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Biomedical subjects

Rodney W Hicks

Publications and source records attributed to Rodney W Hicks.

8 recordsLinked to original sources
PubMed2004

Selected medication-error data from USP's MEDMARX program for 2002.

PURPOSE: Records from USP's MEDMARX database of medication errors for 2002 were studied. METHODS: Records of medication errors submitted to MEDMARX by participating health care institutions during 2002 were analyzed for error category index (whether a medication error actually occurred, whether it reached the patient, and, if so, the effect), node (the point in the medication-use process where the error occurred), type of error, cause, contributing factors, and drug products involved. RESULTS: The number of participating institutions was 482, and the number of medication error records released to MEDMARX was 192,477, an 82.2% increase from 2001. Errors that did not reach the patient were seen in 35% of the records, errors that reached the patient were seen in 49%, and errors that may have contributed to or resulted in harm were seen in 2%. The nodes, types of errors, causes of errors, contributing factors, and leading products by generic name are discussed. CONCLUSION: An analysis of over 192,000 records of medication errors submitted by nearly 500 health care facilities to USP's MEDMARX database in 2002 produced detailed information on the scope and nature of medication errors.

Adverse Drug Reaction Reporting Systems↗
PubMed2004

Medication errors in the PACU: a secondary analysis of MEDMARX findings.

Medication errors commonly occur in many health care settings. This review of medication errors illustrates that complex, fast-paced care delivered in PACUs often occurs in an environment where patients encounter numerous processes as they move from preadmission, to preop holding, to the operating room, to PACU, and then back to a clinical unit or discharge. Using a nationally recognized framework, 645 PACU medication error records were analyzed. The errors resulted in a higher than expected threshold of harm (6.8%), with most errors occurring during the administration phase (59%) of the medication use process. Nearly one quarter of the errors involved an improper dose of a medication. Three quarters of the errors were influenced by distractions. More than 130 different products were present in the sample of cases reviewed. Problem areas identified involved epidural analgesia, patient-controlled analgesia, and duplicate doses.

Causality↗
PubMed2004

Unfractionated heparin: focus on a high-alert drug.

Unfractionated heparin (UFH) is associated with a high rate of drug-related problems due to either its inherent pharmacologic properties or an extension of these properties often caused by medication errors. The drug-related problems associated with UFH can significantly hinder the success of therapy and negatively affect the overall cost of care. Unfractionated heparin has been classified as a high-alert drug by the Institute for Safe Medication Practices. Approximately 2.1% of the total records submitted to the MedMARx national error database were related to UFH; 4.5-5.5% of these errors reported were harmful. With this high potential for error, it is essential that all health care providers adopt a collaborative or systems approach to identify solutions to reduce the occurrence of these medication errors. The Joint Commission on Accreditation of Healthcare Organizations has published national patient safety goals for improving the safety of patient care, many of which are applicable to UFH therapy. Unfractionated heparin drug-related problems not necessarily related to medication errors include heparin-induced thrombocytopenia, bleeding events, and osteopenia. Heparin-induced thrombocytopenia is a serious complication of heparin therapy and remains seriously undiagnosed. Bleeding events often occur with therapeutic as well as prophylactic UFH administration even when monitoring indexes are within the therapeutic range. However, due to the variability associated with UFH monitoring methods, definitive guidelines are lacking to assist in avoiding such serious events. Osteopenia has been associated with long-term UFH therapy; one third of patients experience reductions in bone density, potentially leading to fractures. Today, safer alternative anticoagulation therapies are available, such as the low-molecular-weight heparins. When compared with UFH, these alternative therapies provide equivalent or superior efficacy for numerous indications.

Bone Diseases, Metabolic↗
PubMed2003

Patient safety first alert--epinephrine and phenylephrine in surgical settings.

Epinephrine and phenylephrine always should be used with extreme caution, especially in their most concentrated solutions. This is especially true in the OR where these medications are used for purposes involving extreme variations in doses and strengths. Although these medications may be handled and administered daily, clinicians must be vigilant in their efforts to ensure safe handling practices. Clinicians should monitor patients carefully for any adverse side effects. Practitioners should review up-to-date references for all products, including epinephrine and phenylephrine, and follow the recommended strategies and measures to reduce risks when preparing, handling, or administering these medications in the OR.

Adrenergic alpha-Agonists↗
PubMed2003

Medication errors in the OR--a secondary analysis of Medmarx.

Although medication errors can result in serious patient complications or even death, a paucity of information regarding medication errors that occur in the OR exists. AORN and the US Pharmacopeia (USP) collaboratively conducted a secondary analysis of reports of medication errors that occurred in the OR. These reports were submitted to the USP via the Medmarx program. The findings will give perioperative clinicians further insight into the types and causes of medication errors that occur in the OR and will help them develop potential prevention strategies.

Databases, Factual↗
PubMed2003

Medication errors: experience of the United States Pharmacopeia (USP) MEDMARX reporting system.

Medication errors are pervasive in America's health care system. MEDMARX is an Internet-accessible, anonymous medication error reporting program designed for hospitals and health systems to systematically collect, analyze, and report medication errors. This study examined 154,816 medication error reports that were submitted to MEDMARX between January 1, 1999, and December 31, 2001. Data fields analyzed were error category (based on the National Coordinating Council for Medication Error Reporting and Prevention's Error Category Index), type(s) of error, cause(s) of error, contributing factor(s), and product(s) involved. Approximately two-thirds of the errors reported reached the patient, with relatively few causing harm. Death was reported in 19 occurrences. Errors of omission and improper dose/quantity were the most commonly reported. Performance deficit and procedure/protocol not followed were consistently identified as causes of error. Distractions and workload increase were often cited as contributing factors. There was a similar pattern of products reported in each of the years. Implications for quality assurance, clinical practice, and health policy are presented.

Adverse Drug Reaction Reporting Systems↗