ABSTRACT
OBJECTIVE: To generate, validate and establish a web-based individualised opioid conversion calculator at the University Hospital Basel and to analyse its value and significance. SETTING: A 700-bed university hospital. METHOD: Published data were screened by a Medline search using the keywords: opioid, rotation, switching, potency and dose ratio. Based on this data, the criteria for the conversion calculator were defined. A prospective process validation was performed prior to the approval. Five months after the introduction of the tool, an online survey was performed in order to evaluate its acceptance by users. In the last step, a manual calculation using a written table was compared with the calculator in a cross-over trial with 72 participants in order to assess the findings of the survey. RESULTS: The opioid conversion calculator could be generated for 24 combinations of 6 opioids for 5 different routes of administration. The validation of the calculator was performed successfully without discovering any major or critical defects. The proportion of correct answers increased from 68% using the table to 81% using the calculator (P < 0.001), the median time necessary to answer the ten questions was 8.9 min using the table and 4.8 min using the calculator. CONCLUSION: A web-based opioid conversion calculator was planned, generated, validated and established at the hospital. Based on the results of the online survey and the results of our cross-over trial we conclude that the tool saves time compared to manual calculation and may contribute to patient safety by avoiding calculation errors. With this tool we contribute to the optimisation of processes in hospital and patient safety.
Subject(s)
Analgesia/methods , Analgesics, Opioid/administration & dosage , Drug Dosage Calculations , Pain/drug therapy , Analgesics, Opioid/pharmacokinetics , Analgesics, Opioid/therapeutic use , Computers , Cross-Over Studies , Data Collection , Drug-Related Side Effects and Adverse Reactions , Humans , Internet , Software , Therapeutic Equivalency , Time FactorsABSTRACT
OBJECTIVE: Dental readiness training exercises constitute one form of a specialty medical readiness and training exercise (MEDRETE). Traditional dental missions have been a part of general MEDRETEs and have focused care on extractions and the provision of oral hygiene instructions. This article describes the tenets of a prevention-based dental humanitarian mission to Honduras in 2002. MATERIALS AND METHODS: The U.S. Army Southern Command requested a Dental Specialty MEDRETE for fiscal year 2002. A site visit revealed the absence of water fluoridation, high levels of dental disease, and a desire to have an American dental team perform the dental readiness training exercises at the Escuala Lempira, a low-income elementary school in the Honduran capital city of Tegucigalpa. RESULTS: The U.S. Army Dental Command in conjunction with the 257th Medical Company (Dental Services) performed a pediatric dental readiness training exercises in Tegucigalpa March 4-15, 2002. In over 9 treatment days, there were 369 patient encounters totaling 1,593 treatment procedures. In keeping with the preventive focus of the mission, 514 dental occlusal sealants were provided compared with only 90 extractions. Over dollar 76,000 in dental services was provided. CONCLUSIONS: The 2002 Honduran Dental Specialty MEDRETE represented a changing paradigm from extraction-based dental missions toward prevention-based missions. With this philosophical shift in focused care, Dental Specialty MEDRETEs have the ability to enhance the oral health of children, including those not fortunate enough to have received direct interventional dentistry.
