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ObjectiveTo investigate the changes in overdue doses rates over a 4-year period in an National Health Service (NHS) teaching hospital, following the implementation of interventions associated with an electronic prescribing system used within the hospital.DesignRetrospective time-series analysis of weekly dose administration data.SettingUniversity teaching hospital using a locally developed electronic prescribing and administration system (Prescribing, Information and Communication System or PICS) with an audit database containing details on every drug prescription and dose administration.ParticipantsPrescription data extracted from the PICS database.Intervention(s)Four interventions were implemented in the Trust: (i) the ability for doctors to pause medication doses; (ii) clinical dashboards; (iii) visual indicators for overdue doses and (iv) overdue doses Root Cause Analysis (RCA) meetings and a National Patient Safety Agency (NPSA) Rapid Response Alert.Main outcome measure(s)The percentage of missed medication doses.ResultsRates of both missed antibiotic and non-antibiotic doses decreased significantly upon the introduction of clinical dashboards (reductions of 0.60 and 0.41 percentage points, respectively), as well as following the instigation of executive-led overdue doses RCA meetings (reductions of 0.83 and 0.97 percentage points, respectively) and the publication of an associated NPSA Rapid Response Alert. Implementing a visual indicator for overdue doses was not associated with significant decreases in the rates of missed antibiotic or non-antibiotic doses.ConclusionsElectronic prescribing systems can facilitate data collection relating to missed medication doses. Interventions providing hospital staff with information about overdue doses at a ward level can help promote reductions in overdue doses rates.

The effect of endotoxin on tissue oxygen tension measured at the bladder epithelium was assessed in spontaneously breathing Sprague-Dawley rats anesthetized with halothane. Hyperdynamic (high cardiac output, group A, n = 6) and hypodynamic (low cardiac output, group B, n = 6) circulatory responses were achieved by intravenous administration of Escherichia coli lipopolysaccharide, 10 mg/kg over 30 min or 20 mg/kg over 1 min, respectively. Comparison was made against sham-operated control rats (group C, n = 6). Aortic and renal blood flows increased in group A and fell in group B (P < 0.001). However, in both groups, bladder epithelial oxygen tension rose significantly compared with control (P < 0.01), despite an increasing metabolic acidosis. This is in contradistinction to previous studies of nonseptic insults where bladder epithelial oxygen tension fell in line with an increasing arterial base deficit. If a raised tissue oxygen tension could be demonstrated in other organ beds, this would suggest that decreased utilization of oxygen rather than reduced tissue oxygen availability is responsible for the apparent anaerobic respiration seen in sepsis.

Cavity-integrated transition metal dichalcogenide (TMDCs) excitons have recently emerged as a promising platform to study strong light–matter interactions and related cavity quantum electrodynamics phenomena. Although this exciton-cavity system is typically modeled as coupled harmonic oscillators, to account for the rich solid-state environment, the effect of exciton–phonon interaction needs to be incorporated. We model the system by including a phenomenological deformation potential for exciton–phonon interactions and we elucidate the experimentally measured preferential coupling of the excitonic photoluminescence to the cavity modes red-detuned with respect to the exciton resonance. Furthermore, we predict and experimentally confirm the temperature dependence of this preferential coupling. By accurately capturing the exciton–phonon interaction, our model illuminates the potential of cavity-integrated TMDCs for the development of low-power classical and quantum technologies.