ABSTRACT
UNLABELLED: Evidence suggests that medication safety may be improved through more accurate assessment of renal function and appropriate dosing of renally cleared medications. The purpose of this article is to describe patient renal risk groups, associated medication errors, and ways that nurses can improve renal assessment. METHODS: Medication safety data were collected through voluntary reporting, computerized triggers, pharmacist surveillance, and retrospective chart review. Data were analyzed across 3 renal risk groups. RESULTS: Findings indicated that regarding the detected medication errors, elderly women were more likely to have hidden renal risk and that prescribing errors involving a wrong dose occurred more often in patients with high and hidden renal risk. Antibiotic and diabetic medications were the primary drug categories involved in these medication errors. RECOMMENDATIONS: Results indicated that identification of patients with hidden renal risk can be improved by routinely assessing serum creatinine and estimated creatinine clearance levels during renal assessments. Clinical nurse specialists can use this evidence to promote safer nursing care of renal patients.
Subject(s)
Drug-Related Side Effects and Adverse Reactions , Kidney/drug effects , Medication Errors/prevention & control , Aged , Aged, 80 and over , Education, Continuing , Female , Humans , Male , Middle Aged , Nursing , Risk FactorsABSTRACT
According to the Institute for Advanced Dental Technologies, dental lasers have obtained approximately a 6% market penetration in the United States. Unfortunately, a small percentage of doctors have been disappointed with the technology. This article has been written as a guide for clinicians to use before purchasing a dental laser. It is the hope of the authors that this material will allow the clinicians to have a better appreciation of this technology and maximize its successful integration into practice.
Subject(s)
Dentists , Laser Therapy , Laser Therapy/instrumentation , Decision Making , Dental Equipment/economics , Dental Staff/education , Education, Dental , Equipment Design , Government Regulation , Humans , Laser Therapy/economics , Lasers/classification , Patient Education as Topic , Product Surveillance, Postmarketing , Technology, Dental/education , United StatesABSTRACT
BACKGROUND AND OBJECTIVE: High intensity infrared light from the pulsed Nd:YAG dental laser is absorbed by carious enamel and not absorbed by healthy enamel. Consequently, this system has potential for selective removal of surface enamel caries. Safety and efficacy of the clinical procedure was evaluated in two sets of clinical trials at three dental schools. Selective ablation was evaluated with FTIR spectroscopy. STUDY DESIGN/MATERIALS AND METHODS: Carious lesions were randomized to drill or laser treatment. Pulp diagnosis, enamel surface condition, preparations, and restorations were evaluated by blinded evaluators. In Study I, surface caries were removed from 104 third molars scheduled for extraction. One-week post-treatment teeth were evaluated clinically, extracted, and the pulp was examined histologically. In Study II, 90 patients with 462 lesions on 374 teeth were randomized to laser or drill and followed for 6 months. RESULTS: Pulsed Nd:YAG laser removal of surface enamel caries was demonstrated to be both safe and effective. Caries were removed in all conditions. There were no adverse events and both clinical and histological evaluations of pulp vitality showed no abnormalities. A significantly greater number of preparations in the drill groups vs. laser groups entered dentin (drill = 11, laser = 1, P = 0.007). CONCLUSION: The more conservative laser treatment removed the caries but not the sound enamel below the lesion. The pulsed Nd:YAG dental laser was found to be both safe and effective for surface caries removal.
