Abstract:
:A utilization study was performed in a 2200-bed tertiary care teaching hospital. Data mining was performed on all nasogastric medication prescriptions for patients hospitalized in 2011. Nurses were interviewed by questionnaire. A PDCA (Plan-Do-Check-Act) cycle was used for continuous quality improvement. The proportion of patients with nasogastric tubes (NGT) was 3.2%. A large number of medical orders (n = 6261) involved nasogastric medications with a package insert particularly noting that they should not be crushed or opened (group 1) or medications without a specific formulation recommendation in the package insert but having evidence discouraging NGT dosing (group 2). Of the nasogastrically administered sustained-release or controlled-release formulations, a sustained-release sodium valproate tablet formulation was the most prescribed drug and a sustained-release 2.5 mg felodipine tablet was prescribed with the highest proportion of NGT dosing [NGT/(NGT + oral) = 12.3%]. Among the nasogastrically administered enteric-coated formulations, a myrtol-standardized enteric-coated capsule formulation was the most prescribed drug and a pantoprazole tablet formulation was prescribed with the highest proportion of NGT dosing [NGT/(NGT + oral) = 19.3%]. Proportions of NGT dosing for amiodarone and carbamazepine (group 2) were 4.8% and 6.3%, respectively. The percentage of nurses with adequate knowledge about pharmaceutical dosage formulations was 60%. The rate of answering correctly as to whether medications in group 1 could be crushed or opened was only 30%. Awareness of evidence discouraging NGT dosing of medications in group 2 was zero. Most nurses (90%) left physicians and pharmacists with the entire responsibility for knowledge and decision-making concerning route of drug administration. After a 3-month preliminary intervention, irrational medical orders involving nasogastric administration of medications in group 1 were successfully abolished. The rate of answering correctly as to whether medications in group 1 could be crushed or opened increased to 100%. This utilization study indicates poor awareness concerning nasogastric administration of medication on the part of physicians and nurses, and preliminary intervention measures were efficient in improving knowledge through team cooperation and effort.
journal_name
Ther Clin Risk Managjournal_title
Therapeutics and clinical risk managementauthors
Zhu LL,Xu LC,Wang HQ,Jin JF,Wang HF,Zhou Qdoi
10.2147/TCRM.S37785subject
Has Abstractpub_date
2012-01-01 00:00:00pages
393-401eissn
1176-6336issn
1178-203Xpii
tcrm-8-393journal_volume
8pub_type
杂志文章abstract::Chordomas are rare, locally aggressive skull base neoplasms known for local recurrence and not-infrequent treatment failure. Current evidence supports the role of maximal safe surgical resection. In addition to open skull-base approaches, the endoscopic endonasal approach to clival chordomas has been reported with fav...
journal_title:Therapeutics and clinical risk management
pub_type: 杂志文章,评审
doi:10.2147/TCRM.S50526
更新日期:2015-05-26 00:00:00
abstract:PURPOSE:To report two cases of chronic postoperative cystoid macular edema, resistant to topical therapy, treated with consecutive intravitreal injections of ketorolac tromethamine. METHODS:Four daily intravitreal injections of 500 μg/0.05 mL of ketorolac were given to each patient. Complete clinical examination and O...
journal_title:Therapeutics and clinical risk management
pub_type: 杂志文章
doi:10.2147/TCRM.S97342
更新日期:2016-02-12 00:00:00
abstract:Purpose:Almost all of the publications regarding the treatment of biliary complications after liver transplantation are related to biliary complications after right lobe living donor liver transplantation (LDLT) and cadaveric liver transplantation (LT). The number of publications regarding endoscopic treatment of bilia...
journal_title:Therapeutics and clinical risk management
pub_type: 杂志文章
doi:10.2147/TCRM.S175215
更新日期:2018-10-17 00:00:00
abstract::The treatment of ankylosing spondylitis (AS) and psoriatic arthritis (PsA) positively changed since the introduction of anti-TNFα drugs. These treatments were shown to reduce the symptoms and signs of the diseases and improve the quality of life. However, a variable percentage of patients do not respond to anti-TNFα o...
