Nursefriendly.com: Adverse Events

Showing posts with label Adverse Events. Show all posts

Wednesday, June 8, 2011

Side Effects? These #Drugs Have a Few - NYTimes.com

Dr. Jon Duke of Indiana University was trying to figure out why his patient’s blood platelets were abnormal. Could it be a side effect of one of the dozen drugs the man was taking, a number that is not uncommon among elderly people?

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Mark Pernice/Ashley Nodar

He began reading the label of each and every drug. “I was just overwhelmed,” Dr. Duke said. The lists of possible adverse reactions went on and on.
Now he knows why. In a new paper in the Archives of Internal Medicine, Dr. Duke and two colleagues report that the average drug label lists 70 possible side effects and some drugs list more than 500. “This was beyond even what I’d expected,” he said.
For anyone who has ever had to watch an entire Flomax commercial, the listing of a drug’s side effects is almost a joke. But the question is, why does the list continue to grow?

via nytimes.com

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Tuesday, April 26, 2011

amednews: 1 in 3 patients harmed during hospital stay :: April 18, 2011 ... American Medical News

By Kevin B. O'Reilly, amednews staff. Posted April 18, 2011.

One-third of hospital patients experience adverse events and about 7% are harmed permanently or die as a result, according to a study that detected patient safety problems at a far higher rate than other methods.

The study, in April's Health Affairs, echoes two reports issued in November 2010 that showed rates of adverse events hovering near 25% among hospitalized Medicare patients nationwide and at 10 North Carolina hospitals.

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The findings draw attention to the safety troubles that have lingered in U.S. hospitals in the 12 years since the Institute of Medicine's headline-grabbing report "To Err is Human." The study cited research estimating that up to 98,000 patients die each year due to preventable medical errors.

"This is one of the best studies that now gives us a sense of how much harm is happening to patients in American hospitals," said Robert Wachter, MD, chief of the medical service at the University of California, San Francisco Medical Center, who was not involved in the research. "There is a tremendous amount of harm befalling patients who are admitted to hospitals and humongous opportunities for improvement."

via ama-assn.org

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Thursday, April 14, 2011

Drug Errors on the Rise - NYTimes.com

The number of people treated in hospitals in the United States for problems related to medication errors has surged more than 50 percent in recent years.

In 2008, 1.9 million people became ill or injured from medication side effects or because they took or were given the wrong type or dose of medication, compared with 1.2 million injured in 2004, according to the Agency for Healthcare Research and Quality.

Although several national reports in recent years have sounded the alarm about the toll of medication errors, the latest data show the problem continues to persist. The A.H.R.Q. data measure only patients treated in the hospital or emergency department as a result of a medication error. The data don’t distinguish between prescribing, dispensing or consumer errors. Some of the errors resulted from a physician prescribing the wrong drug or dose; others occurred because a pharmacist or nurse gave the wrong drug, or because a patient at home used the wrong type or dose of medication.

via well.blogs.nytimes.com

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See also: http://www.nursefriendly.com/mederror/
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When to sue your doctor or hospital Should you? | Eye Opener: The Nash & Associates Blog | %post_tags%

Recently, a CNN article titled “Harmed in the Hospital? Should You Sue?” described the story of a two-year-old baby with a septic infection who waited about five hours in the emergency department before being seen by a physician. The child ultimately needed several amputations as a result of the delay in medical treatment.

Using this tragic story as a point of reference, the article suggests a number of criteria to help patients decide when to sue and when not to sue a health care provider. For example, the article correctly suggests that a patient who has not sustained injury should not sue a health care provider even if the health care provider’s conduct might have been negligent. In medical malpractice cases, a plaintiff seeks monetary compensation for injuries. If there are no identifiable injuries, there simply isn’t a case for medical malpractice.

via medicalmalpracticeblog.nashandassociates.com

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Wednesday, March 30, 2011

AIM: Adverse event reporting is on the rise

Although the FDA's Adverse Event Reporting System (AERS) database has been in existence since 1969, more than half of the incidents in it were received in the past decade, according to an article published online March 28 in the Archives of Internal Medicine.
These 2.2 million events represent a 1.65-fold increase from the prior decade, wrote Sheila Weiss-Smith, PhD, from the University of Maryland School of Pharmacy in Baltimore, and colleagues. "Report volume increased from 2000 to 2010 at a mean annual rate of 11.3 percent,” the authors continued.
AERS is a repository of passively reported adverse drug events designed as a safety net so the FDA can monitor all marketed drugs and detect serious safety problems. Weiss-Smith and colleagues sought to characterize the current reporting patterns.

via cmio.net

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Tuesday, March 29, 2011

Arch Intern Med -- Abstract: Patient Education to Prevent Falls Among Older Hospital Inpatients: A Randomized Controlled Trial, March 28, 2011, Haines et al. 171 (6): 516

Arch Intern Med. 2011;171(6):516-524. doi:10.1001/archinternmed.2010.444
Background Falls are a common adverse event during hospitalizationof older adults, and few interventions have been shown to preventthem.
Methods This study was a 3-group randomized trial to evaluatethe efficacy of 2 forms of multimedia patient education comparedwith usual care for the prevention of in-hospital falls. Olderhospital patients (n = 1206) admitted to a mixtureof acute (orthopedic, respiratory, and medical) and subacute(geriatric and neurorehabilitation) hospital wards at 2 Australianhospitals were recruited between January 2008 and April 2009.The interventions were a multimedia patient education programbased on the health-belief model combined with trained healthprofessional follow-up (complete program), multi-media patienteducation materials alone (materials only), and usual care (control).Falls data were collected by blinded research assistants byreviewing hospital incident reports, hand searching medicalrecords, and conducting weekly patient interviews.

via archinte.ama-assn.org

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Wednesday, March 2, 2011

e-Autopsy: Kaiser Hospitals Dig In to Data to Assess Mortality

You've heard the macabre joke that hospitals and doctors "bury their mistakes." Well, here's an interesting twist: At Kaiser Permanente hospitals in Southern California, doctors are doing precisely the opposite. They're rolling back time in the death process – exhuming their unknown mistakes so to speak – to see what, if anything, they can learn in order to save similar patients the next time around.

