Abstract:
BACKGROUND:Poor quality prescribing has been identified as one of the leading causes of medication error and adverse drug events. The aim of this study was to improve the quality of written prescriptions in a general hospital by a combination of serial audits and interventions designed to address identified deficiencies. METHODS:Inpatient medication charts were audited annually from 1998 to 2007. Charts were assessed against predetermined standards for good-quality prescribing. RESULTS:Initially an unacceptable proportion of medication charts failed to document adequately one or more of the following: prescriber identification (58%), legible prescriptions (14%), route of administration (14%), a dose (11%), date (11%) or adequate patient identification (8%). Only 53% of charts had any information about medication alerts and 15% contained at least one verbal order. Interventions designed to address these deficiencies included educational strategies (e.g. feedback of audit results, education sessions for doctors and nurses on prescribing and medication errors) and changes to systems (e.g. modifications to medication charts, development of hospital wide prescribing standards and an alert notification system). Serial audits showed progressive improvements in all items by 2007 including; legibility (97%), patient identification (100%), documentation of date (98%), drug dose (99%) and route (97%), use of medication alerts (98%) and the prevalence of verbal orders (<1%). Identification of prescribers remained suboptimal (81% in 2006, 53% in 2007). CONCLUSION:Serial audits of the quality of prescribing on hospital medication charts can rapidly identify the extent of deficiencies in prescribing practice, facilitate interventions specifically designed to address these and monitor their influence.
journal_name
Intern Med Jjournal_title
Internal medicine journalauthors
Gommans J,McIntosh P,Bee S,Allan Wdoi
10.1111/j.1445-5994.2007.01518.xsubject
Has Abstractpub_date
2008-04-01 00:00:00pages
243-8issue
4eissn
1444-0903issn
1445-5994pii
IMJ1518journal_volume
38pub_type
杂志文章abstract:BACKGROUND:Prothrombinex-VF (a three-factor prothrombin complex concentrate) contains little factor VII. Therefore, the Warfarin Reversal Consensus Guidelines from 2004 published by The Australasian Society of Haemostasis and Thrombosis recommend that it be administered with fresh frozen plasma to reverse warfarin anti...
journal_title:Internal medicine journal
pub_type: 杂志文章
doi:10.1111/j.1445-5994.2010.02237.x
更新日期:2011-04-01 00:00:00
abstract::More than 177 000 potentially preventable healthcare-associated infections (HAIs) occur per annum in Australia with sizable attributable mortality. Organizational systems to protect against HAI in hospitals in Australia are relatively poorly developed. Awareness and practice of infection control by medical and other h...
journal_title:Internal medicine journal
pub_type: 杂志文章,评审
doi:10.1111/j.1445-5994.2009.02004.x
更新日期:2009-09-01 00:00:00
abstract::This paper examines the differences between clinical and public health ethics and provides several examples of contemporary public health challenges that pose ethical questions. The relations among ethics, rights and obligations are explored, because public health philosophers propose these as different ways for publi...
journal_title:Internal medicine journal
pub_type: 杂志文章,评审
doi:10.1111/j.1445-5994.2004.00643.x
更新日期:2004-07-01 00:00:00
abstract:BACKGROUND:Low socioeconomic status is associated with cardiovascular diseases, and an association with atrial fibrillation (AF) could guide screening. AIM:To investigate if indices of advantage/disadvantage (IAD), index of education/occupation (IEO) and index of economic resources were associated with incident AF, in...
journal_title:Internal medicine journal
pub_type: 杂志文章
doi:10.1111/imj.14214
更新日期:2019-10-01 00:00:00
abstract::Haemophagocytic lymphohistiocytosis (HLH) is rare disorder characterised by immune activation leading to cytokine storm and end-organ failure. It is associated with poor prognosis. HLH is predominantly a disease of early childhood, where it often results from genetic defects that impair cytotoxic function of natural k...
journal_title:Internal medicine journal
pub_type: 杂志文章
doi:10.1111/imj.14891
更新日期:2020-05-10 00:00:00
abstract::Severe sepsis is defined as organ dysfunction in the setting of systemic inflammatory response due to infection. With changes in population age, comorbidity and the delivery of medical care, severe sepsis is increasingly common, and can present in every area of the hospital. The major obstacles to improved outcomes in...
journal_title:Internal medicine journal
pub_type: 杂志文章,评审
doi:10.1111/j.1445-5994.2010.02383.x
更新日期:2011-01-01 00:00:00
abstract::As the mortality rate from breast cancer decreases, the issues facing breast cancer survivors are becoming increasingly important. Survivors of all ages may face physical and psychosocial consequences of their diagnosis and treatments. However, the long-term fertility and menopause-related side-effects of adjuvant the...
journal_title:Internal medicine journal
pub_type: 杂志文章,评审
doi:10.1046/j.1445-5994.2003.00377.x
更新日期:2003-08-01 00:00:00
abstract::Extramedullary haemopoiesis (EMH) is a complication commonly associated with beta-thalassaemia intermedia; it is frequently asymptomatic but can sometimes lead to symptomatic tumour-like masses. No guidelines or common consensus are available in literature regarding the different treatment strategies and only single c...
