Nurses’ perceptions of and satisfaction with the use of automated dispensing cabinets at the Heart and Cancer Centers in Qatar: a cross-sectional study

Background Automated dispensing cabinets (ADCs) were introduced in 2010 and 2012 at the Heart Hospital (HH) and National Center for Cancer Care and Research (NCCCR), both run by Hamad Medical Corporation in Qatar. These medication distribution systems provide computer-controlled storage, dispensing, and tracking of drugs at the point of care in patient care units. The purpose of this study was to assess nurses’ perceptions of and satisfaction with the use of ADCs at HH and NCCCR. Methods A cross-sectional study was conducted in the two institutions in May and November 2012 using a piloted, validated, online, and anonymous questionnaire. The questionnaire consisted of four parts: nurses’ sociodemographic and practice characteristics, 21 questions about their perceptions, one question about their overall satisfaction, and one about the system’s ease of use. The self-administered survey was distributed to 503 nurses working at HH and NCCCR over three weeks using Survey Monkey®. Results The survey response rate was 80 % (n = 403). No significant difference was found in perception scores between the two institutions (p = 0.06). Ninety-four percent (n = 378) of nurses agreed that the medication delivery system allowed them to do their job more safely, and 90 % (n = 363) nurses agreed that they now spent less time waiting for medication from the pharmacy than they did before the ADC system was introduced. Eighty seven percent (n = 349) nurses agreed that they were able to administer medication more efficiently with the ADC system. The overall satisfaction rate (either “very satisfied” or “satisfied”) for the two hospitals was 91 %. Conclusions The nurses’ perceptions of and levels of satisfaction with the ADC system were very good over the 6 months after complete implementation and integration at HH and NCCCR. ADCs appear to increase efficiency in the medication process and should therefore improve the quality of care

Microduplications of 16p11.2 are associated with schizophrenia

Recurrent microdeletions and microduplications of a 600-kb genomic region of chromosome 16p11.2 have been implicated in childhood-onset developmental disorders1,2,3. We report the association of 16p11.2 microduplications with schizophrenia in two large cohorts. The microduplication was detected in 12/1,906 (0.63%) cases and 1/3,971 (0.03%) controls (P = 1.2 × 10−5, OR = 25.8) from the initial cohort, and in 9/2,645 (0.34%) cases and 1/2,420 (0.04%) controls (P = 0.022, OR = 8.3) of the replication cohort. The 16p11.2 microduplication was associated with a 14.5-fold increased risk of schizophrenia (95% CI (3.3, 62)) in the combined sample. A meta-analysis of datasets for multiple psychiatric disorders showed a significant association of the microduplication with schizophrenia (P = 4.8 × 10−7), bipolar disorder (P = 0.017) and autism (P = 1.9 × 10−7). In contrast, the reciprocal microdeletion was associated only with autism and developmental disorders (P = 2.3 × 10−13). Head circumference was larger in patients with the microdeletion than in patients with the microduplication (P = 0.0007)

Erythema nodosum following treatment with dasatinib plus chemotherapy in a patient with myeloid blast phase of chronic myeloid leukemia

Key Clinical Message Erythema nodosum (EN) is a type of panniculitis occurring due to various conditions. It can be associated with certain malignancies or manifest as a side effect of drugs. This article presents a unique case of EN in a patient with chronic myeloid leukemia (CML‐blast phase) following dasatinib and chemotherapy. Timely recognition and appropriate management are crucial to alleviate symptoms and consider potential drug‐induced etiology

Advanced Prototype for an Automated Version of the Robotic IV Pole

International audienc

Advanced Robotic IV Pole Flyer

Project Flye

BMIVPOT, a Fully Automated Version of the Intravenous Pole: Simulation, Design, and Evaluation

Robotic intravenous poles are automated supportive instrument that needs to be triggered by patients to hold medications and needed supplies. Healthcare engineering of robotic intravenous poles is advancing in order to improve the quality of health services to patients worldwide. Existing intravenous poles in the market were supportive to patients, yet they constrained their movement, consumed the time of both the patient and the nurse, and they were expensive in regard to what they offer. Although robotic poles overcame some of the movement limitations of the commercial/market poles, they were partially automated and did not offer additional technological features. The aim of our work was to develop a fully automated Biomedical Intravenous Pole Robot (BMIVPOT) to resolve the aforementioned limitations and to offer new technological features to intravenous poles, thereby promoting the health services. Several sensors and build-up materials were empirically chosen to be cost-effective and fulfill our needs. The new prototype was divided into three steps: simulated prototype, real implementation of the prototype, and testing and evaluation. Simulation results showed the best qualitative way to fit all the specifications in the robotic system, such as the shape, sensors, and connections in order to provide the proper functionality of the system. Experimental and real results provided the manufactured parts, implemented sensors, and the final robot. Testing the tracking and the flow sensor performances were provided. Evaluation of our Biomedical Intravenous Pole Robot with alternatives showed that our robot outperforms the other poles in many aspects including the features it offers, the percentage of interventions it comprised, the reliability, and cost-effectiveness. The overall percentage of features offered by our Biomedical Intravenous Pole Robot was 60% higher than that offered by peer research poles and 80% higher than that of the market poles. In addition, the average percentage of integration of interventions (architecture, sensor, wireless, tracking, and mechanical) in the Biomedical Intravenous Pole Robot was at least 56% higher than that of the alternative poles. According to the results, Biomedical Intravenous Pole Robot offers a cost-effective price as compared to the others. As a future prospect, we intend to add more features to this prototype in order to enhance it, such as vital signs detection, and improve the tracking system

