Survey of hospital systems and common serious medication errors.

The Institute for Safe Medication Practices and the University of Illinois at Chicago, College of Pharmacy, undertook a hospital survey of medical-surgical hospitals to determine systems-oriented factors that allow the highest level of medication safety. The study incorporated a peer-reviewed and pretested questionnaire, which focused on critical information necessary to yield quality data for comparison. Through analysis, it was shown that over one third of all medication errors reported in the survey involve just six categories--allergies, insulin, heparin, opiates, PCA devices, and potassium concentrates.

Differential side effect profile of triazolam versus flurazepam in elderly patients undergoing rehabilitation therapy.

Patients (aged 65 years or older) who were hospitalized for rehabilitation therapy after a cerebrovascular accident or other acute debilitating condition participated in a 6-week controlled clinical trial. After a 2-week period of receiving nightly single-blind placebo, patients were randomly allocated to receive either triazolam (0.125 mg) or flurazepam hydrochloride (15 mg) nightly under double-blind conditions. For the final 2 weeks, patients again received single-blind placebo. The study groups' were comparable in their performance on four psychomotor tests done in the morning during the initial placebo period. Triazolam-treated patients showed subsequent improvement on the tests, consistent with practice effects, whereas flurazepam recipients showed performance impairment during treatment. Triazolam-flurazepam differences were significant in the card-sorting and arithmetic tests, and they approached significance for the Purdue pegboard test. Blind ratings by physical therapists indicated significant impairment among flurazepam recipients in their capacity to cooperate with and participate in the rehabilitation tasks; the impairment persisted into the post-treatment placebo period. Similar flurazepam-triazolam differences, although not significant, were reported by occupational therapy and nursing staff members. The findings suggest that the kinetic differences between flurazepam and triazolam may have clinical implications in elderly patients undergoing rehabilitation therapy.