journal_title:Internal medicine journal
pub_type: 杂志文章,评审
doi:10.1111/imj.12386
更新日期:2014-04-01 00:00:00
abstract::Doctor-patient language discordance has been shown to lead to worse clinical outcomes. In this study of patients undergoing primary percutaneous coronary intervention for ST-elevation myocardial infarction at an Australian health service, we demonstrated that limited English proficiency (LEP) is an independent predict...
journal_title:Internal medicine journal
pub_type: 杂志文章
doi:10.1111/imj.13751
更新日期:2018-04-01 00:00:00
abstract:BACKGROUND:There is little existing research on the role that secondary care letters have in ensuring patient understanding of chronic health conditions. AIM:To determine whether minimising the use of medical terminology in medical correspondence improved patient understanding and anxiety/depression scores. METHODS:A...
journal_title:Internal medicine journal
pub_type: 杂志文章,随机对照试验
doi:10.1111/imj.13062
更新日期:2016-05-01 00:00:00
abstract::Vancomycin remains a clinically useful antibiotic despite the advent of several alternative drugs. Optimising vancomycin therapy with therapeutic drug monitoring is widely recommended. The aim of therapeutic drug monitoring is to help the clinician to achieve target pharmacodynamic parameters in the case of vancomycin...
journal_title:Internal medicine journal
pub_type: 杂志文章,评审
doi:10.1111/imj.12036
更新日期:2013-02-01 00:00:00
abstract:BACKGROUND:Peptide receptor radionuclide therapy with 177 Lu-DOTATATE is a promising treatment for inoperable or metastatic neuroendocrine tumours (NET). In 2015, the NSW Ministry of Health provided funding for 177 Lu-DOTATATE treatment of NET under an evaluation framework. AIMS:To examine the safety and outcomes of N...
journal_title:Internal medicine journal
pub_type: 杂志文章,多中心研究
doi:10.1111/imj.14336
更新日期:2019-10-01 00:00:00
abstract:BACKGROUND:Since 1995 patients with relapsed aggressive non-Hodgkin lymphoma have been treated with high-dose chemotherapy (HDC) instead of standard dose chemotherapy (SC) because of superior survival shown in the 'Parma study'. As HDC involves hospital admission and intensive supportive care, the cost of HDC would be ...
journal_title:Internal medicine journal
pub_type: 杂志文章,随机对照试验
doi:10.1111/j.1445-5994.2008.01795.x
更新日期:2009-08-01 00:00:00
abstract:BACKGROUND:The consumption of Energy Drinks (Edks), has increased significantly in the last years, with a growing market that is estimated to reach $61 billion by 2021 worldwide. Several studies demonstrated the physiological and pathological effects of these substances contained in Edks. The most common ingredient con...
journal_title:Internal medicine journal
pub_type: 杂志文章,评审
doi:10.1111/imj.14881
更新日期:2020-05-05 00:00:00
abstract:BACKGROUND: Hepatic epithelioid haemangioendothelioma (HEH) is a rare, low grade malignant neoplasm of endothelial origin which is difficult to diagnose and has a variable outcome. We review five HEH cases from our centre with the aim of identifying clinical predictors of outcome and various therapeutic options. METH...
journal_title:Internal medicine journal
pub_type: 杂志文章
doi:10.1111/j.1445-5994.2009.02043.x
更新日期:2010-10-01 00:00:00
abstract:AIM:Bigge Park Centre (BPC) is a sexual health clinic located in a socially disadvantaged area in Southwest Sydney. This served as a retrospective clinical audit, documenting patient demographics, identifying factors associated with virological, immunological and discordant responses, evaluating the centre's ability in...
journal_title:Internal medicine journal
pub_type: 杂志文章
doi:10.1111/j.1445-5994.2009.01983.x
更新日期:2010-04-01 00:00:00
abstract::Common peroneal neuropathy (CPN) may develop unexpectedly in patients with underlying cancer. To clarify the underlying pathophysiology, clinical and neurophysiological data were prospectively collected from 10 oncology clinic patients referred for neurological assessment after the onset of foot weakness. In all patie...
journal_title:Internal medicine journal
pub_type: 杂志文章
doi:10.1111/j.1445-5994.2012.02836.x
更新日期:2012-07-01 00:00:00
abstract::A cross-sectional survey of 265 adult patients with haematological malignancy, haemoglobinopathy or human immunodeficiency virus was performed to determine the potential risk of infection from animal exposures. One hundred and thirty-seven (52%) owned an animal; the majority were dogs (74%) and cats (39%), but 14% own...
journal_title:Internal medicine journal
pub_type: 杂志文章
doi:10.1111/imj.13361
更新日期:2017-03-01 00:00:00
abstract::A 22-year-old woman presented with methanol toxicity manifesting as headache, reduced conscious state and visual change after consuming home-made grappa. She progressed to a coma with fixed mydriasis and severe acidaemia (pH 6.55). She was treated with empirical antidote administration (intravenous ethanol) and enhanc...
