On Fri, 2006-05-05 at 16:46, Kevin Toppenberg wrote: > See below > > On 5/5/06, Ruben Safir <[EMAIL PROTECTED]> wrote: > > I was reading this today: > > > > While these numbers are impressive, .... > > What numbers? Did you mean to include a link to an article? > > they are likely to be a significant > > underestimation of the problem. First, the two studies from which the > > statistics are extracted are believed to offer conservative figures > > because they were limited to injuries of a specified level of harm, they > > required a high threshold to determine whether an adverse event was > > preventable or negligent, and they included only those errors documented > > in patient records.2 Second, these statistics represent errors in > > hospitals only. More recently, Barker and colleagues observed a > > persistence of the problem in defining 19% of doses administered in > > health care facilities to be in error and 7% rated as potentially > > harmful.3 > > > > 20% of the doses is impressive. > > Reuben, I am always very skeptical of these studies. Does 20% of all > doses make any sense to you?
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. > I have a hard time believing it. A > typical patient may well be on 8 drugs in the hospital, and TID --> 24 > doses a day. So 20%=5 erroneous does a day? I bet this is a > statistacal aberration. Or else I am very nieve. Perhaps the bigger > the numbers quoted, the more likely that one will get one's paper > published? > > Who was working with he Pharmacy > > modules? Was that Kevin? Is there a means for error reporting and > > tracking? > > I haven't seen anything about error tracking, but I am very focused on > a small part of the pharmacy package right now ... drug > classifications with the VA classes. What a headache! 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. > I thought I > was done, and then found 5,000 more drugs in the FDA database that > were completely new to the VA database, so there are no potential > matches that can be used to suggest drug classes for the new drugs. > Also, I have never seen so many drugs that I have never heard of in my > life. All kinds of combination tablets with unfamiliar tradenames.... > Not a surprise. My gut tells me that the FDA listing is not the best place to work off of. Ruben ------------------------------------------------------- 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
