Automated dispensing cabinets still risky
According to recent survey findings by the Institute for Safe Medication Practices, although use of automated dispensing cabinets (ADCs) for medications has become prevalent in the last decade, safety improvements have not kept pace. Processes for verifying medication placement after restocking of ADCs and processes for having another practitioner double-check a medication removed via an override and before a pharmacy review increased only 18% and 10%, respectively. Only 56% of respondents reported that all ADCs in their facilities were capable of providing a direct interface between the pharmacy information system and ADCs so that pharmacists could profile, screen and approve medications before they were removed from the cabinet for administration.
Respondents also reported problems with ADC stock, with 35% indicating that they always or frequently encountered multiple concentrations of medications in ADCs and 23% reporting that non-medications were stored in their facility's ADCs. Regarding workflow and practice habits, 30% of frontline nurses said that they always or frequently had to wait in line to access the ADC, and 48% reported that the ADCs were not located in areas free from distractions. In addition, only 69% of frontline nurses reported that they always or frequently remove only one patient's medication at a time, implying that nearly one-third of nurses remove multiple patients' medications at a time, which is a practice that is known to contribute to medication administration errors.
New CMS statement of work focuses on patient safety and prevention
The Centers for Medicare & Medicaid Services has announced a new statement of work for their 53 quality improvement (QI) organizations. Under the new statement of work, the QI organizations will focus on patient care transitions, protecting Medicare patients, patient safety and prevention, as well as promoting the adoption of value-driven healthcare, the use of health information technology and the reduction of health disparities. The QI organizations will be required to provide direct QI support to nursing homes, hospitals and physicians' offices; use standardized tools; and meet periodic milestones to maintain their contracts.
Nurses are soft targets for the pharmaceutical industry
An analysis of nursing literature has found that nurses' education does not prepare them to deal with pharmaceutical companies' promotional tactics, and many nurses appear to accept promotional materials uncritically. Researchers examined published nursing literature for articles that explored the influence of pharmaceutical companies on nurses and their education. Only 13 of the 32 articles they found expressed any serious concerns about the pharmaceutical industry's role in influencing nurses' behavior; 14 articles expressed mild concern, viewed the support of the industry as generally favorable or identified both the harms and the benefits of the industry's involvement in health care, and four articles were identified as "clearly industry-friendly."
Although many articles about the undue influence of the pharmaceutical industry on nurses say that nurses simply need to be aware of the problem and thereby avoid any complicity in unethical medication promotion, the authors argue that many nurses are not trained in critical appraisal and do not appear to understand the mechanisms by which marketing strategies operate. The authors encourage nurses to reevaluate the educational information of promotional literature they receive, which "is carefully selected, prone to bias, and hardly likely to be as beneficial as many believe."
Washington state nurse staffing agreement signed
Washington state hospitals and nursing groups have agreed to develop nurse staffing policies that will promote patient safety and support the well-being of staff members. The agreement was signed in conjunction with proposed state legislation that calls for nurses and hospital administrators to collaboratively develop nurse staffing plans, quality indicators for nurse staffing related to medical errors, and best practices for staffing and quality care. The groups that signed the agreement and support the legislation include the Washington State Hospital Association, Northwest Organization of Nurse Executives, SEIU Healthcare 1199NW, United Staff Nurses Union, Local 141 UFCW, and the Washington State Nurses Association.
Iowa launches patient medication card
The Iowa Healthcare Collaborative has released a medication card to help patients and healthcare providers improve medication safety and communications. Patients are encouraged to record all their medications on a MedCard that they can show clinicians any time they visit a healthcare provider. The use of MedCards is expected to help promote discussions of appropriate medication use between patients and healthcare providers.
Engineers develop new, larger medical scanner
Engineers have developed a new medical scanner that is one of the largest in the world and will allow physicians to produce more sensitive images of the human body faster and at a lower cost than currently available scanners. The new scanner is also easier to use and has very large active pixel sensors with an imaging area of approximately 6 cm2. The technology was specifically developed to use for imaging applications such as x-ray and mammography. The engineers are currently working on using this technology to produce wafer-scale imagers that will be able to produce images approaching the width of the human torso.
Large social networks may improve patients' postoperative recovery
Patients with a large support network of family and friends may experience less pain and anxiety after undergoing a surgical procedure, which can have a substantial positive impact on their postoperative recovery, according to the Journal of the American College of Surgeons. It has long been known that social connectedness and social network size affect a person's health and well-being, and stressful events such as undergoing a surgical procedure can increase the need for social support. A new study has found that patients with limited social connections may require more pain medications, have longer hospital stays and need additional caregiver attention after a surgical procedure.
Researchers studied 605 patients who received massages as adjuvant treatment for postoperative pain. Patients were given a questionnaire before their surgery that assessed their number of friends and relatives and how frequently they had contact with members of their social networks. Patients also used visual analog scales to rate their levels of preoperative and postoperative pain intensity and unpleasantness, as well as their postoperative levels of anxiety, depression, relaxation and inner peace. The researchers also evaluated participants' daily opiate use, postoperative complications and length of stay. They found that patients who reported a smaller social network had higher preoperative pain intensity, unpleasantness and anxiety. The researchers recommend that patients be preoperatively screened for pain and anxiety because these are strong predictors of a more difficult postoperative recovery.
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