Background Errors in the medication use process are common. Little is known about preparation and administration errors in resource-restricted settings, including Vietnam. Purpose To determine the frequency, type and severity of medicines preparation errors and administration errors in two Vietnamese hospitals and identify associated factors. Materials and Methods This is a prospective study using an observation-based approach, carried out in two urban public hospitals. Four trained pharmacy students observed all drugs prepared and administered on six wards, 12 hours per day on 7 consecutive days. Severity of errors was judged by experts using a validated method. Multivariable logistic regression was performed to explore error-associated factors. ResultsIn total, 2122 out of 5635 preparations or administrations of medicines were erroneous. The error rate was 37.7% (95% confidence interval 36.4–38.9%). The most frequent errors involved administration technique, preparation technique, omission, and dose (53.1%, 32.6%, 5.0%, and 2.6%, respectively). Severity was judged to be moderate in 87.8% of the cases, followed by severe (8.8%), and minor errors (3.4%). Slightly lower medication error rates were observed during afternoon drug rounds than at other times of the day (32.1% vs. 39.7%, p = 0.00). Much higher error rates were observed for anti-infective drugs than for any other class of drugs (77.8% vs. 28.9%, p = 0.00). Medicines with complex preparation procedures were more likely to generate errors than simple ones (58.1% vs. 24.7%, p = 0.00), and the error rate of intravenous medicines was much higher than that of other medicines (73.2% vs. 12.4%, p = 0.00). Conclusions This is one of the first large studies investigating medication errors in resource-restricted settings. In around a third of all medicines potentially clinically-relevant errors occurred, which is higher than in most other studies. Administration technique, preparation technique and omission errors were most commonly encountered. Drug round, drug class, complexity of preparation and administration route were error-related factors. Interventions focusing on intravenous medicines with complex preparation procedures are needed to improve patient safety. No conflict of interest.
The main reason lighting control is being applied is to reduce energy consumption. However, there are many more reasons for lighting control to be optimised in buildings. Lighting systems can be controlled to enhance or optimise effects beyond vision. Automatic control of electric lighting systems or daylight systems is one way of adjusting someone’s personal lighting conditions. In addition, it is relevant for office workers to know how they can adjust their personal lighting conditions themselves in order to optimise their effects beyond vision (e.g. alertness). Therefore, this article describes a process of identifying predictors that influence personal lighting conditions. The dataset used in this article is gathered during a field study in the Netherlands in spring 2017. This article describes linear mixed models for daily mean illuminances and correlated colour temperatures both throughout the entire day and only at work. These models demonstrated that weather conditions, fixed and flexible personal conditions, office worker’s daily schedule and workspace characteristics influence personal lighting conditions. Weather conditions and fixed and flexible personal conditions though are difficult or impossible to control by the office workers themselves. However, adjustments in personal lighting conditions can be accomplished by the office workers themselves by changing their daily schedules and the workspace characteristics. The findings show that these two predictor categories may explain 4% to 20% of the variance in personal lighting conditions.
Background Medication safety has been a concern for decades worldwide, but there is still relatively little research about interventions to reduce medicines administration errors in hospitals, especially in resource-restricted settings such as Vietnam. Our large study on the frequency and type of medication errors in Vietnamese hospitals indicated that the highest risk was associated with intravenous medication administration [1]. PurposeTo investigate the effect of intensive training on the frequency of intravenous medicines preparation and administration errors in an urban public hospital in Vietnam. Materials and MethodsThis was a controlled intervention study with pre- and post-intervention measurements using a direct observation method, carried out in two critical care units: Intensive Care Unit (ICU – intervention ward), and Post-Surgical Unit (PSU – control ward). The intervention consisted of lectures plus practical ward-based teaching sessions, carried out by a clinical pharmacist and a nurse. In each ward, all intravenous doses prepared and administered by nurses were observed 12 hours per day, on 7 consecutive days, each period. ResultsA total of 1294 doses were observed, 718 in ICU and 576 in PSU. Error rate on the intervention ward (ICU) decreased from 62.7% to 52.5% (P = 0.01); preparation errors including wrong dose, deteriorated drug, wrong technique of preparation decreased significantly (p < 0.05). On the control ward (PSU) there was no significant change in error rates (73.8% vs. 73.1%, p = 0.85); almost all preparation error types were similar in both periods (p > 0.05), except for technique errors, which was increased from 15.5% to 25.9% (p < 0.05). Conclusions Intensive training showed a slight improvement in overall and specific error rates, particularly preparation errors. Further measures are needed to improve patient safety. Reference EAHP abstract titled: “Errors in medication preparation and administration in Vietnamese hospitals”, by H.T. Nguyen et al, No conflict of interest.
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