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Biomedical subjects

N M Davis

Publications and source records attributed to N M Davis.

At least 91 records · Page 5Linked to original sources
PubMed1992

Free flow associated with electronic infusion devices: an underestimated danger.

Accidental, uncontrolled free flow after removal of administration sets from electronic infusion devices (EIDs) has only occasionally been reported. Recent evidence indicates that this problem is far more widespread and serious than previously understood. Well-documented cases of accidental death and serious injury have now come to light and are a particular cause for concern. Many of the EIDs commonly used in hospitals incorporate sets that offer no protection if someone removes the set from the device without first closing the set's flow control clamp. Because the problem has infrequently been reported and the risk is not well appreciated, only minimal warnings are issued about the problem by manufacturers. Standard intravenous tubing sets and other nonprotected EID sets are less expensive than protected sets and some hospitals have acquired EIDs that use unprotected sets without an adequate understanding of the risks of free flow (i.e., fluid overload and drug toxicity). Therefore critically ill patients receiving certain types of intravenous fluids or critical care drugs may be at great risk of injury when an overinfusion occurs. This article provides a better understanding of the extent of the problem and offers suggestions for minimizing or eliminating the problem.

Critical Care↗
PubMed1992

Look-alike and sound-alike drug names: the problem and the solution.

This list of 645 pairs of look-alike and sound-alike drug names (1,290 names are shown; they are listed both ways), has been complied to graphically emphasize the importance for the pharmaceutical industry, the United States Adopted Name (USAN) Council, and Food and Drug Administration (FDA) to select new names with great care. It also stresses to health professionals the necessity of writing legibly, writing complete orders, speaking slowly and clearly when giving verbal orders, carefully reading prescription orders, knowing what is wrong with patients, maintaining records of previous drugs patients have received, and learning about new drug products. It also indicates that patients must be educated about the medications they are taking. Your cooperation in alerting the authors of names they may have overlooked or of new problems would be greatly appreciated. When a sufficient number of additions are received, an updated list will be published.

Drug Information Services↗
PubMed1990

Detection and prevention of ambulatory care pharmacy dispensing errors.

There have been few studies of errors committed in ambulatory care pharmacies. Errors can be classified as incorrect strength, wrong product, wrong dosage form, wrong quantity, incorrect or omitted labeling (such as directions, patient's name, prescriber's name, auxiliary label, drug name, or strength), dispensing deteriorated drugs, and dispensing in non-childproof containers. Errors can be prevented by possessing and using knowledge, by proper performance and by having good systems in effect to prevent and/or uncover errors. Some contributing factors, which cause errors, are distraction and interruption, poor work habits, thoughtless robot-like performance, workloads past the safety threshold, poor working conditions, poorly written and incomplete prescriptions. A prime system to prevent errors from reaching the patient is the old tried and true system of having work checked by another person. The use of patient profiles can aid in reducing errors. The activity of patient counseling can reduce errors. Suggestions are made to reduce the number of errors made. A simple quality assurance program is presented. Case studies of medication errors are presented. The future use of bar-coding should be an extremely useful tool for preventing medication errors.

Ambulatory Care↗
PubMed1990

A survey of hospital policies on verbal orders.

The authors present the results of surveys of directors of nursing and directors of pharmacy on the types and extensiveness of the policies their institutions have implemented to control the use of verbal and telephone orders. One hundred hospitals were selected at random from 874 hospitals meeting the following criteria: 250 beds or larger, general medical surgical, short stay, and nongovernmental. The survey results demonstrated that a significant number of hospitals are attempting to regulate the use of verbal and telephone orders. However, only 35.5% of the hospitals surveyed have any policies that prohibit the use of verbal orders when the physician is physically present on the unit where the order is given, in non-emergency and non-bedside procedure situations. Relative to the above policy, directors of nursing state that this policy is followed 41.1% of the time and directors of pharmacy in the same institutions state that the policy is adhered to 11.1% of the time. In addition to the survey, the authors explain situations that may serve as a source of medication errors when using verbal or telephone orders. They also offer several precautions to take when the use of verbal and telephone orders is absolutely necessary.

Drug Therapy↗