Ethyl glucuronide for detecting alcohol lapses in patients with an alcohol use disorder.

Urine ethyl glucuronide (EtG) was screened in 75 patients during a hospital-based treatment for an alcohol use disorder. During follow-up, EtG was detected in 35 (14.6%) of the 239 urine samples. Positive screens were found in 22 patients (29%), of whom nine were outpatients (39.1% of all outpatients) and 13 inpatients (25.0% of all inpatients). Of the 22 patients with positive EtG, five (22%) also gave a positive breath alcohol test and 10 (45.5%) reported recent alcohol consumption; 12 (54.5%) gave a negative breath alcohol test and declared no alcohol lapse. Ethyl glucuronide has been found useful in detecting covered lapses.

Medication errors management process in hospital: a 6-month pilot study.

The objectives of this study are to assess the relevance of the medication error reporting system in a French teaching hospital, to enable the collection of medication error reports and to take corrective actions to reduce occurrence. This is a prospective pilot study based on blame-free reporting by healthcare professionals. The study setting is five medical/surgical departments in a French teaching hospital over a 6-month period. The main outcomes of this study are types, frequency, and consequences of medication errors reported. Over a 6-month period, 47 medication errors were reported. Twenty-eight (60%) were related to the prescription process, of which 17 were prescribing errors, 10 were because of data capture error and one was because of software malfunction. Ten medication errors (21%) were related to the dispensing process and eight (17%) to errors occurring during drug administration. Finally, one medication error (2%) was related to prescription, dispensing, and administration. The reporting process was accepted by most healthcare professionals who agreed to initiate medication errors reports upon assurance that data collection will be confidential. The reporting process led to several avoidance actions to minimize the medication error risk. Maintaining confidentiality embedded within a nonpunitive environment, this method was accepted by all participating personnel. Medication errors could be collected, reviewed, and corrective actions taken. This strategy can be a first step in a long-term ongoing process to prevent future medication errors in hospitals.

[Stopping smoking and constipation]. / Constipation à l'arrêt du tabac.

INTRODUCTION: Among the symptoms that may occur with smoking withdrawal, constipation is relatively frequent, but little studied. CASE: Three women reported that constipation developed when they stopped smoking and improved during transient relapses. DISCUSSION: This constipation sometimes produces serious functional disorders and can induce relapse. It occurs especially among women and those predisposed to it. Nicotine, by acting on the parasympathomimetic system, increases intestinal peristalsis, and a cigarette can appear to be effective self-medication. Magnesium salts are the first-line treatment for this problem. If they fail, neostigmine, an anticholinesterase with parasympathomimetic activity, appears remarkably effective in correcting this disorder.

[A survey of pain prevalence at Albert-Chenevier Hospital. Comparison of patient, caregivers and physician assessments]. / Enquête de prévalence de la douleur à l'Hôpital Albert-Chenevier. Comparaison des évaluations menées par les patients, les soignants et les médecins.

The purpose of this study is to estimate the prevalence of pain in hospitalized patients and to compare pain assessments performed by patients, caregivers and physicians. This cross-sectional study was based on evaluating pain with three questionnaires. Two structured questionnaires explored the patient's and physician's points of view about hospital pain management. Caregivers used the validated Doloplus-2 scale. The three assessments were considered consistent when all three indicated the presence or absence of pain. All inpatients (447) were included. The prevalence of pain was 57% when assessment was performed by caregivers and 53% when it was performed by physicians. Among patients included in the prevalence study, 366 could express themselves and agreed to answer the self-assessment questionnaire (82%): 66% of these patients reported pain. Patients and physicians often reported leg pain. Assessment of pain produced a higher level of pain intensity when performed by patients than when by physicians. Furthermore, 88% of patients reporting pain received pain relief treatment: nevertheless patients felt that their pain was satisfactorily managed in only half of their locations, and they had a less positive appreciation of their level of pain management than physicians did. Our study showed that many psychiatric patients declared they suffered pain. Full consistency between the three assessments was noted for half the cases. One out of ten patients experiencing pain was not identified.