AD. Results: Data from MWM tests, including escape latency and traveled distance, demonstrated that I. germanica extract could markedly improve spatial memory in comparison to control. Moreover, the plant had a significantly better effect on the performance of AD rats in the probe test. Conclusion: I. germanica extract can successfully reverse spatial learning dysfunction in an experimental model of AD. Further neuro psyco-pharmacological studies are mandatory to reveal the mechanism of action of this natural remedy in the management of AD symptoms

Correlation between workplace culture, learning and medication errors

The occurrence of medication errors in intensivecare units can bring about irreparable damageand even lead to death in hospitalized patients.In this respect, numerous investigations have suggestedthat many factors including workplace culture and learningfrom error can affect the incidence rates of such errorsin these units. Accordingly, the present study was to shedlight on the correlation between workplace culture, learningfrom error, and reporting rate of medication errorsamong nurses in intensive care units affiliated to teachinghospitals of Shahid Beheshti University of Medical Sciencesin Iran.Methods: A descriptive-analytical study was conductedamong 120 nurses working in intensive care units in fourteaching hospitals in the city of Tehran. Then, the questionnairesdeveloped by Gulley et al., Rybowiak et al., andWakefield et al. were used to collect the data related toworkplace culture, learning climate, and medication errors.Results: The findings of this study indicated that increasedlearning from error in nurses working in intensivecare units could lower reporting rate of medication errors(r=-0.312, p-value=0.001); there was also a significantrelationship between workplace culture and reportingrate of medication errors, so that enhancing workplaceculture could reduce reporting rate of medication errors(r=-0.239, p-value=0.012).Conclusion: Improving workplace culture via supportingemployee creativity and innovation as well as promotinglearning environment through an employee reward systemalong with avoidance of punishments and reprimands fornurses during the occurrence of errors could be effective inmitigating the incidence rates of medication errors

The Effect of Observing Animated Model and Static Images and Combined Model on Motor Learning of Handstand Balance Skill

The aim of this research was to investigate the effect of observing animated model, static images and combined model on motor learning of handstand balance skill. 45 subjects (mean age 8.03±1.7 yr) were randomly divided into three experimental groups: observation of animated model, static images, combined model. Subjects trained handstand balance skill for three weeks (three sessions per week). Pretest, acquisition test and retention test was performed for three groups. Subjects' scores were obtained by calculating mean scores of three gymnastic referees based on specific norm of Gymnastics Federation. The results of two-way ANOVA with repeated measures showed significant effects of the three methods on motor learning of handstand balance skill (pv=0.001). Also, the results showed no significant difference between the combined model and animation model groups (pv=0.156). Finally, both combined model and animation model groups were better than static images group (pv=0.001). As a whole, results suggest that observation of animation is a useful modeling method of learning handstand balance skill in childhood. It is also suggested that static images be used along with the animations as a supplement

Percutaneous transluminal angioplasty and stenting of the vertebral artery ostium with balloon-mounted bare coronary stents

Background : Vertebral artery ostial stenosis (VAOS) is one of the most frequent causes of posterior circulation stroke. Percutaneous angioplasty and stenting (PTAS) is one of the treatment modalities. Patients and Methods : This is a longitudinal observational study from September 2006 to February 2009, conducted at hospitals affiliated with the Shiraz University of Medical Sciences, Shiraz, southern Iran. The patient cohort included patients with posterior circulation stroke or transient ischemic attack (TIA) and more than 70% VAOS, and patients with asymptomatic VAOS of more than 70% and aplasia or total occlusion of the contralateral VA or subclavian artery. All the patients underwent PTAS with balloon-mounted bare coronary stents. Technical success, procedural complications, composite outcomes of death, stroke or TIA in the vertebrobasilar territory during the first 30 days, stroke or TIA in the vertebrobasilar territory, and restenosis during follow-up, were assessed. Results : During the study period, 81 patients (mean age 68 + 8.9 years, 63 (78%) males, 71 symptomatic and 18 asymptomatic) underwent the procedure. Technical success was achieved in 88 (99%) patients. Procedure-related complications, other than puncture site complications, were seen in two patients (2.2%). The composite outcome of death, stroke or TIA in the vertebrobasilar territory during the first 30 days was 1%. None of the patients had clinical recurrence or restenosis during the follow-up (mean follow-up 14 months). Conclusion : Percutaneous transluminal angioplasty and stenting of the proximal VA was feasible and safe. The risk of restenosis should be analyzed in long-term studies with angiographic follow-up