ABSTRACT
OBJECTIVES: Evaluate the compliance of practices of nursing professionals related to the preparation and administration of drugs in 2018. Discuss the evolution of compliance practices from 2014 to 2018. METHODS: Prospective transversal observational study. Based on an observation grid with 55 compliance criteria, we conducted direct observation of medication doses prepared and administered by nursing professionals. For each compliance criterion, the auditor could indicate whether the practice was compliant, non-compliant or not applicable. A convenience target of 250 observations has been set. RESULTS: A total of 252 doses of drugs were observed between March 1, 2018 and April 29, 2018. Drug doses were observed by day (52 %), evening (30 %) or night (18 %) mainly nurses (80 %) working on regular shifts (94 %). Just over half of the doses required preparation by a nurse (58 %) and almost half of the doses were administered parenterally (48 %). In 2018, the observed compliance rate of the drug circuit ranged from 25.0 % to 86.3 %. CONCLUSION: This descriptive study shows a compliance rate of practices of nursing professionals related to the preparation and administration of drugs, which varies from 25.0 % to 86.3 % by observed stage of the drug circuit. 2018. The study identified 15 action actions for continuous improvement.
Subject(s)
Drug Compounding/standards , Nurses/standards , Pharmaceutical Preparations/administration & dosage , Practice Patterns, Nurses'/standards , Adult , Child , Cross-Sectional Studies , Guideline Adherence , Humans , Infusions, Parenteral , Longitudinal Studies , Medical Audit , Medication Errors , Prospective Studies , Quebec , Time FactorsABSTRACT
OBJECTIVE: The goal of the present study was to systematically assess treatment quality, perceptions, and cognitive function of elderly patients with diabetes admitted to an acute geriatric hospital from different home environments (nursing home residents, home care, assisted living, family caregivers, self-sufficient). METHODS: Quality of diabetes treatment, metabolic control (HbA(1c)), nutrition, treatment satisfaction, cognition, disability, and level of dependency were assessed in 128 patients with diabetes. RESULTS: Out of 128 patients, 87 patients (68%) showed an HbA1c≤8% according to the guidelines for aging people with diabetes of the German Diabetes Association (DDG). Compared to patients living independently at home, the metabolic control in nursing home residents and their treatment satisfaction were as good. They had a higher degree of dependency though (Barthel, p<0.001), more strongly impaired mobility (Tinetti, p<0.01), less diabetes knowledge (p<0.001), inferior cognitive performance (MMSE, SPMSQ, p<0.01), and a higher prevalence of depression (GDS) (p<0.01). Better cognitive function correlated with better diabetes knowledge (r=0.49; p<0.001), but not with better metabolic control. CONCLUSION: The treatment of geriatric patients with diabetes mellitus requires individual considerations and interdisciplinary care. Particularly the continuing education of geriatric nurses could contribute to improved diabetes treatment quality in nursing home residents.
Subject(s)
Diabetes Mellitus, Type 2/therapy , Long-Term Care/standards , Patient Admission , Quality Indicators, Health Care/standards , Activities of Daily Living/classification , Aged , Aged, 80 and over , Assisted Living Facilities/standards , Caregivers , Comorbidity , Dependency, Psychological , Disability Evaluation , Germany , Glycated Hemoglobin/metabolism , Home Care Services/standards , Homes for the Aged/standards , Humans , Independent Living , Male , Mobility Limitation , Nursing Homes/standards , Nutritional Status , Patient Satisfaction , Quality Assurance, Health Care/standards , Self Care/standardsABSTRACT
The detrimental results of shoe use manifested both in the foot and in footwear were studied and found to support earlier views that inflared alignment is a significant factor in foot damage. Mechanical implications of alignment also confirmed our impression that the inflared alignment is a deleterious influence. Absence of conclusive physiologic evidence justifying inflaring and the death of end results from use of standard straight last footwear for comparative evaluation suggest that further inquiry regarding this feature is warranted, with view to its elimination.