Population Pharmacokinetics of Intravenous Methotrexate in Patients with Hematological Malignancies: Utilization of Routine Clinical Monitoring Parameters

Background and Objective: Clinical response to methotrexate in cancer is variable and depends on several factors including serum drug exposure. This study aimed to develop a population pharmacokinetic model describing methotrexate disposition in cancer patients using retrospective chart review data available from routine clinical practice. Methods: A retrospective review of medical records was conducted for cancer patients in Qatar. Relevant data (methotrexate dosing/concentrations from multiple occasions, patient history, and laboratory values) were extracted and analyzed using NONMEM VII. A population pharmacokinetic model was developed and used to estimate inter-individual and inter-occasion variability terms on methotrexate pharmacokinetic parameters, as well as patient factors affecting methotrexate pharmacokinetics. Results: Methotrexate disposition was described by a two-compartment model with clearance (CL) of 15.7 L/h and central volume of distribution (Vc) of 79.2 L. Patient weight and hematocrit levels were significant covariates on methotrexate Vc and CL, respectively. Methotrexate CL changed by 50% with changes in hematocrit levels from 23 to 50%. Inter-occasion variability in methotrexate CL was estimated for patients administered the drug on multiple occasions (48 and 31% for 2nd and 3rd visits, respectively). Conclusion: Therapeutic drug monitoring data collected during routine clinical practice can provide a useful tool for understanding factors affecting methotrexate pharmacokinetics. Patient weight and hematocrit levels may play a clinically important role in determining methotrexate serum exposure and dosing requirements. Future prospective studies are needed to validate results of the developed model and evaluate its usefulness to predict methotrexate exposure and optimize dosing regimens.This study was funded by a UREP award [UREP15-019-3-008] from the Qatar National Research Fund (a member of The Qatar Foundation).Scopu

Prototype Advancement of the Robotic IV Pole: Preliminary Simulation

International audienceThe Intravenous (IV) poles are medical and healthcare facilities utilized to deliver medications to patients over a scheduled time. Existing Intravenous poles are either commercial poles, that are found in the market, or robotic poles, that are still under research. Despite commercial poles hold and deliver medications, they restricted the movement of patients, consumed the nurses' time and were costly. The robotic poles in research were able to overcome the movement restrictions however, they needed external accessories to maneuver the pole and they carried light weights merely. The aim of our project is to develop a new prototype for solving the shortcomings of both commercial and robotic poles in order to enhance the healthcare service provided to patients. In this paper we provide the simulation of our automated robotic IV pole to offer new technological features. Several cost-effective build up materials were carefully chosen in this prototype. The first step was the simulation of the prototype of the new robotic pole including its different parts and components, using AutoCAD. Simulation results showed five contributions separated according to the function and/or merged according to the prototype. The preliminary results also showed the best qualitative way to fit all the specifications in the robotic system, such as the overall simulated shape, sensors and connections in order to provide the proper functionality of the system. The experimental development will be consider in our future work

Prevalent peripheral arterial disease and inflammatory burden.

BackgroundStrong evidence implicates inflammation in the development of atherosclerotic heart disease but less is known about peripheral arterial disease (PAD). Our objective was to test the hypothesis that a composite index of inflammatory burden is associated with PAD.MethodsCross-sectional analysis of a randomly-selected group of 903 community-dwelling men in the MrOS cohort recruited between 2000 and 2002. Using blood samples, we measured seven cytokines and related these levels to prevalent PAD (ankle-brachial index (ABI) <0.9) both individually and as part of an "inflammatory burden score" (a composite sum of the number of pro-inflammatory cytokines in the highest quartile).ResultsOverall, 6.75% of men had ABI <0.9. The odds of prevalent PAD were higher in men with the highest quartile (Q4) levels of interleukin-6 multivariable (MV) adjusted (odds ratio (OR) =3.95 (95% CI, 1.4-11.3), tumor necrosis factor alpha OR = 4.44 (95% confidence interval (CI), 1.5-12.8), and C-reactive protein OR = 3.63 (95% CI, 1.4-9.4) compared to men in Q1. The magnitude of the association of these cytokines with PAD was similar to the effect of being 10 years older, OR = 2.41 (95% CI, 1.16-3.7). These significant effects persisted after additional MV adjustment for smoking except for CRP. Men with the highest inflammatory burden score (≥3) had 3.6 (95% CI, 1.5-8.7) increased odds of PAD, p trend = 0.03. After smoking adjustment the linear trend was borderline statistically significant (p trend = 0.10).ConclusionInflammatory burden is associated with prevalent PAD, an association similar to aging 10 years. The inflammatory effects of smoking contributes to the underlying association between inflammation and PAD