On Fri, May 05, 2006 at 07:56:38PM -0400, Kevin Toppenberg wrote: See - http://www.ismp.org/
> On 5/5/06, Ruben Safir <[EMAIL PROTECTED]> wrote: > ... > >Yes - not only does it make sense, but I've confirmed this rate in my > >own studies both in ***ambutitary*** care settings (ir: at the counter > >in Rite-Aid) and in the hospital (following the nurses around). And > >this is while I was watching them. In fact, my data showed nearly 27% > >of the doses to be medically incorrect, and nearly 47% of the IV drugs > >given on the floors as being incorrect, and that was just from what I > >could see and not accounting for dosing errors, or miss use of drugs by > >physicians which my students and I did not catch even before following > >the nurse around. > > So can you give some examples? Would this be like using septra DS > once daily instead of the usual BID? Almost no nursing staff puts the correct amount of solution into the antibiotic solution, and normally keep the drugs too long after reconstitution. Over %20 of the Amphotericin orders where administrated without protection from light in one location I was in ***DESPITE*** the Pharmacy sending the doses up with protection (which was ripped off the bag). Almost all doses of floxicin type antibiotics are dosed incorrectly in patient populations over the age of 65. Pravacol is almost always prescribed without a dossage adjustment of ancillary drug therapy, especially Warfarin. Nearly 12% of the l-thyroxine RX's I've seen are just filled or written wrong because of large number of doses and poor communications. etc etc etc... > Are these prescription writing > errors that you, the pharmacist, would catch? How about just flatout errors. Like Vicoden RX's without doses, quantities, or clear instructions. Apxil instead of Paxil CR, the wrong form of Diltezam HCl being prescribed from what patients have been previously getting, to finding out that patients on anti-depressants have been having nighmares only to be treaded with Ambien instead of switching off to a different anti-depresant. Its depressing to work through all of this. Doxycycline to Pregnant women from Dermatologists, HCTZ to patients with severe sulfa allergies, Norvasc with pateints with prolongs ST problems rather than treating the arythimic problems ... on and on. I love Priscriptions is NO NAMES on them, NO Dates on them... > I mess up prescriptions > not infrequently, i.e. --forget to put a quantity, forget to specify > direction etc. But I don't often get the sig wrong in terms of actual > dosing instructions. > > >At one point it was discussed about what to do with Physician Order > >Entry and interaction warnings. I strongly recommend the inclusion of > >those warnings. In addition, if it was me, nobody would ever order a med > >without the prescribing information on the screen write next to the drug > >and annotation from the department heads and the pharmacy. > > Such systems have been designed, and impatient doctors don't usually > tolerate them.. > > >Not a surprise. My gut tells me that the FDA listing is not the best > >place to work off of. > > > True, but when I was asking around, it was the only database I could > find, and no one had a better suggestion. So now I am stuck with it. > But ANY database that is complete will have all this old 'junk' in it. > The Red Book should have been nearly complete.. Sorry about that. > Kevin > > > ------------------------------------------------------- > Using Tomcat but need to do more? Need to support web services, security? > Get stuff done quickly with pre-integrated technology to make your job > easier > Download IBM WebSphere Application Server v.1.0.1 based on Apache Geronimo > http://sel.as-us.falkag.net/sel?cmd_______________________________________________ > Hardhats-members mailing list > Hardhats-members@lists.sourceforge.net > https://lists.sourceforge.net/lists/listinfo/hardhats-members -- __________________________ Brooklyn Linux Solutions So many immigrant groups have swept through our town that Brooklyn, like Atlantis, reaches mythological proportions in the mind of the world - RI Safir 1998 DRM is THEFT - We are the STAKEHOLDERS - RI Safir 2002 http://fairuse.nylxs.com "Yeah - I write Free Software...so SUE ME" http://www.mrbrklyn.com - Consulting http://www.inns.net <-- Happy Clients http://www.nylxs.com - Leadership Development in Free Software http://www2.mrbrklyn.com/resources - Unpublished Archive or stories and articles from around the net http://www2.mrbrklyn.com/downtown.html - See the New Downtown Brooklyn.... ------------------------------------------------------- Using Tomcat but need to do more? Need to support web services, security? Get stuff done quickly with pre-integrated technology to make your job easier Download IBM WebSphere Application Server v.1.0.1 based on Apache Geronimo http://sel.as-us.falkag.net/sel?cmd=lnk&kid=120709&bid=263057&dat=121642 _______________________________________________ Hardhats-members mailing list Hardhats-members@lists.sourceforge.net https://lists.sourceforge.net/lists/listinfo/hardhats-members
