Biomedical subjects

Robert Genest

Publications and source records attributed to Robert Genest.

3 recordsLinked to original sources

PubMed2003

What do we know about medication errors in inpatient psychiatry?

BACKGROUND: Adverse drug events (ADEs) have been implicated as a cause of substantial morbidity and mortality. Psychiatrists have successfully characterized one category of ADE--adverse drug reactions (ADRs), which have been studied from a medication-specific psychopharmacology frame of reference. The literature on ADEs, both preventable and nonpreventable, was reviewed within the broader patient safety framework. METHODS: English-language studies involving ADEs and medication errors in psychiatry for 1996 through 2003 were identified on MEDLINE and by using a hand search of bibliographies. RESULTS: Few reports on the incidence and characteristics of medication errors in psychiatric hospitals could be found. Psychiatrists may not be sufficiently aware of the harm caused by errors, methodological issues regarding error detection, the validity of reported medication error rates, and the challenge of creating a nonpunitive error-reporting culture. PREVENTION STRATEGIES: Application of a systems-oriented approach to ADE reduction and the promotion of a nonpunitive culture are essential. Clinical and pharmacy staff could monitor the literature for published reports of preventable adverse events and review those reports in multidisciplinary team meetings. CONCLUSIONS: Psychiatry would benefit from learning about the terminology used in describing medication errors and ADEs. Relatively few data are available regarding the frequency and consequences of medication errors in psychiatry; more research is needed.

Antipsychotic Agents↗

PubMed2003

Use of chart and record reviews to detect medication errors in a state psychiatric hospital.

OBJECTIVE: This study compared the effectiveness of using a review team and the usual self-reporting method in detecting different types of medication errors in a state psychiatric hospital. METHODS: Medication errors were defined by using widely accepted criteria. Rates of prescription, transcription, administration, and dispensing errors were determined, and the risk of harm from each error was rated as high, moderate, or low. A review team was assigned to retrospectively review 31 patient records for prescription, transcription, and administration errors for a total of 1,448 patient-days. Dispensing errors, which can only be determined concurrently, were reported for an equivalent number of patient-days. The error rate was compared with the rate that was determined by the usual method of self-reports from all nursing and medical staff. RESULTS: In the 31 charts retrospectively reviewed and the dispensing events concurrently reviewed, the team detected a total of 2,194 medication errors, whereas a total of nine errors were self-reported for the same patient group. Administration errors accounted for more than half of the total (66 percent), followed by transcription errors (23 percent), prescription errors (11 percent), and dispensing errors (less than 1 percent). Nineteen percent of errors were rated as having a low risk of harm, 23 percent as having a moderate risk, and 58 percent as having a high risk. CONCLUSIONS: Use of a review team should be considered as a method for detecting and reporting medication errors.

Hospitals, Psychiatric↗

PubMed2002

Reducing errors in discharge medication lists by using personal digital assistants.

This study examined whether the number of errors in discharge medication lists at a psychiatric hospital would decrease when the practice of transcribing the lists by hand from physicians' discharge orders was replaced by the use of personal digital assistants (PDAs) to create and directly print out such lists. In a four-month period before the use of PDAs was introduced, 20 of the 110 hand-transcribed lists (22 percent) contained errors. In the four-month period after the use of PDAs was implemented, seven of the 90 PDA-generated lists (8 percent) contained errors. Use of a PDA may be helpful in providing safer patient care.

Computers, Handheld↗