journal_title:Therapeutics and clinical risk management
pub_type: 杂志文章,评审
doi:10.2147/TCRM.S100091
更新日期:2016-10-21 00:00:00
abstract:BACKGROUND:Hypertension is a highly prevalent risk factor for cardiovascular disease in patients with type 1 diabetes mellitus. Elevated blood pressure (BP) promotes the development and progression of microvascular complications, eg, nephropathy and retinopathy. The purpose of this study was to identify and detect earl...
journal_title:Therapeutics and clinical risk management
pub_type: 杂志文章
doi:10.2147/TCRM.S87751
更新日期:2015-10-05 00:00:00
abstract:Purpose:We aimed to present our experience with total hip arthroplasty in patients with previous hip arthrodesis. Patients and methods:This was a retrospective study, in which clinical and radiological outcomes of total hip arthroplasty performed in 17 patients (mean age 54.2±8.5 years; age range 33-68 years; female t...
journal_title:Therapeutics and clinical risk management
pub_type: 杂志文章
doi:10.2147/TCRM.S163569
更新日期:2018-04-11 00:00:00
abstract::East Asians are prone to higher systemic exposure and increased risk of bleeding compared to other races after administration of antiplatelet agent(s). The aim of this systematic review was to compare and evaluate the appropriateness of a lower dose versus standard dose of ticagrelor in East Asians. A systematic searc...
journal_title:Therapeutics and clinical risk management
pub_type: 杂志文章,评审
doi:10.2147/TCRM.S152276
更新日期:2018-01-08 00:00:00
abstract:Background:Cardiovascular diseases (CVD) combined with Type 2 diabetes mellitus (T2DM) frequently occurred. In this study, we aimed at exploring the prognostic significance of blood neutrophil-lymphocyte ratio (NLR) in these types of patients. Patients and Methods:Between June 30, 2010 and August 30, 2017, 1454 pati...
journal_title:Therapeutics and clinical risk management
pub_type: 杂志文章
doi:10.2147/TCRM.S244623
更新日期:2020-05-19 00:00:00
abstract::Japanese encephalitis (JE) is one of severe viral encephalitis that affects individuals in Asia, western Pacific countries, and northern Australia. Although 67,900 JE cases have been estimated among 24 JE epidemic countries annually, only 10,426 have been reported in 2011. With the establishment of JE surveillance and...
journal_title:Therapeutics and clinical risk management
pub_type: 杂志文章,评审
doi:10.2147/TCRM.S51168
更新日期:2015-03-19 00:00:00
abstract::Trichosporon asahii is an emerging opportunistic pathogen that is life-threatening particularly for immunosuppressed patients. Only a few studies have described Trichosporon infection in kidney transplant recipients. This study reports a 67-year-old male kidney transplant recipient who developed fatal fungemia and pne...
journal_title:Therapeutics and clinical risk management
pub_type:
doi:10.2147/TCRM.S67299
更新日期:2014-09-30 00:00:00
abstract:BACKGROUND:Multifactor cardiovascular disease is the leading cause of death; besides well-known cardiovascular risk factors, several emerging factors such as mental stress, diet type, and physical inactivity, have been associated to cardiovascular disease. To date, preventive strategies are based on the concept of abso...
journal_title:Therapeutics and clinical risk management
pub_type: 杂志文章
doi:10.2147/TCRM.S16523
更新日期:2011-01-01 00:00:00
abstract::The management of acute episodes in schizophrenia is frequently initiated in the psychiatric emergency department and requires rapid intervention to relieve distress and psychiatric symptoms. Both non-pharmacological and pharmacological interventions are needed to calm the patient and prevent potential harm to the pat...
journal_title:Therapeutics and clinical risk management
pub_type: 杂志文章
doi:10.2147/tcrm.2007.3.1.3
更新日期:2007-03-01 00:00:00
abstract::Background: Avian AIV-H7N9 influenza progresses rapidly and has a high fatality rate. However, it lacks an early effective biomarker to predict disease severity and fatal outcomes successfully. Our study aimed to explore whether the neutrophil-to-lymphocyte ratio (NLR) taken within 24 h after admission can predict dis...
