Pharmacist Staffing, Technology Use, and Implementation of Medication Safety Practices in Rural Hospitals

CONTEXT: Medication safety is clearly an important quality issue for rural hospitals. However, rural hospitals face special challenges implementing medication safety practices in terms of their staffing and financial and technical resources. PURPOSE: This study assessed the capacity of small rural hospitals to implement medication safety practices, with particular focus on pharmacist staffing and the availability of technology. METHODS: A telephone survey of a national random sample of small rural hospitals was conducted from March to May 2005 (N = 387 hospitals, 94.6% response rate). Survey respondents included pharmacists (89%) and directors of nursing (11%). Multivariate analyses examined the relationships between hospital organizational and financial variables and (1) the amount of pharmacist staffing; (2) use of pharmacy computers for medication safety activities; and (3) implementation of medication safety practices. FINDINGS: Many small rural hospitals have limited hours of on-site pharmacist coverage. Almost one quarter of hospitals either do not have a pharmacy computer or are not using it for clinical purposes. Half of the hospitals have implemented 4 key medication safety practices. Level of pharmacist staffing, use of technology, and implementation of medication safety practices are significantly related to hospital financial status and accreditation. CONCLUSIONS: Implementation of protocols related to medication use and key medication safety practices are areas where small rural hospitals could improve. The study results support a continuation of Medicare cost-based reimbursement policies to help ensure financial stability and support quality and patient safety activities in small rural hospitals.     

The p53-targeting human phosphatase hCdc14A interacts with the Cdk1/cyclin B complex and is differentially expressed in human cancers

Background  

The evolutionary conserved cyclin-dependent kinase phosphatase hCdc14A has been shown to play potential roles in the regulation of mitotic exit and in the centrosome duplication cycle. We have recently shown that hCdc14A also can interact with the tumor suppressor p53 both in vitro and in vivo and specifically dephosphorylates the ser315 site of p53 in vitro. In this study we developed antibodies against hCdc14A to investigate the expression and regulation of hCdc14A in human tissues and cancer cells.     

The effect of treatment with angiotensin-converting enzyme inhibitors on survival of pediatric patients with dilated cardiomyopathy

Summary Outcome in 81 pediatric patients with dilated cardiomyopathy was reviewed to assess whether treatment with angiotensin-converting enzyme (ACE) inhibitors affected survival. Age at onset was 3.6±0.6 years. Twenty-seven children (group 1) were treated with ACE inhibitors. Conventional therapy was used in the remaining 54 patients (group 2). There were no significant differences between the two groups in age at onset, left ventricular shortening fraction, left ventricular end-diastolic pressure, or mean pulmonary artery pressure. Patients treated with ACE inhibitors had a significantly better survival during the first year (p<0.05) with continuation of this trend throughout the second year (p=0.06). Beyond 2 years there was a tendency toward better survival in ACE inhibitor-treated patients, but the differences were no longer significant (p=0.14). These data, along with observations in adult patients with chronic cardiac failure, indicate that converting enzyme inhibitors have a beneficial effect on prolonging survival of infants and children with severe left ventricular dysfunction from dilated cardiomyopathy.     

Successful treatment of acute lymphoblastic leukemia in a child with cystic fibrosis

A 3 1/2 year old girl with cystic fibrosis who underwent successful treatment for acute lymphoblastic leukemia remains in complete remission 36 months after diagnosis. We also report high clearance rates of three antineoplastic agents in this patient. Drug doses were adjusted to achieve optimal systemic exposure. © 1994 Wiley-Liss, Inc.     

Use of Breast Cancer Screening by Older Hispanic Women

The purpose of this exploratory study was to provide information on older Hispanic women's access to and use of breast cancer screening services. Interviews were conducted with 150 Hispanic women, 47 to 93 years of age, in a southwestern city. The results indicated that differences in use and compliance with recommended screening guidelines were due primarily to differences in access to the health care system and attitudes about preventive care. Targeted strategies for these women have to be developed and implemented to ensure that they receive the necessary information to avail themselves of breast cancer screening procedures.     

Comparative effects of luminance and scatter on the pattern visual evoked potential and eye-hand reaction time

We investigated the effect of reduced luminance and increased scatter on the pattern visual evoked potential and eye-hand reaction time evoked to a check size of 0.5° in 10 normal subjects. Data analysis indicated that a reduction in luminance as well as an increase in scatter caused a statistically significant increase in the peak time of the pattern visual evoked potential P₁₀₀ wave. The reaction time, however, was not significantly affected by the initial 0.9-log unit attenuation of the stimulus luminance or the 0.3 scatter filter. Further attenuation of luminance or increase of scatter also yielded statistically significant increases. Our results suggest that the reaction time is less affected by a reduction in luminance or an increase in scatter of a 0.5° stimulus than the pattern visual evoked potential is and therefore represents a more reliable test to assess visual function, especially in the presence of medial opacities, which are known to reduce luminance and produce scatter.