Peritoneal dialysis prescription suitable for children with anuria.
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Peritoneal dialysis patients with anuria have a poor prognosis because of uremia and volume overload. In the present paper, I discuss a suitable prescription for children with anuria. The discussion begins with the principles of prescription from the viewpoint of guidelines. Next, I present prescription and adequacy in children with regard to Kt/V urea, creatinine clearance, phosphorous, and ultrafiltration. Finally, I discuss how to prescribe for anuric children. (+info)
The effect of electronic prescribing on medication errors and adverse drug events: a systematic review.
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Comparison of RFID systems for tracking clinical interventions at the bedside.
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In recent years, there have been high expectations for RFID technologies applied in the medical field, particularly for automatic identification and location of patients and medical supplies. However, few studies have measured the applicability of currently available RFID technologies in a medical environment. To determine the technical factors that affect the performance of RFID systems, we examined the performance of different types of tags for medications, medical equipment, nurses, and patients under different experimental conditions. Three kinds of passive RFID tags and one active RFID tag were used in our study. Passive tags were affected by materials such as liquid and metal. Tags based on 13.56MHz were most suited for identifying medications. Tag placement was one of the main factors involved in correct identification of nurses, patients, and medical equipment. The results of this study may help decision makers decide whether (which) RFID technologies are useful for tracking clinical workflow. (+info)
Enhancing an ePrescribing system by adding medication histories and formularies: the Regenstrief Medication Hub.
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Medication histories improve health care quality and safety; formularies serve to control costs. We describe the implementation of the Regenstrief Medication Hub: a system to provide both histories and formularies to the Gopher ePrescribing application. Currently the Medication Hub aggregates data from two sources: the RxHub consortium of pharmacy benefit managers, and Wishard Health Services. During one month, the system generated 53,764 queries, each representing a patient visit. RxHub responded with 4,012 histories; Wishard responded with 23,421 histories. The Medication Hub aggregated and filtered these histories before delivering them to Gopher. However, clinician users accessed the histories during only 0.6% of prescribing sessions. The Medication Hub also managed drug benefit eligibility data, which enabled formulary-based decision support. However, clinicians heeded only 41% of warnings based on the Wishard Formulary, and 16% of warnings based on commercial formularies. The Medication Hub is scalable to accommodate additional pharmacy data sources. (+info)
Evaluating the technical adequacy of electronic prescribing standards: Results of an expert panel process.
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To support more informed prescribing decisions, e-prescribing systems need data on patients' medication histories and their drug-specific insurance coverage. We used an expert panel process to evaluate the technical adequacy of two standards for delivering this information, the Medication History function of the NCPDP SCRIPT Standard and the NCPDP Formulary and Benefit Standard. METHODS: We convened a panel representing 14 organizations that had experience with these standards. Experts within each organization submitted narrative responses and ratings assessing the standards in 6 domains, including data quality,completeness, usability, and interoperability. Areas of disagreement were discussed in recorded teleconferences. Narrative was analyzed using a grounded-theory approach. RESULTS: Panelists agreed that the structure of the Medication History Standard was adequate for delivering accurate and complete information but implementation problems made the data difficult to use for decision support.The panel also agreed that the Formulary and Benefit Standard was adequate to deliver formulary status lists, but other parts of the standard were not used consistently and group-level variations in coverage were not represented. A common problem for both standards was the lack of unambiguous drug identifiers; panelists agreed that RxNorm deserves further evaluation as a solution to this problem. CONCLUSIONS: A panel of industry experts found the basic structure of these two standards to be technically adequate, but to enable benefits for patient care, improvements are needed in the standards' implementation. (+info)
Data standards and improvement of quality and safety in child health care.
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