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Percentage of medication errors by nurses vacancy,cure for type 2 diabetes 2014 wtc,what is the number 1 cause of type 2 diabetes,diabetes miracle cure guide reviews 2014 - Downloads 2016

Errors and irregularities in IV drug preparation can have a broad range of consequences ranging from harmless to serious to fatal.
Since the early 70s more and more studies of the quantity of parenteral medication errors have been published30.
A study published in Health Affairs examined the records of 795 patients at three teaching hospitals. To read the entire article, click on New Study Finds Medical Error Rates are Underreported. The problem is highlighted by the fact that these elder care facilities simply do not have adequate and properly trained staff to properly monitor a continually aging population.  Furthermore, elderly patients are often unable to effectively monitor the types of drugs that are entering their bodies. Please contact our elder abuse and nursing home neglect attorney if you or a loved one has been injured as a result of a medication error in a nursing home. Furthermore, while medications might be given correctly, some types of drugs are incompatible with others.   Untrained or negligent health professionals have been known to mix these medications, which can also lead to injuries or death. The use of pharmaceuticals is an essential element of the American health care system, helping to treat acute illnesses and maintain control of chronic conditions in many people. This Statistical Brief presents data from the Healthcare Cost and Utilization Project (HCUP) on medication- or drug-related adverse outcomes that were seen in hospitals in 2008, updating previously published information on inpatient stays in 2004.5 In addition, we provide information on these occurrences in treat-and-release emergency department (ED) visits.
Among inpatient stays with drug-related adverse outcomes, the mean patient age was 62.8 years. Over the five years between 2004 and 2008, there was a 52 percent increase in drug-related adverse outcomes in the inpatient setting—more than half of this increase was due to corticosteroids, anticoagulants, and sedatives and hypnotics. In the inpatient setting, corticosteroids, such as prednisone, caused 13.2 percent of all drug-related adverse outcomes. Over 53 percent of all inpatient stays with a drug-related adverse outcome were for patients 65 or older.
Among treat-and-release ED visits involving drug-related adverse outcomes, analgesics and antibiotics were common causes of events for all age groups. A similar pattern was observed in treat-and-release ED cases, although the mean age of 39.4 years was significantly lower than the mean age for inpatient cases. For each hospital stay or ED visit, multiple drug-related adverse outcomes can be reported. As shown in table 2, in the inpatient setting, hormones and synthetic substitutes were the most common cause of general drug-related adverse outcomes, responsible for 16.1 percent of all drug-related adverse outcomes (345,300 events).
From 2004 to 2008, the proportion of drug-related adverse outcomes caused by agents that affect blood constituents also increased.
In the inpatient setting, hormones, analgesics, and systemic agents were among the top five most common causes of drug-related adverse outcomes for all age groups (figure 4). Among treat-and-release ED visits, analgesics and antibiotics were among the most common causes of drug-related adverse outcomes for all age groups (figure 5). The estimates in this Statistical Brief are based upon data from the HCUP 2008 Nationwide Inpatient Sample (NIS) and 2008 Nationwide Emergency Department Sample (NEDS).
The principal diagnosis is that condition established after study to be chiefly responsible for the patient's admission to the hospital or visit to the ED. ICD-9-CM is the International Classification of Diseases, Ninth Revision, Clinical Modification, which assigns numeric codes to diagnoses. Total hospital charges were converted to costs using HCUP Cost-to-Charge Ratios based on hospital accounting reports from the Centers for Medicare and Medicaid Services (CMS).8 Costs will tend to reflect the actual costs of production, while charges represent what the hospital billed for the case. HCUP is a family of powerful health care databases, software tools, and products for advancing research. The HCUP Nationwide Inpatient Sample (NIS) is a nationwide database of hospital inpatient stays. The HCUP Nationwide Emergency Department Database (NEDS) is a unique and powerful database that yields national estimates of emergency department (ED) visits.
AHRQ welcomes questions and comments from readers of this publication who are interested in obtaining more information about access, cost, use, financing, and quality of health care in the United States.
6 Specific ICD-9-CM codes used in this study are listed in the Definitions section of this report. Reducing Error Potential with Carousel ImplementationMichael Hodgkins, CPhTMarch 2011 - Vol. Attending to continual demands to improve the cost-effectiveness of patient care requires emphasis be placed on decreasing drug inventory and reducing error rates, which makes pharmacy automation a necessity.
A large percentage of this reduction in error rates was realized from the decline in errors leaving the pharmacy.
Michael Hodgkins, CPhT, is the distribution operations supervisor for Eastern Maine Medical Center in Bangor, Maine.
Consumer Operated and Oriented Plan Programs (COOPs) were really a political compromise between Members of Congress who wanted a public plan option and those who didn’t. Our most popular newsletter, Daily Policy Digest summarizes the most topical public policy issues from today's newspapers, scholarly journals and think tanks.
