Development of a computerized pharmacy therapeutic recommendation tracking program.

Several important lessons were learned during this pilot project. First, the timely feedback of results, in the form of a concise report, to the pharmacists documenting the recommendations was very useful and aided in their future participation in the program. Second, the design of the database that restricted the data entry person to choose from a list of scrollable choices enhanced the utility of the database for reporting purposes. Future work is needed to facilitate data entry by the pharmacist recording the recommendation.

Computer applications in quality assurance.

To tackle the present and future demands of the health care system, a coordinated effort of science and technology is necessary. The information age is upon us, and the medical community desperately needs the assistance of the new tools technology has provided. The application of personal computers and information databases holds much promise for health care.

Impact of a clinical pharmacist on antibiotic prescribing. A multicenter trial.

Within the past two decades, hospital pharmacists have become increasingly involved in providing consultation to physicians for drug management. Antibiotic use has become a complex and rapidly expanding discipline, complicated by the introduction of multiple new antimicrobial agents, each with unique features, and the pressures of prospective payment schemes. This study demonstrated that a team including a pharmacist had a positive impact on medical residents' utilization of antibiotics.

Medication errors in neonatal and paediatric intensive-care units.

In a 4-year prospective quality assurance study, 315 iatrogenic medication errors were reported among the 2147 neonatal and paediatric intensive-care admissions, an error rate of 1 per 6.8 admissions (14.7%). The frequency of iatrogenic injury of any sort due to a medication error was 66/2147 (3.1%)--1 injury for each 33 intensive-care admissions. 33 (10.5%) errors were potentially serious, 32 (10.2%) caused mild patient injuries, and 1 patient had acute aminophylline poisoning after receiving five intravenous doses of the drug at a dosage ten times higher than prescribed, owing to a calculation error during dilution. A longitudinal monitoring system helps to identify iatrogenic complications due to medication errors and may help in implementing preventive measures.

Surgical management of corrosive gastric injuries.

Four cases of extensive corrosive gastric injury requiring surgical treatment are presented. Appropriate management of this life-threatening entity requires an awareness of its subtle presentation plus a well planned surgical approach.