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BRIDGING THE GAP: MEDICATION RECONCILIATION IN THE INPATIENT AND OUTPATIENT SETTINGS USING AN ELECTRONIC DATABASE MAINTAINED BY PHARMACY TECHNICIANS. Ruchi Tiwari * , Shelly Morvay, Karl H. Kappeler Columbus Children's Hospital, 700 Children's Drive, Columbus, OH, 43205 tiwarir chi.osu Statement of purpose: To assess the accuracy and utilization of the pharmacy technician sustained medication reconciliation database at Columbus Children's Hospital. Statement of methods: Compliance with The Joint Commission's National Patient Safety Goal will be measured by random audits of patient records. An audit of the provider's use of the electronic database at clinic visits will measure the utility and convenience of the reconciled information. Incident report review and quality assurance checks by management will assess the accuracy of pharmacy technician maintenance of the database. As a measure of efficiency in updating the electronic database, the number of reconciled medications not entered within 48 hours over the course of a month will be evaluated. Summary of results: Providers access the medication list in the database 97% of the time for reconciling for patients for whom a medication list already exists. Complete reconciliation rates for admission and discharge in October 2006 were 94% and 71% respectively. Completed home medication lists on admission have increased from 84% to 91%. Similarly, outpatient reconciliation rates were approximately 91%. Pharmacy technician data entry accuracy is approximately 98%. Pharmacy technicians entered 80% of all medication reconciliation reports into the database within 24 hours of receipt. Finally, pharmacy technicians were able to enhance the surveillance of our medication use system by detecting near-misses. Conclusions: The electronic database provides immediate access to current medication lists for providers and patients after each visit. Pharmacy technicians have knowledge of drug dosage forms which promotes a safe database maintenance system with error checking. Learning Objectives: Determine the potential impact of pharmacy technicians in the medication reconciliation process. Evaluate the use of an electronic database for improving medication reconciliation and communication between providers. Self Assessment Questions: Pharmacy technicians with pediatric-specific drug dosage form knowledge provide a potential advantage in maintaining an accurate database. T F An electronic database provides an effective bridge the inpatient and outpatient environments for paperless medication reconciliation. T F.
`Now can you think what the Mirror of Erised shows us all?' . Harry thought. Then he said slowly, `It shows us what we want . whatever we want .' `Yes and no, ' said Dumbledore quietly. `It shows us nothing more or less than the deepest, most desperate desire of our hearts.' J K Rowling, Harry Potter and the Philosopher's Stone.
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REFERENCES 1. Calabrese JR, Fatemi SH, Woyshville MJ: Antidepressant effects of lamotrigine in rapid cycling bipolar disorder. J Psychiatry 1996; 153: 1236 Gilman JT: Lamotrigine: an antiepileptic agent for the treatment of partial seizures. Ann Pharmacother 1995; 29: 144151 VIVEK KUSUMAKAR, M.B., F.R.C.P.C. Halifax, N.S., Canada LAKSHMI N. YATHAM, M.B., F.R.C.P.C. Vancouver, B.C., Canada and flecainide.
SBP by 15 to Hg; if SBP did not increase as desired, the dose was increased by 25 to The bolus injection was repeated at least three times at whatever dose was found to be efficacious, and then the linear regressions of RR and SBP were calculated, including all of the points between the beginning and end of the increase in SBP. If the correlation coefficients were statistically significant, the results of the test were considered for the analysis see example in Fig 3 ; . The final slope PheBRS ; was the mean of at least three tests and was considered to be an index of BRS ms mm Hg.
Cardiovascular effects and time-course of action of cisatracurium in infants and children during thiopentone alfentanilnitrous oxideoxygen anaesthesia O. A. MERETOJA * , G. MEAKIN, T. TAIVAINEN * , R. J. PERKINS * , K. WIRTAVUORI * , A. K.MURPHY * AND L. RAIHA * Department of Anaesthesiology, Children's Hospital University of Helsinki, FIN-00290 Helsinki, Finland, and Royal Manchester Children's Hospital, Manchester Cisatracurium Nimbex ; is a purified form of one of the stereoisomers of atracurium, which lacks significant histamine releasing and flexeril.
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Prototypes Using the flax fabrics presented above, prototypes were manufactured by vacuum infusion as can be seen in Fig. 6. Figs. 6 a ; and 6 c ; show that the produced fabrics can be used to manufacture components of a complex shape. The sandwich structure of Fig. 6 b ; shows a possible structural application of the developed fabrics.
Hours including the Sainsbury's pharmacy on Regent Road a 100 hour pharmacy ; and the Boots the Chemists stores at Salford Keys and Market Street. 3.16 The applicant has failed to provide any evidence to suggest that the existing pharmacies in the area are unable to meet the present demand for pharmaceutical services. A neighbourhood does not necessarily have to contain a pharmacy if services are accessible in adjacent neighbourhoods. Boots the Chemists Ltd believe that the existing pharmacies are easily accessible to residents of the neighbourhood in question and, although the PCT consider Blackfriars Road and Silk Street to be neighbourhood boundaries there are no significant barriers that would hinder residents of this neighbourhood from accessing the pharmacies in Mocha Parade. There is pedestrian access across the bridge on Blackfriars Road as it crosses the River Irwell to the north of the neighbourhood. To support the application, the applicant has listed a number of housing developments that are taking place. However, several of these sites are outside of the PCT defined neighbourhood, these include the land at Cambridge Riverside between the River Irwell and Sussex Street Cottenham Lane ; that the applicant has stated will be developed for high density housing and the new housing being built at Springfield Lane, Meadow Road and Flax Street. Furthermore, the applicant has not provided any evidence to suggest that the existing pharmacies will not be able to accomodate any increase in demand for pharmaceutical services brought about by any such developments. In conclusion, Boots the Chemists Ltd submit that the application does not meet the required criteria of regulation 12 1 and flu.
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THE AUTONOMIC NERVOUS SYSTEM is involved in the regulation of hepatic glucose metabolism. It has been demonstrated, for example, that electrical stimulation of the vagus nerves induces activation of the liver enzyme glycogen synthase, which in turn increases glycogen synthesis and reduces glucose output 19 ; . Conversely, electrical stimulation of the splanchnic nerve induces activation of the liver enzyme glycogen phosphorylase, which in turn increases glycogenolysis and glucose output 20 ; . Taken together, these data have been interpreted to suggest that activation of the parasympathetic nervous system promotes glucose uptake and hepatic glycogen deposition while activation of the and flumist.
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