Whether they like it or not, patients are likely to manage more of their own care in the future. The National Patient Safety Agency in the United Kingdom has compiled figures showing the type of medication error incidents that actually occur.
Care was taken to exclude stays and visits associated with illicit drug use or with evidence of intentional harm, self-inflicted or otherwise. Only 18.5 percent of treat-and-release ED visits with a drug-related adverse outcome were for elderly patients.
Psychotropics were another common drug-related adverse outcome for all age groups younger than 65.


For 8,400 inpatient cases and 14,600 ED cases with neuropathy or dermatitis drug-related adverse outcome codes, the ICD-9-CM codes do not identify whether the origin of the adverse outcome was poisoning or adverse effects due to drugs administered properly.
Leading this category were corticosteroids, such as prednisone, the cause of 13.2 percent of all inpatient drug-related adverse outcomes (283,700 events).
This is based on a total of 2,147,700 drug-related adverse outcome events in 1,874,800 inpatient stays, and 997,100 events in 838,000 ED visits with at least one drug-related adverse outcome recorded. This category includes drugs for relieving pain and reducing fever, such as acetaminophen (an aromatic analgesic, such as Tylenol), non-steroidal anti-inflammatory drugs (including salicylates, such as aspirin), opiates including methadone, and antirheumatics such as indomethacin. HCUP data include OB-GYN, ENT, orthopedic, cancer, pediatric, public, and academic medical hospitals. For each hospital, a hospital-wide cost-to-charge ratio is used because detailed charges are not available across all HCUP States.
Sponsored by the Agency for Healthcare Research and Quality (AHRQ), HCUP includes the largest all-payer encounter-level collection of longitudinal health care data (inpatient, ambulatory surgery, and emergency department) in the United States, beginning in 1988.
The NEDS was constructed using records from both the HCUP State Emergency Department Databases (SEDD) and the State Inpatient Databases (SID). We also invite you to tell us how you are using this Statistical Brief and other HCUP data and tools, and to share suggestions on how HCUP products might be enhanced to further meet your needs. Clarifying adverse drug events: A clinician's guide to terminology, documentation, and reporting.
To realize these goals, we decided to employ carousel technology to provide automated inventory management and additional layers of safety checks. He has been system administrator and automation engineer for the pharmacy since implementation of the technology in 2009.
Pre-printed cards are placed in the pharmacy and nursing units, as well as in other areas where errors may occur. Wrong transcription and incorrect labeling can both lead to much more severe consequences than simply a wrong drug dose. Excluded are long-term care, rehabilitation, psychiatric, and alcoholism and chemical dependency hospitals.
Hospital charges reflect the amount the hospital charged for the entire hospital stay and does not include professional (physician) fees. The NIS is a sample of hospitals and includes all patients from each hospital, regardless of payer. The challenge to such a decision often lies in clearing obstacles that impede the integration of multiple automation systems, not only for smaller and rural hospitals, but for many mid-size and large facilities as well.
Automating the process is what made the difference for our hospital in our efforts to decrease dispensing errors to patients. Employees are encouraged to fill out a card when they see an error occur or discover a process that might lead to an error.
These errors can lead to a mix-up of patients or a mix-up of the prescribed drug, to a wrong application route, a wrong time for application, omission of the drug or even to side effects or infections.
It was found that in more than 4,107 cases (28.9 % of total) the most frequent medication error was wrong dose, strength or frequency of the prescribed drug. Please note, a discharge of this nature will be included in the NIS if it occurred in a community hospital. It is drawn from a sampling frame that contains hospitals comprising about 95 percent of all discharges in the United States. The NEDS was created to enable analyses of ED utilization patterns and support public health professionals, administrators, policymakers, and clinicians in their decision-making regarding this critical source of care. While proper technology implementation invariably leads to increased efficiency, convincing administration that the costs of implementation will be offset by long-term safety and efficiency gains may not be as straightforward. Outcomes: Soft GainsPresenting verifiable figures makes it clear to administration that the time and expense dedicated to carousel implementation has produced financial returns, but it is important also to present benefits that cannot be quantified monetarily. With the advent of the Internet and the ease of access to medical information, patients no longer have to rely on physicians to answer every question.
The vast size of the NIS allows the study of topics at both the national and regional levels for specific subgroups of patients. To justify the initial cost, it is necessary to demonstrate a positive and realistic return on investment to the governing administration and major stakeholders. One of the first things we noticed after our carousel implementation was how streamlined the pharmacy had become.
These cards are collected throughout the week and the findings are sent to multiple committees and departments for review.
At Eastern Maine Medical Center, a 411-bed facility in Bangor, Maine, we considered implementing carousels and pharmacy scanning for many years before the project was approved.
Technicians no longer had to search for medications on the floors and the increased focus on dispensing resulted in a 60% faster response for our STAT and first-dose orders. Source: AHRQ, Center for Delivery, Organization, and Markets, Healthcare Costs and Utilization Project, Nationwide Inpatient Sample and Nationwide Emergency Department Sample, 2008.
