We implemented a realistic medication-use system errors simulation in a mother-child hospital, with a wide audience. This simulation was an effective, relevant and innovative tool to raise the health care professionals' awareness of critical processes.
SUMMARY The method of isotropic photorefraction has been used in a trial of refractive screening of 6-9 month old infants. Data are presented on the calibration of the method against retinoscopic measurements and its reliability. In photorefractive screening of 1096 infants under cyclopentolate cycloplegia 5% were found to be hypermetropic (over +3-5 D), 4*5% myopic, and 1-3% anisometropic (over 1 D). These refractive errors were confirmed on retinoscopic follow-up (with the exception of a few anisometropes). Follow-up of controls shows that one small refractive error was missed in 52 infants. We conclude that photorefraction is a valid and practical screening technique. Longitudinal study of infants with refractive errors will assess the value of early detection, in particular for prediction and prevention of strabismus.The commonest preschool vision problems at the present time are strabismus and amblyopia. Estimates of their occurrence vary widely,'-' with the average being somewhere about 5%. This is a far higher incidence than that of more handicapping visual problems such as infant cataract, retinal pathologies, and neural defects, which affect much less than 1% of the preschool population. Consequently, cases of strabismus (both confirmed cases and pseudostrabismus) and amblyopia make up the majority of children attending ophthalmological clinics. Thereare not yet any generally accepted preventive measures to reduce the incidence of strabismus and amblyopia, and the success of treatment for such cases is very variable.8The data of Ingram et al.9 suggest that infants with a refraction of +2-5 D or more hypermetropia at age 1 year are 20 times more likely to develop strabismus and amblyopia than children with a more nearly emmetropic refraction. This raises the possibility that refractive screening of the population in infancy could identify children at risk of these disorders, and that early refractive correction might reduce that risk by reducing excessive accommodative convergence. 10 Early refractive screening could also detect anisometropia and any myopic errors that might significantly impair children's vision. However, the scarcity and expense of skilled retinoscopists on a large scale makes it unlikely that retinoscopic screening will be widely adopted in the near future.We have developed a new method, isotropic photorefraction, which offers a means of refractive screening which can be carried out by paramedical personnel after a short training period, with apparatus and procedure that is rapid, reliable, and relatively inexpensive.Pilot programmes for infant vision screening using this method are underway in Cambridge and in the Avon area. In this paper we describe the screening procedure and some results of the first 18 months of the Cambridge programme. (Data from Avon will be the subject of a separate report.) These results give an idea of the success of the programme in detecting early refractive problems; the outcome in terms of predicting and preventing strabismus and amblyopia will only be ...
The nursing staff members were satisfied with the use of ADC and believed it made their work easier, promoted safe patient care, and were perceived to reduce medication incidents/accidents.
This descriptive study confirms the positive perception and satisfaction of nurses exposed to medication carts. However, interruptions are a major concern and source of dissatisfaction. The focus group has revealed many issues which will be improved.
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