Background: Medication reconciliation is the process of comparing a patient's medication orders to all of the medications that the patient has been taking. Unfortunately, medication errors are common in our health system accounting for significant proportion of patient harm. The main objective of our study was to explore the effect of self-designed intervention in improving the accuracy of patient current medication list in the outpatient settings. Methods: The study designed entailed collection of data from October 2013 to March 2014. The data collected in October (The pre-intervention) was compared to the post-intervention data in March 2014. Following interventions were performed: Education of residents, nurses and patients, frequent reminders to the residents to perform medication reconciliation, sending notifications to the residents who failed to perform medication reconciliation, reminding the patients get all refills at the time of appointment and reminding the patients to bring pill bottles at each appointment. The pre-intervention data was compared with the post-intervention data for different types of medication errors. Normality of the variables was pre assessed. Non-parametric analysis using Fisher's exact test was performed for comparison of categorical variables. Conclusion: In conclusion, our intervention improved the accuracy of patient current medication list in the electronic records as accurate as possible. For clinics and hospitals, medication reconciliation can enhance delivery of high value cost conscious care to the patients by reducing medication errors.
Pulmonary vein thrombosis (PVT) is a challenging diagnosis and has been described in association with or as a complication of pulmonary tumors, lung surgeries, atrial myxoma, and after radiofrequency catheter ablation for atrial fibrillation. There are not many reported cases of PVT associated with medication use. We present a case of a 53-year-old male with a history of severe persistent asthma on omalizumab, who presented with shortness of breath and was found to have PVT on computed tomography scan of the chest. The hypercoagulable workup was normal, and the patient did not have a history of malignancy or pulmonary surgeries. Currently, available data suggest an association between omalizumab use and increased risk of arterial thrombotic events. However, on a literature search, we could not find any reported cases of PVT with omalizumab treatment.
Multidrug-resistant enterococcal nosocomial invasive infections are a rising concern faced by the medical community. Not many options are available to treat these highly virulent organisms. Risk factors for developing these highly resistant organisms include prolonged hospital stay, previous antibiotic use, and immunosuppression. In this article, we report a case of daptomycin-resistant enterococcal native infective endocarditis treated with off-label use of quinupristin-dalfopristin.
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