journal_title:Internal medicine journal
pub_type: 杂志文章
doi:10.1111/imj.13725
更新日期:2018-03-01 00:00:00
abstract::The author, a physician in late middle age reflects on his own medical career, the aging of those who have taught him and also of those whom he has taught. He describes the sense of ennui and déjà vu. The things that seemed important as a younger doctor seem less important. He has adopted a different paradigm and has ...
journal_title:Internal medicine journal
pub_type: 杂志文章
doi:10.1111/j.1445-5994.2006.01256.x
更新日期:2006-12-01 00:00:00
abstract:AIMS:To characterize long-term mortality trends for infectious and parasitic diseases in Australia during the twentieth century, explore influencing factors and provide suggestions to health policy-makers. METHODS:A descriptive study was conducted. Deaths due to communicable diseases from 1907 to 1997 were tallied, ac...
journal_title:Internal medicine journal
pub_type: 杂志文章
doi:10.1046/j.1445-5994.2003.00354.x
更新日期:2003-04-01 00:00:00
abstract:BACKGROUND:The relationship between serum triglycerides (TG) level and the risk of coronary heart disease (CHD) mortality remains controversial. AIMS:To evaluate whether TG level is a risk factor for CHD in elderly people from general population, and to look for interactions between TG and other risk factors. METHODS...
journal_title:Internal medicine journal
pub_type: 杂志文章
doi:10.1111/j.1445-5994.2005.00940.x
更新日期:2005-10-01 00:00:00
abstract:BACKGROUND:Neoadjuvant chemoradiation therapy (CRT) is standard of care treatment for locally advanced rectal cancer (LARC). A pathologic complete response (pCR) following CRT is an early indicator of treatment benefit and associated with excellent survival outcomes. As capecitabine replaces infusional 5-fluorouracil (...
journal_title:Internal medicine journal
pub_type: 杂志文章
doi:10.1111/imj.15045
更新日期:2020-09-08 00:00:00
abstract::Heart failure remains an ultimately fatal condition that causes significant symptoms as it progresses. The involvement by palliative services in this patient group has been suboptimal despite many years of guidance from international cardiac societies who recommend a palliative focus for these patients. At Hutt hospit...
journal_title:Internal medicine journal
pub_type: 杂志文章
doi:10.1111/imj.14218
更新日期:2019-03-01 00:00:00
abstract:BACKGROUND:Stroke neurologists, vascular surgeons, interventional neuroradiologists and interventional cardiologists have embraced carotid angioplasty and stenting (CAS) because of potential advantages over carotid endarterectomy (CEA). At Austin Health, a multidisciplinary neuro-interventional group was formed to stan...
journal_title:Internal medicine journal
pub_type: 杂志文章
doi:10.1111/j.1445-5994.2010.02285.x
更新日期:2011-11-01 00:00:00
abstract::Diabetes can lead to a myriad of microvascular and macrovascular complications - with the leading cause of mortality in diabetes being cardiovascular disease. Low-density lipoprotein cholesterol, along with non-high-density lipoprotein cholesterol and triglycerides are proven, modifiable risk factors for cardiovascula...
journal_title:Internal medicine journal
pub_type: 杂志文章,评审
doi:10.1111/imj.14291
更新日期:2019-12-01 00:00:00
abstract:BACKGROUND:The Northern Territory (NT) has a long history of heavy alcohol consumption with a correspondingly high attributable morbidity and mortality. AIMS:We aimed to describe the number of admissions to Intensive Care associated with alcohol misuse. METHODS:Prospective case-control study including all admissions ...
journal_title:Internal medicine journal
pub_type: 杂志文章
doi:10.1111/imj.15212
更新日期:2021-01-19 00:00:00
abstract:BACKGROUND:The association between the use of angiotensin-converting enzyme inhibitors (ACEI) and angiotensin receptor blockers (ARB) and mortality in end-stage renal disease (ESRD) patients lacks sufficient evidence. AIM:To investigate the efficacy of ACEI and ARB in ESRD patients. METHODS:This nationwide retrospect...
journal_title:Internal medicine journal
pub_type: 杂志文章
doi:10.1111/imj.13971
更新日期:2018-09-01 00:00:00
abstract:BACKGROUND:In recent years, there has been a significant increase in the number of cancer treatments that have become available. However, it has remained difficult to choose the most appropriate time to cease active therapy in individual patients. AIMS:To determine the proportion of patients being treated with palliat...
journal_title:Internal medicine journal
pub_type: 杂志文章
doi:10.1111/imj.13260
更新日期:2017-03-01 00:00:00
abstract:BACKGROUND:Patients who suffer from acute IgE-mediated allergy to a cephalosporin antibiotic are frequently assumed to be at high risk of allergy to other cephalosporins and penicillins. AIM:To define cross-reactivity patterns in patients with confirmed allergy to a cephalosporin. METHODS:Subjects presenting with a h...
journal_title:Internal medicine journal
pub_type: 杂志文章
doi:10.1111/imj.14229
更新日期:2019-08-01 00:00:00