Characteristics of Medication Administration Error Alerts in Application of Mobile Medication System / 기본간호학회지

Purpose@#To assess characteristics the application of mobile medication system and medication administration error (MAE) alerts in a general hospital. @*Methods@#The subject hospital adopted a mobile medication system in 2016. All medication administrations in the general wards and ICUs were automatically recorded in real-time using identification barcodes, drug barcodes, and hand-held point-of-care devices. MAE alert logs were recorded from April 1st 2017 to March 31st 2018. For this study analysis was done using Pearson’s chi-squared test for potentially related factors of MAE alerts included administration time, order type, medication route, and length of nurse’s employment. @*Results@#The total number of medications during the period of this study was 3,227,990. Among them, 2,698,317 medication doses were recorded, resulting in the system application rate of 83.6%. The system application rate was significantly correlated with all factors related to potential MAE alters. In this study 23,314 MAE alerts(0.9% of the total medication doses) were identified. The MAE alerts were related to new (OR=2.26, p<.001) and emergency (OR=2.25, p<.001) orders, and administration at a non-standard time (OR=2.032, p<.001). Medication route (p<.001), and nurse’s employment duration(p<.001) were also related. @*Conclusion@#A mobile medication system contributes to improving patient safety by preventing potential MAEs. The MAE alerts were related to administration time, order type, medication route, and duration of nurse’s employment. In order to prevent medication administration errors, it is necessary to standardize the process of medication and create an environment in which medication administration can be performed in a planned situation.

Deep Vein Thrombosis in Patients with Pulmonary Embolism: Prevalance, Clinical Significance and Outcome

PURPOSE: Deep venous thrombosis (DVT) and pulmonary embolism (PE) are considered as similar disease entities representing different clinical manifestations. The objectives of this study were: 1) to determine the prevalence and outcome of DVT in patients with PE; 2) to identify additional risk factors for PE-related unfavorable outcome and 30-day all-cause mortality; and 3) to establish the clinical importance of screening for concomitant DVT. MATERIALS AND METHODS: From January 2013 to December 2015, a total of 141 patients with confirmed PE were evaluated. The prevalence and outcome of DVT in patients with PE was determined. Furthermore, the potential risk factors for PE-related unfavorable outcome and 30-day all-cause mortality were also analyzed. RESULTS: The prevalence of concomitant DVT was 45.4%. PE-related unfavorable outcome was observed in 21.9% of all concomitant DVT, with all-cause mortality of 21.9%. There was no significant relationship between the presence of concomitant DVT and the development of PE-related unfavorable outcome or all-cause mortality. Our results indicated that heart rate >100/min and peripheral oxygen saturation <90% were independent predictors for PE-related unfavorable outcome. Regarding all-cause mortality, active malignancy and hypotension or shock were significant risk factors. CONCLUSION: Our findings demonstrate that approximately half of patients with PE possess DVT. However, this study failed to establish any clinical significance of concomitant DVT for PE-related unfavorable outcome and all-cause mortality. Tachycardia and hypoxemia were identified as significant predictors for PE-related unfavorable outcome along with active malignancy and hypotension or shock as significant risk factors of all-cause mortality.

Assessment of Nurses' Nutritional Knowledge and Educational Needs Regarding Stroke Specific Diet Regimens

PURPOSE: Although the prevalence rate of chronic diseases is rapidly increasing due to an unhealthy diet in Korea, nurses may not have enough nutritional knowledge to educate their patients. This study investigated the level of nurses' nutritional knowledge for chronic diseases as well as for strokes, and the needs for nurses' nutritional education. METHODS: This research is a descriptive research conducted from April to August of 2014, on 242 nurses who work with stroke patients, in two tertiary general hospitals in the city of Seoul, South Korea. RESULTS: The average nutritional knowledge score of our subjects was 19.9+/-2.51 (range 12-24). The correct response rate was 83% which was higher than expected. However, many nurses (31-66%) answered incorrectly on items such as 'Drinking low-fat milk is better than whole milk', and 'Seasoning with a large amount of soy sauce instead of salt can reduce sodium consumption'. We also found that nurses who received continuing education regarding nutrition scored higher than those who did not (p=.020). There was no correlation between nutritional knowledge and the need for nutritional education (r=.034, p=.601). CONCLUSION: The level of nutritional knowledge of the nurses was relatively low and irrelevant to the completion of nutrition courses during university or duration of experience. Rather, the relevance was higher when the nurse received nutrition-related training after graduating from university. Our results imply that continuous nutritional education is necessary for hospital nurses.