BackgroundRespiratory syncytial virus (RSV) is responsible for severe respiratory infections and higher costs in medical care. The two aims of this work were to assess the performances of SOFIA®RSV tests in “real-life-laboratory” conditions (study 1) and implemented at point-of-care testing in a pediatric emergency department (ED, study 2), during two consecutive winter seasons.MethodsIn study 1, fresh nasopharyngeal swabs from patients of all ages were sampled in 1.5 ml of Universal virological Transport Medium (UTM) and prospectively tested using SOFIA®RSV tests. In study 2, conducted in a pediatric ED, nasopharyngeal swabs were placed in 3 ml of UTM. All SOFIA®RSV tests were confirmed by molecular testing, considered as reference method. The epidemiological and clinical features of tested patients, as well as the care of these patients after obtaining quick results were evaluated.ResultsThe sensitivities of SOFIA®RSV in infants (aged under 24 months) performed in the laboratory and in the pediatric ED were respectively 95% (95% CI: 86.8–98.1) and 74.8% (95% CI: 68.0–80.9) compared to PCR. In study 1, the sensitivity among children (from 2 to 15 years old) and adults (above 15 years old) dropped to 45% (95% CI: 23.1–68.5) and 59% (95% CI: 32.9–81.6), respectively. In study 2, there were some differences in bed-management of SOFIA®RSV positive compared to SOFIA®RSV negative infants.ConclusionsSOFIA®RSV tests performed in the laboratory and in the pediatric ED show high and satisfactory sensitivities among young children under 24 months, which supports its robustness and reliability. However, the impact of these tests on patient care at point-of-care cannot be clearly assessed when considering the limits of the study 2 design.Electronic supplementary materialThe online version of this article (doi:10.1186/s12879-017-2557-8) contains supplementary material, which is available to authorized users.
Background Computerized provider-order-entry (CPOE) system is known to improve quality, increase efficiency, and reduce medication errors. The pharmacist, through the electronic validation, can provide improvements to the patient pharmacotherapy. However, not all hospitals follow the same method to make such proposals. Purpose To analyse the type of interventions made in our hospital. To validate process intervention. Materials and Methods Pharmacists interventions were studied over a period of one year (June 2011–May 2012). Both prescription and validation are performed in the computer programme Farmatools®. The pharmacist used to write a warning on the patient treatment. Alerts were reviewed the following day and we checked if the recommendation was accepted or not by the physician. Interventions were classified according to the type of recommendation, the drug and whether it was accepted. Results A total of 788 interventions were analysed (2.2 per day). The most frequent (27%) was dose adjustment for renal failure, followed by switching from intravenous to oral route (16%), change of dose (13%) and indication (12%). Other interventions were medication reconciliation, duplicity, therapeutic equivalent and adverse reaction. The most frequent drugs were enoxaparin (24%), pantoprazole (12%), paracetamol (5%), insulin (5%), digoxin (4%), amoxicilin-clavulanic (4%) and levofloxacin (4%). Only 72% of the recommendations were reviewed. From this, 54% were accepted. Conclusions Although 788 interventions have been studied, there are many who have not been registered in the programme, so it could not be analysed. We observed that the dose adjustment for renal failure, especially enoxaparin, is recorded systematically, but this does not occur with other types of interventions. Acceptance is lower than those reported in literature, so we can conclude that the method of communication with the clinician is inadequate and should be strengthened with verbal communication. No conflict of interest.
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