A peer review-based quality assurance system.
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Hospital Bed Capacity, 500 and over↗
Biomedical subjects
D J Harry
Publications and source records attributed to D J Harry.
Documenting pharmacists' interventions on a hospital's mainframe computer system.
The development and implementation of a code that enables pharmacists to document their clinical interventions in the hospital's computerized patient records is described. To allow data to be entered in patient records from terminals throughout the hospital that are linked to the mainframe computer, a code was developed to summarize each pharmacist recommendation. The coded information is added to the computer entry for the specific drug requiring intervention. A computer program was developed inhouse for generating daily reports of the pharmacist interventions. During an initial 25-day study period, 300 interventions were documented; house staff physicians accepted the pharmacists' recommendations in 257 (85.7%) of these interventions. An additional 17 (6%) of the interventions resulted from physicians' requests for pharmacists' recommendations. In addition to review of all pharmacist clinical interventions, this system allows review of a specific target drug to determine compliance with institutional drug-use guidelines. Through use of the computer program developed at this hospital, information that documents pharmacists' clinical services can be entered directly into patients' records on the hospital's mainframe computer system and retrieved as useful reports.
Academic Medical Centers↗
Pharmacy-coordinated program that encourages physician reporting of adverse drug reactions.
A pharmacy-coordinated program for encouraging physician reporting of adverse drug reactions (ADRs) is described. The ADR surveillance program at the Medical Center Hospital of Vermont, a 500-bed tertiary-care hospital, is in its fifth year. Key elements are close interaction between physicians and pharmacists, feedback, program promotion, and financial incentive. The program is promoted chiefly to house staff physicians. A physician may identify a suspected ADR, or he or she may be alerted by a pharmacist. The physician completes the first part of a form, which requests information on the patient, the severity of the reaction, the actions taken, and any predisposing factors. A pharmacist reviews the incident independently and in consultation with the reporter and then completes the second part of the form, which asks the pharmacists to assess the probability that the drug caused the ADR and to classify the reaction. A summary is sent to the physician and may be reported to the FDA and the manufacturer. Each report earns the reporter a $5 stipend. Information from the ADR forms is entered into a dBASEIII PLUS computer program for later retrieval and analysis. During a 12-month period, 175 ADR reports (out of a total of 249 reports) were received from house staff members, compared with about 4 voluntary reports received annually before the program began. The ADR surveillance program has increased physician reporting of ADRs and produced a reliable database that can be used to influence hospital policy and promote education.
Drug-Related Side Effects and Adverse Reactions↗
Antigen detection for human immunodeficiency virus.
The recent development of enzyme immunoassay procedures for the direct determination of human immunodeficiency virus (HIV) antigens has been of significant benefit in both clinical and research applications. The historical development of HIV antigen assays as well as their current and future applications for use in the clinical microbiology laboratory are reviewed. A detailed description of selected commercially available assays is presented, and a comparison is made of various parameters, including sensitivity, specificity, and cost. The use of the HIV antigen assay as an alternative to the reverse transcriptase assay in virus culture applications is also discussed. In addition, the diagnostic and prognostic utility of the HIV antigen assay is considered for various patient groups, including neonatal, high-risk asymptomatic, seronegative, and seropositive patient populations. The use of the HIV antigen assay as an adjunct to anti-HIV antibody testing, as well as its utility in assessing the therapeutic efficacy of antiviral drug therapy, is discussed. The biology of HIV antigen expression and modulation of anti-HIV antibody titers during infection are also discussed in terms of two possible models.
AIDS Serodiagnosis↗
Enzyme immunoassay for the detection of Giardia lamblia.
An enzyme immunoassay (EIA) was developed for direct detection of Giardia lamblia antigens in fecal specimens. The EIA was evaluated by testing specimens from 1,331 subjects in the USA and Egypt. For the 353 specimens from human subjects in the USA there was a 97% overall agreement between the results of the EIA and direct microscopic examination, yielding a sensitivity and specificity of 92% and 99% respectively. Due to adverse field conditions the EIA did not perform as well in the specimens collected and tested in Egypt. The sensitivity and specificity for 585 human specimens from Egypt were 74% and 97% respectively.
Animals↗
More on production of carbon dioxide gas after reconstitution of ceftazidime.
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Carbon Dioxide↗
Evaluation of the CAP microcomputer-based SNOMED encoding system.
The microcomputer-based SNOMED encoding system, recently announced by the CAP, has been evaluated in a setting designed to emulate the typical surgical pathology environment. Key features such as minimization of manual entry, ease of use, data integrity, and convenient retrieval capabilities were examined. The system was found to perform satisfactorily in all such features.
Computers↗
Do you understand the role of software? It's the key to performance of laboratory computer systems.
Pathologists making decisions regarding computer applications in their laboratories need to understand all three aspects of computer technology: software, the user interface, and hardware. Of these, software may be the most important. This article identifies problems associated with software usage, taking into account contraints imposed by hardware and personnel, then suggests criteria for evaluating software. If pathologists are to derive maximum benefit from their investment in automated technology, they need to understand the intrinsic role of software in computer-based systems.
Computers↗
Measurement of ionized magnesium in biological fluids.
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Azo Compounds↗
Computer assisted transcutaneous oxygen monitoring.
A computerized system for acquisition of data from a transcutaneous PO2 (PtcO2) monitor is presented. A North Star Computer, Inc., "Horizon" microcomputer was used in this system. The PtcO2 monitor was a Radiometer TCM-1 equipped with an external printer interface. The system had a custom interface module to accept binary-coded decimal data from the PtcO2 monitor. In addition, a 16-channel, 12-bit A/D module, a real-time clock module with interrupt capability, and a high-resolution graphics module were incorporated.
Computers↗
Computerized transcutaneous monitoring incorporating laser Doppler velocimetry.
Measurements of transcutaneous oxygen tension, transcutaneous carbon dioxide tension, transcutaneous heater power, transcutaneous electrode temperature, and peripheral perfusion at the gas measurement site (assessed by laser Doppler velocimetry) are monitored by a microprocessor-based data acquisition system. Arterial blood pressure, central venous pressure, pulmonary artery pressure, respiration rate, and heart rate may be simultaneously captured with the system unattended for 12-hour intervals. This computerized monitoring system is mobile and easily applied by medical technologists to adult or neonatal intensive care patients. Simultaneous collection of the measurement data has facilitated research on the interrelationships of the measured parameters. It should be helpful in assessing optimal therapeutic interventions as well as the changing physiology of acutely ill patients.
Adult↗