journal_title:Therapeutics and clinical risk management
pub_type: 杂志文章
doi:10.2147/TCRM.S206930
更新日期:2019-07-24 00:00:00
abstract:Background:Treatment-related problems (TRPs) may pose risks for patients if unaddressed. With the increased complexity of health care, it is important to target pharmacists' efforts to patients that are at high risk for TRPs. Objectives:The present study aimed to identify medications most commonly associated with TRPs...
journal_title:Therapeutics and clinical risk management
pub_type: 杂志文章
doi:10.2147/TCRM.S180747
更新日期:2018-11-16 00:00:00
abstract:Background:Liver cirrhosis is an uncommon but not rare side effect of amiodarone-induced hepatotoxicity. Patients with hepatitis B virus and hepatitis C virus infections are at a high risk for developing liver cirrhosis. However, the relationship between this treatment and risk of liver cirrhosis in high-risk chronic h...
journal_title:Therapeutics and clinical risk management
pub_type: 杂志文章
doi:10.2147/TCRM.S174868
更新日期:2019-01-10 00:00:00
abstract::Hepatitis C virus (HCV) management in the transplant setting is still an open issue. The therapeutic strategies being addressed include: (a) pre-transplant prophylaxis (to prevent the infection of the transplanted organ); (b) post-transplant prophylaxis (to reduce the possibility of developing acute hepatitis); (c) ma...
journal_title:Therapeutics and clinical risk management
pub_type: 杂志文章
doi:
更新日期:2006-03-01 00:00:00
abstract::Patients with cancer have a 6-7-fold higher risk of venous thromboembolism (VTE) as compared with non-cancer patients. Effective and safe anticoagulation for the prevention and treatment of VTE is the cornerstone of the management of patients with cancer, aiming to decrease morbidity and mortality and to improve quali...
journal_title:Therapeutics and clinical risk management
pub_type: 杂志文章,评审
doi:10.2147/TCRM.S49063
更新日期:2014-06-13 00:00:00
abstract::Background: Endoscopic sinus surgery (ESS) has been the definitive treatment for chronic rhinosinusitis (CRS), but the complications caused perioperatively may affect patients' quality of life (QoL). This study aims to evaluate the effects of enhanced recovery after surgery (ERAS) on improving perioperative QoL in ESS...
journal_title:Therapeutics and clinical risk management
pub_type: 杂志文章
doi:10.2147/TCRM.S199630
更新日期:2019-06-04 00:00:00
abstract:OBJECTIVE:The aim of this study was to compare the knowledge, attitude and barriers of pharmacy technicians and pharmacists toward pharmacovigilance, adverse drug reactions (ADRs) and ADR reporting in community pharmacies in Yemen. METHODS:This cross-sectional survey was conducted among community pharmacists and pharm...
journal_title:Therapeutics and clinical risk management
pub_type: 杂志文章
doi:10.2147/TCRM.S140674
更新日期:2017-09-07 00:00:00
abstract::Parkinson's disease (PD) is a progressive neurodegenerative, dopamine deficiency disorder. The main therapeutic strategies for PD treatment relies on dopamine precursors (levodopa), inhibition of dopamine metabolism (monoamine oxidase [MAO] B and catechol-O-methyl transferase inhibitors), and dopamine receptor agonist...
journal_title:Therapeutics and clinical risk management
pub_type: 杂志文章
doi:
更新日期:2007-06-01 00:00:00
abstract::Pemphigus vulgaris (PV) is a life-threatening disease belonging to the pemphigus group of autoimmune intra-epidermal bullous diseases of the skin and mucosae. The therapeutic management of PV remains challenging and, in some cases, conventional therapy is not adequate to induce clinical remission. The cornerstone of P...
journal_title:Therapeutics and clinical risk management
pub_type: 杂志文章,评审
doi:10.2147/TCRM.S142471
更新日期:2018-04-27 00:00:00
abstract:Introduction:Preservation of endodontically treated teeth (ETT) depends upon several patient-related and operator-related factors. The objectives of this study were to assess the effects of different types of coronal restoration and delayed placement on ETT survival. Methods:Data on dates of root canal treatment (RCT)...