But they're not doing it the old way through invasive autopsies. Those are expensive, increasingly unpopular with families, forbidden by some religions, and often don't reveal that much about errors in the process of hospital care.

Kaiser has a new concept, the e-Autopsy.

Kaiser's hybrid manual and electronic mortality review uses storytelling and specialists' scrutiny to study medical charts of patients who died in the hospital. The process builds a precise timeline of what happened. The goal is to prevent death and/or improve end-of-life care by looking for places to improve—from ambulatory settings prior to admission to the inpatient bedside.

via healthleadersmedia.com

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Monday, February 28, 2011

Rare Fractures Linked To Drugs For Weak Bones : NPR

The study found 716 atypical fractures among more than 200,000 Ontario women over 68. The researchers calculate the risk at one or two atypical fractures for every 1,000 women who took bisphosphonate drugs for more than five years.

Enlarge Courtesy of Dr. Jennifer Schneider
An X-ray of Schneider's right femur (thighbone), which broke suddenly as she was standing on a New York subway train.

Courtesy of Dr. Jennifer Schneider
An X-ray of Schneider's right femur (thighbone), which broke suddenly as she was standing on a New York subway train.

That's fairly rare, and considerably less than the risk of another potential side effect from these drugs, a condition called osteonecrosis of the jaw — the death of part of the jawbone, following a major dental procedure. Still, since tens of millions of women are taking bisphosphonates, the Ontario study suggests thousands of them may suffer devastating atypical fractures every year.

But here's the dilemma: Many women really need these drugs, because they really do work to prevent ordinary hip fractures caused by osteoporosis.

via npr.org

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Wednesday, February 2, 2011

Impact of a statewide intensive care unit quality improvement initiative on hospital mortality and length of stay: retrospective comparative analysis -- Lipitz-Snyderman et al. 342 -- bmj.com

The US Institute of Medicine highlighted the serious problem of patient safety and importance of evidence based quality improvement initiatives to reduce adverse events.1 Evidence that quality improvement initiatives intended to reduce adverse events result in a measurable impact on other important outcomes, such as mortality and length of hospital stay, is limited. Without this evidence, hospitals and healthcare payers face uncertainty about whether investment in any specific quality improvement intervention will significantly benefit patients and represent a good use of limited financial resources.

The Michigan Health and Hospital Association Keystone ICU (intensive care unit) project, developed by researchers at Johns Hopkins and undertaken by the Michigan Health and Hospital Association, about 80 of its member hospitals, and researchers at Johns Hopkins Medical Institutions, is a recent example of a successful, large scale quality improvement initiative.2 3 4 The project adopted a comprehensive approach to improving patient safety that included promoting a culture of safety, improving communication between providers, and implementing evidence based practices to reduce rates of catheter related bloodstream infections and ventilator associated pneumonia. Evidence based interventions for preventing catheter related bloodstream infections were promoting handwashing, full barrier precautions, skin antisepsis with chlorhexidine, avoiding the femoral site during catheter insertion, and removing unnecessary catheters. Interventions to prevent ventilator associated pneumonia included a mechanical ventilator “bundle” consisting of use of semirecumbent positioning, daily interruption of sedation infusions, and prophylaxis for peptic ulcer disease and deep venous thrombosis.5 The project showed that measures of culture and infection rates in the intensive care unit were substantially improved for up to 36 months after implementing the quality improvement measures.2 4 5 6

via bmj.com

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Wednesday, June 8, 2011

Side Effects? These #Drugs Have a Few - NYTimes.com

Mark Pernice/Ashley Nodar

Tuesday, April 26, 2011

amednews: 1 in 3 patients harmed during hospital stay :: April 18, 2011 ... American Medical News

Thursday, April 14, 2011

Drug Errors on the Rise - NYTimes.com

When to sue your doctor or hospital Should you? | Eye Opener: The Nash & Associates Blog | %post_tags%

Wednesday, March 30, 2011

AIM: Adverse event reporting is on the rise

Tuesday, March 29, 2011

Arch Intern Med -- Abstract: Patient Education to Prevent Falls Among Older Hospital Inpatients: A Randomized Controlled Trial, March 28, 2011, Haines et al. 171 (6): 516

Wednesday, March 2, 2011

e-Autopsy: Kaiser Hospitals Dig In to Data to Assess Mortality

Monday, February 28, 2011

Rare Fractures Linked To Drugs For Weak Bones : NPR

Wednesday, February 2, 2011

Impact of a statewide intensive care unit quality improvement initiative on hospital mortality and length of stay: retrospective comparative analysis -- Lipitz-Snyderman et al. 342 -- bmj.com

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