Open in a separate window Source: Community Tracking Study site visits. In many cases, these service additions, expansions, and enhancements were viewed by respondents as duplicating services in an attempt to compete for physicians and patients. From to hospital occupancy rates on average increased in the 12 markets, but remained relatively low 65 percent.
What Do We Know? Fortescue, MD; David W. Bates, MD, MSc implementation of prevention strategies. We end with a Ambulatory Pediatrics ;4: Children are at particularly high risk of medication er- P atient safety is an increasingly well-recognized pub- rors.
Many factors contribute to this risk, including lic health problem. These estimates came from 2 particularly those with immature renal and hepatic sys- main studies: Adolescents with chronic diseases such as diabetes Colorado-Utah Study.
Ten-fold errors result from medication orders, with 7 in errors having a potential misplaced decimal points in drug dosing or stock medi- for injury potential adverse drug event [ADE] and 1 in cine dilutions. The consequences of fold errors may be errors resulting in an ADE.
For example, a case series of 22 Event Prevention Study documented 6. Similarly, frequencies of medication errors in adult outpatients. In this article, we discuss resulted in significant morbidity. Of concern, 1 was an why children are particularly prone to errors and review outpatient overdose by parents caused by a language bar- pediatric studies of medication errors.
We then explore rier. There have been several highly publicized deaths potential prevention strategies using a systems-based ap- from fold errors, including the routine postoperative proach as advocated by the Institute of Medicine report, death of a 9-month-old after a fold morphine over- Crossing the Quality Chasm.
Further- Off-label prescribing is very common in pediatrics be- more, different methodologies vary not only in numbers cause many drug companies have not performed appro- of errors captured but also in types of errors captured.
For priate pediatric trials prior to Food and Drug Administra- example, direct observation methods are best suited to tion approval. Consequently, many drugs have achieved detect drug administration errors, whereas chart review widespread pediatric use prior to rigorous safety testing. Pediatric prescribing, like that in adults, faces issues such as trailing zeroes and the use of abbreviations.
Trained incomplete information on labels.
Treatment was required for the child care. Another early study of pediatric medication errors and Methods ADEs involved pharmacy review of medication order Using Medline, we searched terms frequently associ- sheets at 2 large pediatric hospitals,22 finding 0.
We reviewed all pertinent literature to identify tients aged 2 years or less. In addition, we spoke test not reported.
Interestingly, this study found the low- with national experts to identify additional articles. One est error rates in patients in the neonatal intensive care author R.
Dosing errors were the most tal, 14 were selected for inclusion Table. A prospective erature consisted of controlled observational studies, study of medication errors in a PICU reviewed or- whereas case series were excluded. Research reports have used the following A study of consecutive prescribing errors identified terms: A study of they are intercepted prior to reaching the patient or be- orders written during patient-days for a total of cause the patient fortuitously tolerates the error without 11 doses25 used several processes to identify errors, an injury.
Finally, ADEs are actual injuries resulting from including review of medication orders, medical records, drug use. Some of these are associated with errors and pharmacist intervention logs, incident reports, and the are considered preventable, whereas others are unavoid- medication administration record as well as staff solici- able and are considered nonpreventable.
We used these tation of errors. The lack of administration errors. Seventy-one percent of errors oc- standardized definitions for medication errors and their se- curred at the point of transcription versus other steps in quelae makes it difficult to compare studies and highlights the medication use process such as ordering or adminis- the importance of standardized definitions for both re- tering.
A prospective study of pediatric medication errors and ADEs analyzed patients at 2 pediatric institutions Results of Literature Review using chart, medication order sheet, and medication ad- Measured rates of medication errors vary, depending on ministration record review as well as voluntary and solic- the type and intensity of the data collection methodology.
Emergency Department Studies Kozer Incident report review is another methodology that has been commonly used to investigate pediatric medication errors and ADEs.
In general, incident reports capture many fewer errors and ADEs than chart review. We identified 3 pediatric studies utilizing Relationship among medication errors, potential adverse drug incident reports.Health Care Utilization Arleica Oakley HCS October 28, Urmi Bhaumik, Facilitator Health Care Utilization Health care utilization has caused for debate for almost a century in the United States (US).
U.S. citizens have faced the challenge of not being able to properly access affordable and convenient health care providers and services.
What are the major factors that have resulted in the shift in utilization from inpatient hospitalization to ambulatory care services? What are the implications of this shift for hospitals, consumers, and the healthcare delivery system? (An appropriate length to answer this question is two to four paragraphs.).
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Chapter 5 1. Identify the major factors that have resulted in the shift in utilization from inpatient hospitalization to ambulatory care services. Describe the implication of this shift for hospitals, consumers, and the health care delivery system as a whole.
Jul 01, · Identify the major factors in the shift in utilization from inpatient hospitlization to ambulatory care? Implications that would result from shift in utilization from inpatient to ambulatory for hospitals,consumers?
Is belief/disbelief a limiting factor? Answer initiativeblog.com: Resolved. Chapter 5 1. Identify the major factors that have resulted in the shift in utilization from inpatient hospitalization to ambulatory care services.
Describe the implication of this shift for hospitals, consumers, and the health care delivery system as a whole. a%(39).