journal_title:Therapeutics and clinical risk management
pub_type: 杂志文章
doi:10.2147/TCRM.S223233
更新日期:2020-02-21 00:00:00
abstract::Experimental data indicate that several pharmacological agents that have long been used for the management of various diseases unrelated to cancer exhibit profound in vitro and in vivo anticancer activity. This is of major clinical importance, since it would possibly aid in reassessing the therapeutic use of currently...
journal_title:Therapeutics and clinical risk management
pub_type: 杂志文章,评审
doi:10.2147/TCRM.S82049
更新日期:2015-05-18 00:00:00
abstract::The advent of exponential growth of novel agents tested and approved for the treatment of patients with metastatic castration-resistant prostate cancer (mCRPC) has brought about a need for understanding of the mechanism of action, side-effects, and clinical efficacy of these drugs as they relate to these patients. Thi...
journal_title:Therapeutics and clinical risk management
pub_type: 杂志文章,评审
doi:10.2147/TCRM.S57509
更新日期:2014-08-16 00:00:00
abstract:BACKGROUND:The aim of this open-label, randomized, parallel-group pilot study was to evaluate the efficacy of cefditoren pivoxil and levofloxacin in terms of speed of reduction in inflammatory parameters, clinical recovery, and microbiological eradication. METHODS:Forty eligible patients with acute exacerbation of chr...
journal_title:Therapeutics and clinical risk management
pub_type: 杂志文章
doi:10.2147/TCRM.S41131
更新日期:2013-01-01 00:00:00
abstract::Angioid streaks are visible irregular crack-like dehiscences in Bruch's membrane that are associated with atrophic degeneration of the overlying retinal pigmented epithelium. Angioid streaks may be associated with pseudoxanthoma elasticum, Paget's disease, sickle-cell anemia, acromegaly, Ehlers-Danlos syndrome, and di...
journal_title:Therapeutics and clinical risk management
pub_type: 杂志文章
doi:
更新日期:2009-02-01 00:00:00
abstract::Therapy of soft tissue sarcomas represents an area of significant unmet need in oncology. Angiogenesis has been explored as a potential target both preclinically and clinically, with suggestions of activity. Pazopanib is a multitargeted tyrosine kinase inhibitor with prominent antiangiogenic effects. In a Phase II stu...
journal_title:Therapeutics and clinical risk management
pub_type: 杂志文章,评审
doi:10.2147/TCRM.S84792
更新日期:2016-06-09 00:00:00
abstract:BACKGROUND AND AIMS:The aims of this study were to explore the correlation between chronic hepatitis B virus (HBV) drug-resistant mutation profiles and the efficacy of nucleoside analog rescue therapy in patients with initial antiviral treatment failure. PATIENTS AND METHODS:Patients with initial antiviral therapy fai...
journal_title:Therapeutics and clinical risk management
pub_type: 杂志文章
doi:10.2147/TCRM.S78128
更新日期:2015-03-12 00:00:00
abstract:OBJECTIVES:The significance of early ischemic changes (EIC) on computed tomography (CT) within 3 hours after stroke onset remains controversial. The semi-quantitative Alberta Stroke Program Early CT Score (ASPECTS) is found to have prognostic value in early stroke. This study assesses factors associated with the presen...
journal_title:Therapeutics and clinical risk management
pub_type: 杂志文章
doi:10.2147/tcrm.s2812
更新日期:2008-08-01 00:00:00
abstract:OBJECTIVE:International travelers from non-endemic areas are at high risk of contracting malaria due to their lack of immunity. Prevention is therefore of outmost importance and is achieved through effective and safe chemoprophylaxis, which reduces the risk of fatal disease. Among the various antimalarial drugs availab...
journal_title:Therapeutics and clinical risk management
pub_type: 杂志文章
doi:10.2147/tcrm.s3782
更新日期:2008-10-01 00:00:00