More than just crushing: a prospective pre-post intervention study to reduce drug preparation errors in patients with feeding tubes.

WHAT IS KNOWN AND OBJECTIVES: Incorrect drug preparation for patients with feeding tubes can result in harm for the patient and the preparing person. Combined intervention programs are effective tools to reduce such preparation errors. However, to date, intervention programs have been mostly tested in hospitals with computerized physician order entry (CPOE), unit-dose systems, or ward-based clinical pharmacists. Hence, the primary objective of this study was to develop and evaluate an intervention program tailored to hospitals without such preconditions. METHODS: We conducted a prospective pre-/post-intervention study on a gastroenterological intensive care unit (ICU) and a surgical ward for oral, dental and maxillofacial diseases (surgical ward). During the study periods, observers documented and evaluated drug preparation processes of all peroral drugs for patients with feeding tubes. The primary endpoint was the rate of inappropriately crushed and/or suspended solid peroral drugs in regards to all solid peroral drugs. RESULTS AND DISCUSSION: Altogether, we evaluated 775 drug preparation processes of solid peroral drugs on the ICU and 975 on the surgical ward. The intervention program significantly reduced incorrect crushing and/or suspending of solid peroral drugs for administration to patients with feeding tubes from 9·8% to 4·2% (P < 0·01) on the ICU and from 5·7% to 1·4% (P < 0·01) on the surgical ward. WHAT IS NEW AND CONCLUSION: The implementation of the newly developed intervention program significantly reduced the rate of inappropriately prepared solid peroral drugs, suggesting that it is an effective measure to enable safe drug administration for inpatients with feeding tubes.

[Use of histoacryl tissue adhesive in iliac crest biopsy]. / Zur Anwendbarkeit von Histoacryl-Gewebekleber bei der Beckenkammbiopsie.

In the up to now most customary methods of the biopsy of the iliac crest it was usual to shut the incision of the skin necessary for the intervention after having finished the biopsy with a clamp or a suture, which, as a rule could be removed together with a fracture bandage covering all only after a week, which on principle made necessary a repeated consultation of the physician. The restrictions in the development of physical activities or in the settlement of hygienic necessities (prohibition of shower and bath) showed that these methods are unsuitable for the diagnostic interests in sports medicine. Therefore on 41 test persons or patients 44 biopsies were performed with a modified technique after Jamshidi and Swaim, using histoacryl tissue adhesive as closure of a wound. The course without complications and the shortening of the time up to the removal of the protective bandage to 2-3 days show, that this technique is suited also for the application in sports medicine and in so-called "risk biopsies".

[Decrease of mitogen stimulation of lymphocytes in rheumatoid arthritis]. / Verminderung der Mitogenstimulation von Blutlymphozyten bei der rheumatoiden Arthritis.

Peripheral blood lymphocytes of 51 patients with rheumatoid arthritis and of 14 healthy blood donors were cultivated in autologous and homologous normal pool-serum and stimulated with phytohemagglutinin (PHA-P), concanavalin A (Con A) and pokeweed mitogen (PMW) in different doses. In autologous as well as in homologous pool-serum the 3H-thymidine uptake of stimulated lymphocytes from patients with rheumatoid arthritis was significantly depressed independent of the mitogen concentration used. Serum from patients with rheumatoid arthritis depressed the activation of blood donor lymphocytes by Con A and PWM. The depression of lymphocyte activation was not related to the presence of rheumatoid factors in the serum, the severity of the disease and the anti-rheumatic therapy.