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61.
Leung AA Keohane C Amato M Simon SR Coffey M Kaufman N Cadet B Schiff G Zimlichman E Seger DL Yoon C Song P Bates DW 《Journal of general internal medicine》2012,27(7):801-807
BACKGROUND
It is uncertain if computerized physician order entry (CPOE) systems are effective at reducing adverse drug event (ADE) rates in community hospitals, where mainly vendor-developed applications are used.OBJECTIVE
To evaluate the impact of vendor CPOE systems on the frequency of ADEs.DESIGN AND PATIENTS
Prospective before-and-after study conducted from January 2005 to September 2010 at five Massachusetts community hospitals. Participants were adults admitted during the study period. A total of 2,000 charts were reviewed for orders, medication lists, laboratory reports, admission histories, notes, discharge summaries, and flow sheets.MAIN MEASURES
The primary outcome measure was the rate of preventable ADEs. Rates of potential ADEs and overall ADEs were secondary outcomes.KEY RESULTS
The rate of preventable ADEs decreased following implementation (10.6/100 vs. 7.0/100 admissions; p?=?0.007) with a similar effect observed at each site. However, the associated decrease in preventable ADEs was balanced against an increase in potential ADEs (44.4/100 vs. 57.5/100 admissions; p?0.001). We observed a reduction of 34.0% for preventable ADEs, but an increase of 29.5% in potential ADEs following implementation. The overall rate of ADEs increased (14.6/100 vs. 18.7/100 admissions; p?=?0.03), which was driven by non-preventable events (4.0/100 vs. 11.7/100 admissions; p?0.001).CONCLUSIONS
Adoption of vendor CPOE systems was associated with a decrease in the preventable ADE rate by a third, although the rates of potential ADEs and overall ADEs increased. Our findings support the use of vendor CPOE systems as a means to reduce drug-related injury and harm. The potential ADE rate could be reduced by making refinements to the vendor applications and their associated decision support. 相似文献62.
Michael R. Jaff DO Mark Bates MD Timothy Sullivan MD Jeffrey Popma MD Xingyu Gao MS Margo Zaugg RN BSN Patrick Verta MS Stat DVM MD 《Catheterization and cardiovascular interventions》2012,80(3):343-350
Background : Atherosclerotic renal artery stenosis (ARAS) causes hypertension (HTN) and threatens renal function (RF). The HERCULES Trial is a prospective, multicenter trial of renal stenting in patients with uncontrolled HTN and ARAS evaluating the safety and effectiveness of the RX Herculink Elite Renal Stent System (Abbott Vascular, Santa Clara, CA). Results : Mean systolic blood pressure (SBP) at baseline was 162 mm Hg. Nearly 70% of patients were receiving three or more antihypertensive medications (mean 3.4 medications per patient). Baseline serum creatinine was 1.2 ± 0.4 and 61.5% of subjects had estimated glomerular filtration <60. The restenosis rate was 10.5% at 9 months. The study device, procedure, and clinical success rates were 96.0, 99.2, and 98.0%, respectively. Freedom from major adverse events was 94.8%. At 9 months, the mean SBP significantly decreased (mean 145, paired t test P < 0.0001) after stenting with no change in medications. There was no correlation between SBP reduction and baseline BNP or BNP reduction. 相似文献
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Quantitative assessment of the upper airway in infants and children with subglottic stenosis 下载免费PDF全文
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Srihari S. Naidu MD FACC FAHA FSCAI J. Dawn Abbott MD FACC FSCAI Jayant Bagai MD FSCAI James Blankenship MD MSc MSCAI Santiago Garcia MD FACC FSCAI Sohah N. Iqbal MD FACC FSCAI Prashant Kaul MD FSCAI Matheen A. Khuddus MD FACC FSCAI Lorrena Kirkwood RN BSN MS Steven V. Manoukian MD FACC FAHA FSCAI Manesh R. Patel MD FAHA Kimberly Skelding MD FACC FAHA FSCAI David Slotwiner MD FACC FHRS Rajesh V. Swaminathan MD FSCAI Frederick G. Welt MD FACC FSCAI Daniel M. Kolansky MD FACC FAHA FSCAI 《Catheterization and cardiovascular interventions》2021,98(2):255-276
The current document commissioned by the Society for Cardiovascular Angiography and Interventions (SCAI) and endorsed by the American College of Cardiology, the American Heart Association, and Heart Rhythm Society represents a comprehensive update to the 2012 and 2016 consensus documents on patient-centered best practices in the cardiac catheterization laboratory. Comprising updates to staffing and credentialing, as well as evidence-based updates to the pre-, intra-, and post-procedural logistics, clinical standards and patient flow, the document also includes an expanded section on CCL governance, administration, and approach to quality metrics. This update also acknowledges the collaboration with various specialties, including discussion of the heart team approach to management, and working with electrophysiology colleagues in particular. It is hoped that this document will be utilized by hospitals, health systems, as well as regulatory bodies involved in assuring and maintaining quality, safety, efficiency, and cost-effectiveness of patient throughput in this high volume area. 相似文献
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Kevin W. McConeghy PharmD MS Elizabeth White APRN PhD Orestis A. Panagiotou MD PhD Christopher Santostefano RN BSN Christopher Halladay ScM Richard A. Feifer MD MPH Carolyn Blackman MD James L. Rudolph MD Vince Mor PhD Stefan Gravenstein MD MPH 《Journal of the American Geriatrics Society》2020,68(12):2716-2720
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