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Biomedical subjects

Wm Claiborne Dunagan

Publications and source records attributed to Wm Claiborne Dunagan.

10 recordsLinked to original sources
PubMed2005

Redesigning an infection control application to support an enterprise model.

As the demands on hospital infection control teams increase, it becomes less efficient for them to use paper-based surveillance methods. The existing electronic infection control surveillance system at our largest facility was not designed to support a multi-hospital model. Our goal was to redesign the application using generic, open source technologies, and make it flexible enough to support the infection control surveillance needs of the entire enterprise.

Cross Infection↗
PubMed2005

Automatic detection of spironolactone - related adverse drug events.

Due to increasing reports of spironolactone associated life-threatening hyperkalemia, we implemented a rule in our automated event detection system to monitor serum potassium results in patients receiving spironolactone. In 2004, 419 (10.49%) of 3995 admissions at 3 BJC HealthCare hospitals were identified as having hyperkalemia while on spironolactone. For a 9-month period in one facility, 33 of 52 automatically detected potential ADEs had been validated by pharmacists through manual chart review to have spironolactone as a contributing factor (PPV=63.5%).

Adverse Drug Reaction Reporting Systems↗
PubMed2005

Using outpatient prescription claims to evaluate medication adherence in an acute myocardial infarction population.

We have previously shown that using computerized alerts and academic detailing results in significant improvement in physician adherence to secondary prevention guidelines for acute myocardial infarction. However, information about patient medication adherence after hospital discharge was not previously available. Using electronic outpatient prescription claims data, medication adherence for a coronary artery disease population is described.

Ambulatory Care↗
PubMed2005

Physicians' knowledge and attitudes about coronary heart disease prevention guidelines and technology assisted interventions.

BJC Healthcare is conducting a randomized controlled study to evaluate the impact of a technology-assisted pharmacist intervention on physicians' adherence to national coronary heart disease (CHD) prevention guidelines. We surveyed physicians to assess their knowledge of the guidelines and attitudes toward pharmacist-mediated interventions.

Attitude of Health Personnel↗
PubMed2005

Customizing a commercial rule base for detecting drug-drug interactions.

We developed and implemented an adverse drug event system (PharmADE) that detects potentially dangerous drug combinations using a commercial rule base. While commercial rule bases can be useful for rapid deployment of a safety net to screen for drug-drug interactions, they sometimes do not provide the desired rule sensitivity. We implemented methods for enhancing commercial drug-drug interaction rules while preserving the original rule base architecture for easy and low cost maintenance.

Adverse Drug Reaction Reporting Systems↗
PubMed2005

Concordance between medication histories and outpatient electronic prescription claims in patients hospitalized with heart failure.

Using an electronic prescription claims database and electronic hospital records, we retrospectively compared outpatient heart failure (HF) prescriptions dispensed with reported use obtained during medication histories taken at hospital admission. We found significant disagreement between each source for all but one HF medication class.

Clinical Pharmacy Information Systems↗
PubMed2003

Monitoring pharmacy expert system performance using statistical process control methodology.

Automated expert systems provide a reliable and effective way to improve patient safety in a hospital environment. Their ability to analyze large amounts of data without fatigue is a decided advantage over clinicians who perform the same tasks. As dependence on expert systems increase and the systems become more complex, it is important to closely monitor their performance. Failure to generate alerts can jeopardize the health and safety of patients, while generating excessive false positive alerts can lead to valid alerts being dismissed as noise. In this study, statistical process control charts were used to monitor an expert system, and the strengths and weaknesses of this technology are presented.

Clinical Pharmacy Information Systems↗
PubMed2003

Validation of automated event triggers using laboratory values related to two problem-prone drugs.

We used computerized alerts to identify patients with laboratory values that could be related to medication errors associated with digoxin and warfarin. Over a six-week period at two inpatient facilities, we generated 62 laboratory-based alerts for warfarin, and 66 for digoxin. The positive predictive value for these alerts representing a preventable event was 71% and 57% for warfarin and digoxin, respectively.

Anticoagulants↗