The perceptions of nurses towards barriers to the safe administration of medicines in mental health settings

The purpose of this study was to investigate perceptions of barriers to safe administration of medicines in mental health settings. A cross‐sectional survey was used, and 70 mental health nurses and 41 students were recruited from a mental health trust and a university in Yorkshire, UK. Respondents completed a questionnaire comprising closed‐ and open‐response questions. One item, which contained seven sub‐items, addressed barriers to safe administration of medication. Seven themes—five nurse‐ and prescriber‐focused and two service user‐focused—were abstracted from the data, depicting a range of barriers to safe administration of medicines. Nurse‐ and prescriber‐focused themes included environmental distractions, insufficient pharmacological knowledge, poorly written and incomplete medication documentation, inability to calculate medication dosage correctly, and work‐related pressure. Service user‐focused themes comprised poor adherence to medication regimens, and cultural and linguistic communication barriers with service users. Tackling medication administration error is predominantly an organizational rather than individual practitioner responsibility.     

A retrospective analysis of the risk factors for allergic reactions induced by the administration of oxaliplatin

This study retrospectively investigated the clinical features and risk factors of allergic reactions induced by oxaliplatin administration. This study investigated the incidence of allergic reactions and analysed the background and laboratory data in patients with colorectal cancer treated with oxaliplatin‐based chemotherapy at Kyushu Medical Center between April 2012 and September 2012. A total of 62 patients were included in this study. The number of patients in the allergic and non‐allergic groups was 7 and 55 respectively. The incidence of allergic reactions was 11.3%. We compared the patients' characteristics and laboratory data between the two groups and found that the average dose of dexamethasone in the allergic group was significantly lower than that observed in the non‐allergic group (P = 0.0111). Furthermore, the incidence of allergic reactions in the group that received prophylaxis of less than 12 mg of dexamethasone was significantly higher than that observed in the group that received more than 12 mg of dexamethasone (P = 0.0103). In conclusion, a lower dexamethasone dose is a possible risk factor for allergic reactions induced by the administration of oxaliplatin; however, given the retrospective design used in this study, further validation of this finding is warranted.     

Prognostic factors in upper gastrointestinal bleeding

In this study we examined factors of possible prognostic value about outcome in a consecutive series of 2217 patients with hematemesis and melena. Death occurred in 189 (8.5%) patients, and 243 (11%) patients experienced rebleeding. Death was significantly associated with rebleeding, age over 60 years, and the finding of blood in the stomach at endoscopy. Rebleeding was significantly associated with melena, identification of a gastric or duodenal ulcer, endoscopic stigmata of hemorrhage such as blood, clot, and active bleeding, and the finding of shock at admission. However, female gender, previous history of ulceration, or indigestion of ulcerogenic drugs, especially nonsteroidal antiinflammatory drugs, were poor predictors of either death or rebleeding. We conclude that the identification of patients at a high risk could contribute to improved management of patients with gastrointestinal bleeding, including early therapeutic intervention.