Evaluation of the B-SAFE campaign to reduce clinically significant warfarin-drug interactions among fee-for-service Medicare beneficiaries.

The objective of this study was to evaluate the effectiveness of a health communication campaign designed to reduce the rate of serious warfarin-related drug interactions. The B-SAFE campaign was conducted in 2009 to educate patients located in a Michigan hospital's service area about the risk of serious adverse drug events associated with warfarin. The rate of warfarin-related drug interactions among Medicare fee-for-service (FFS) patients admitted to the exposed hospital with hemorrhagic complications was compared with the rate of warfarin-related drug interactions among a similar cohort admitted to a control hospital before and after the campaign. The χ(2) test and logistic regression were used to analyze differences. The authors observed a marginally significant decline in the rate of warfarin-related drug interactions (odds ratio [OR] = 0.66; 95% confidence interval [CI] = 0.33-1.29) among FFS Medicare patients admitted for bleeding complications to the hospital targeted by the B-SAFE campaign. The same association was not observed in the control hospital (OR = 1.15; CI = 0.42-3.14). These findings suggest that patient exposure to the B-SAFE campaign may have resulted in a decrease in the rate of clinically significant warfarin-related drug interactions.

Microbial growth on the anesthesia machine.

The purpose of this study was to determine the amount of microbial growth that develops on the anesthesia machine after a full day's use in the operating room. This descriptive bacteriology study is relevant to anesthesia practice because of the proximity of the oropharynx and multiple body fluids to anesthesia equipment and the potential for cross-contamination to patients and staff. The Wilcoxon signed rank test was used to evaluate the change in colony-forming units (CFUs) before and after use of equipment. The resulting P value of 0.12 indicated that the observed CFU increase was not statistically significant at the .05 level. The study identified many organisms that survive on the anesthesia machine tabletop, namely, coagulase-negative Staphylococcus, Bacillus, alpha Streptococcus, Acinetobacter, Staphylococcus aureus, and gram-negative rods. Several were expected to be found; however, alpha Streptococcus, Acinetobacter, S aureus, and gram-negative rods are pathogenic organisms causing respiratory infections and bacteremia, especially in patients with compromised conditions. Terminal cleaning methods may have changed during the course of the study, thereby contributing to the volume of microbes present before use and distorting the change in the number of CFUs before and after use.