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PubMed1983

Inadequate medical order writing. A source of confusion and increased costs.

Audits of medication and intravenous fluid orders and of return to the pharmacy of unused intravenous solutions were conducted in 1980 at a university teaching hospital in response to a prevailing impression among pharmacists that physicians' orders were often written in an incomplete, nonstandardized fashion and that intravenous fluid wastage was common. A disturbing number of order were incomplete and judged to be ambiguous. Less than 25% of orders for intravenously given solutions contained adequate instructions for subsequent administration of fluids. Intravenous fluid return amounted to an estimated loss of $137,695 per year in wasted material and labor. The results of the audits were disseminated among the staff. In addition, the pharmacy changed its operations to detect more quickly and correct the problems caused by ambiguous orders. Later studies showed a reduction in the return of unused intravenous fluids and some improvement in order writing. Inadequate and ambiguous orders were still judged to be a problem, however, especially intravenous fluid orders that omitted instructions for subsequent fluid requirements and "open-ended" intravenous fluid orders. Such orders were eight times more likely to be associated with return of unused intravenous fluids than orders with adequate instructions for giving fluids subsequently.

Drug Prescriptions↗
PubMed2004

S. Weir Mitchell's prose and poetry on the American Civil War.

The prose and poetry of S. Weir Mitchell (1829-1914)--related to the American Civil War--encompass a very significant portion of his non-medical writings. The Civil War, more than any other single event, shaped his future career as one of the founders of American neurology. Indeed, it should not be surprising how the war was also such a driving force in his non-medical writings. His novels, once widely read, now are scarcely noted. His accounts of the social, political and economic events of the Civil War are of historical interest to students of the period. Neuroscientists as a group, like others, are apt to be unfamiliar with these writings, with the possible exception of "The Case of George Dedlow." A major purpose of this essay is to introduce readers, especially neuroscientists, to Weir Mitchell's fictional works in which neurological cases so often appear. One appreciates more the medical aspects of his novels, written as they were by a first-hand observer. His non-medical writings, poetry and prose, are to a large extent timeless and can be appreciated by today's readers.

Drama↗
PubMed1973

The history of medical libraries from 2000 B.C. to 1900 A.D.

Tablets said to date back to 2000 b.c. represent the earliest medical writings so far discovered. The history of the medical library (defined as a place where a collection of medical writings is kept) is traced through ancient and medieval civilizations, and the dependence of advancement or decline on the attitude toward learning and knowledge is demonstrated.The change in structure of medical libraries that took place around the 1500s with the development of scientific societies is discussed. Medical libraries of Colonial America are described and the history is brought forward to the era of public library collections of medical material in the early 1900s.

American Medical Association↗
PubMed1993

Teaching residents to write a research paper.

Medical writing and publications are important in developing a scholarly basis for residency programs and in providing a learning experience for both resident and faculty mentors. Residency directors must provide the stimulus and support for both faculty and residents' varied creative activities. This support manifests itself in a commitment to scholarly activity (including a dedicated research person), the procurement of available research materials, the establishment of a process or plan for beginning a research project, and the development of a method for rewarding or recognizing faculty and residents who produce scholarly works. Some osteopathic residency programs may need to train faculty in research skills at the same time that residents are learning to write. Trained faculty are better models and coaches for residents engaged in research. Beginning with a fundamental, but disciplined, writing program, both faculty and residents may learn methods for sharing new knowledge or acquiring those skills necessary to critically analyze the medical literature.

Internship and Residency↗
PubMed2000

Ethical responsibilities of editors, reviewers, and authors.

Scientific misconduct, which is neither new nor unique, is prevalent in the medical literature. Although fabrication of data obviously is unethical, and although ethical rules of conduct for certain aspects of medical studies, such as informed consent, are theoretically accepted worldwide, numerous authors do not adhere to ethical rules of conduct. Ethically, the editor is responsible, as a gatekeeper, for ensuring that material to be published is accurate and valid. Thus, the editor's main responsibility is to the reader. Nonetheless, the editor also must serve the author by selecting unbiased reviewers and by providing the assurance that material will be selected for publication based solely on the scientific quality of the material. Peer reviewers are obligated to maintain a posture of confidentiality throughout the review process. Authors are responsible for adequate planning before undertaking a study, and for safeguarding patients' rights during the study. The author must read all cited references completely, strive for accuracy, and be certain that the material reported is valid, because it will be used in the treatment of patients. Hopefully, awareness of the ethical problems related to medical writing will provide a clearer understanding of the ethical aspects of medical writing.

Authorship↗