ABSTRACT
BACKGROUND: Patients in intensive care units are prone to the occurrence of medication errors. Look-alike, sound-alike drugs with similar drug names can lead to medication errors and therefore endanger patient safety. Capitalisation of distinct text parts in drug names might facilitate differentiation of medication labels. The aim of this study was to test whether the use of such 'tall man' lettering (TML) reduces the error rate and to examine effects on the visual attention of critical care nurses while identifying syringe labels. METHODS: This was a prospective, randomised in situ simulation conducted at the University Hospital Zurich, Zurich, Switzerland. Under observation by eye tracking, 30 nurses were given 10 successive tasks involving the presentation of a drug name and its selection from a dedicated set of 10 labelled syringes that included look-alike and sound-alike drug names, half of which had TML-coded labels.Error rate as well as dwell time, fixation count, fixation duration and revisits were analysed using a linear mixed-effects model analysis to compare TML-coded with non-TML-coded labels. RESULTS: TML coding of syringe labels led to a significant decrease in the error rate (from 5.3% (8 of 150 in non-TML-coded sets) to 0.7% (1 of 150 in TML-coded sets), p<0.05). Eye tracking further showed that TML affects visual attention, resulting in longer dwell time (p<0.01), more and longer fixations (p<0.05 and p<0.01, respectively) on the drug name as well as more frequent revisits (p<0.01) compared with non-TML-coded labels. Detailed analysis revealed that these effects were stronger for labels using TML in the mid-to-end position of the drug name. CONCLUSIONS: TML in drug names changes visual attention while identifying syringe labels and supports critical care nurses in preventing medication errors.
Subject(s)
Medication Errors , Syringes , Male , Humans , Prospective Studies , Medication Errors/prevention & control , Patient Safety , Drug Labeling/methods , Critical CareABSTRACT
A retrospective review of 23 patients with restricted motion after 32 combined digital injuries or amputations in zone II treated with tenolysis was conducted at an average follow-up of 5 years. Significant functional improvement was achieved in 28 out of 32 digits (88%). Total active motion improved on average 51 degrees after dorsal tenolysis, 55 degrees after palmar tenolysis, and 63 degrees after combined dorsopalmar tenolysis. Using the Buck-Gramcko scoring system, 15 digits reached excellent results, 8 showed a good result, 4 had a fair result, and 5 were rated as poor. No digits were lost. All patients returned to a full-time job. Complications consisted of 16% flexor tendon ruptures after palmar or combined tenolyses. In contrast, dorsal tenolysis proved to be a safe procedure. Prerequisites for success are compliant patients who are willing to undergo therapy for at least 3 months postoperatively. Despite the demanding postoperative therapy, the individual patient satisfaction is high following tenolysis.