When evaluating new automation proposals, approval committees tend to zero in on a single issue—the overall cost of the project. Our pharmacy buyer now generates an accurate order report in minutes rather than manually searching for items on shelves, a process that used to take a significant amount of time each day.
In the past, much of the medical literature was available only at large libraries, medical schools or by subscription to expensive scholarly medical journals.
In this case, the total required investment was significant, as the physical plant upgrade costs and ongoing service contract charges had to be included with the hardware price. This new capability has helped to reduce over-ordering, increase efficiency, and streamline the purchasing process.


Now, much of this literature is readily available to anyone with Internet access.11 According to a recent survey of patients visiting an internal medicine practice, more than half (54 percent) had used the Internet to gather health information. However, by forecasting reductions in carrying inventory, expired medications, dispensing errors, and medication errors reaching the patient, as well as an increase of inventory turns, we presented a strong case that the project was well worth the upfront cost, along with the yearly expenditure for service contracts and operations. Replacing an Outdated System Before implementing the carousel, we used an antiquated ordering system. In our hospital, the financial costs of implementation were returned exponentially in both the hard and soft gains the system delivers. An equal number (60 percent) did not discuss the findings with their physician.12 Another way patients find out about medicine is direct-to-consumer advertising, which is mostly about drug therapies. As the medication distribution model continues to evolve and incorporate new technologies, it is important to consider not only the immediate financial cost, but also the dividends in improved patient care and safety the system will offer over time.
The process for replenishing medications was equally inefficient; our buyer simply walked the rows looking for items in need of replenishment, scanned those items, and input the amount she thought would be needed. As we continue to revise our distribution model and move toward bedside bar coding, we expect to see error rates reduced even further. Medical science has made enormous advances in the past few decades, increasing the range of therapies available to patients. If an item moved faster that particular week, she would order extra so that we would not run out.
Although this process was managed accurately the majority of the time, any processes that rely on human interaction introduce the potential for error. When patients develop heart disease they often can choose between invasive surgery or various drug treatments. To mitigate this risk, we focused our efforts on those points in the system that could potentially fail.
For instance, heart disease may be treated with surgery, such as angioplasty with stents to open clogged arteries or coronary bypass grafts where arteries are too clogged to reopen. We looked to carousel hardware and software to improve the dispensing process for technicians, as well as add electronic safety gates that would prevent errors from passing through and potentially reaching patients. Among them: 1) Increasing medical specialization means that no single physician can provide all the information patients need, and 2) Physicians do not have enough time to give their patients complete information on their health. As medical knowledge has grown, an increasing proportion of doctors have specialized so that no individual physician can provide all the care a patient may need. A recent study in the American Journal of Public Health estimates that physicians would spend seven hours a day providing preventive care counseling to patients if they followed all of the recommendations of the U.S.
For instance, during a 20-minute office visit physicians spend less than one minute discussing planning and treatment, on the average. Doctors discuss options and help patients arrive at a treatment based on their preferences during fewer than one in 10 office visits.
Patients seeking medical information on their own are partially substituting for the service of physicians.30 A few hours spent on the Internet may substitute for a costly face-to-face office visit. In the 1980s and 1990s, employers began replacing fee-for-service health plans with managed care in an attempt to reduce their health care costs. Managed care organizations tried to hold costs down by negotiating deeply discounted fees with providers and by limiting access to services they deemed unnecessary.
They often limited doctor discretion and replaced it with protocols for managing patient care. Employers are increasingly shifting health care costs and risks to employees.34 For instance, during the period from 1993 to 2004, the average annual deductible workers with conventional health plans had to pay before insurance began to pay rose an average of 86 percent from $222 to $414. HSAs allow individuals and employers to make annual deposits up to the health insurance deductible. The health insurance policy accompanying an HSA must have an overall deductible of at least $1,000 for an individual or $2,000 for a family policy. A typical plan works like this: When individuals enter the medical marketplace, they spend first from their HSA. If they exhaust their HSA funds before reaching the deductible, they then pay out-of-pocket. Thus a young person could accumulate hundreds of thousands of dollars by the time he or she retires.44HSA balances belong to the individual account holders and remain theirs if they switch jobs, become unemployed or retire.
The funds can be used to pay expenses not covered by insurance, insurance premiums while unemployed and health expenses during retirement.
Though FSAs have no insurance requirement and no funding limits, they may be used only for medical expenses.
Moreover, employees forfeit any funds left in the FSA at year’s end or when they leave their job. FSAs would be more attractive to workers (and would come closer to leveling the playing field) if they were made portable from year to year, and from job to job.Health Reimbursement Arrangements (HRAs). At an employer’s discretion, workers may roll over unspent HRA balances from year to year and may have access to leftover balances after they leave a job. Although HRAs are more flexible than FSAs, in the long run they too are governed by a use-it-orlose- it rule.
The funds can be spent only on health care or insurance premiums and can never be withdrawn as cash.



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