A Gold(I) Oxide Double Perovskite: Ba2AuIO6.

Oxide perovskites offer improved stability compared to halide perovskite compounds for optoelectronic applications. Here, we report the first gold-containing double perovskite, Ba2AuIO6, and compare it to Ba2AgIO6 and Ba2NaIO6. Ba2AuIO6 and Ba2AgIO6 exhibit a monoclinic distortion from the cubic perovskite structure possessed by Ba2NaIO6 and have similar lattice constants despite the nominally larger size of Au+ compared to Ag+. Ba2AgIO6 shows photoluminescence (PL) at 2.10 eV, and Ba2AuIO6 exhibits PL at 1.30 and 1.47 eV. As prepared, both compounds appear stable under visible light at room temperature but decompose when subjected to gentle heating followed by illumination. Our data suggest that this behavior is due to the presence of -OH defects in the crystal structures. This discovery provides a new route to semiconductors with a near-IR band gap and identifies engineering challenges that must be addressed to use oxide perovskites for optoelectronic devices.

A quantitative evaluation of medication histories and reconciliation by discipline.

BACKGROUND/OBJECTIVE: Medication reconciliation at transitions of care decreases medication errors, hospitalizations, and adverse drug events. We compared inpatient medication histories and reconciliation across disciplines and evaluated the nature of discrepancies. METHODS: We conducted a prospective cohort study of patients admitted from the emergency department at our 760-bed hospital. Eligible patients had their medication histories conducted and reconciled in order by the admitting nurse (RN), certified pharmacy technician (CPhT), and pharmacist (RPh). Discharge medication reconciliation was not altered. Admission and discharge discrepancies were categorized by discipline, error type, and drug class and were assigned a criticality index score. A discrepancy rating system systematically measured discrepancies. RESULTS: Of 175 consented patients, 153 were evaluated. Total admission and discharge discrepancies were 1,461 and 369, respectively. The average number of medications per participant at admission was 8.59 (1,314) with 9.41 (1,374) at discharge. Most discrepancies were committed by RNs: 53.2% (777) at admission and 56.1% (207) at discharge. The majority were omitted or incorrect. RNs had significantly higher admission discrepancy rates per medication (0.59) compared with CPhTs (0.36) and RPhs (0.16) (P < .001). RPhs corrected significantly more discrepancies per participant than RNs (6.39 vs 0.48; P < .001); average criticality index reduction was 79.0%. Estimated prevented adverse drug events (pADEs) cost savings were $589,744. CONCLUSIONS: RPhs committed the fewest discrepancies compared with RNs and CPhTs, resulting in more accurate medication histories and reconciliation. RPh involvement also prevented the greatest number of medication errors, contributing to considerable pADE-related cost savings.

Impact of Adoption of Smart Pump System With Continuous Capnography Monitoring on Opioid-Related Adverse Event Rates: Experience From a Tertiary Care Hospital.

OBJECTIVES: The use of opioid analgesics for pain management in hospitalized patients is associated with a high risk of adverse events, including respiratory depression which may lead to respiratory arrest and death. Patients who experience opioid-related adverse drug reactions (ADRs) have been shown to experience longer and more costly hospital stays and have a higher risk of requiring a readmission after discharge. In this study, we report on the impact of the introduction of Wesley Medical Center's Safe Medication Practice Protocol on opioid-related ADRs. METHODS: A retrospective, pre-post cohort study using electronic health records combined with manual chart review was undertaken at the Wesley Medical Center, a 760-bed tertiary care facility. The Safe Medication Practice Protocol incorporating a smart infusion pump system with capnography monitoring was implemented in May 2010 hospital-wide. The number and severity of ADRs and the duration of opioid treatment were compared between the pre (2007-April 2010) and post (May 2010-2014) periods. RESULTS: A total of 139,734 (pre-period) versus 267,573 (post-period) patients received opioid treatment during the hospital stay. Compared with the pre-period, the post-period resulted in a 79.2% reduction in the number of severe adverse reactions (3.08 vs 0.64 per 10,000 patients treated with opioid, P < 0.0001) as well as a shorter duration of opioid treatment (average 2.05 vs 1.37 days, P < 0.0001). CONCLUSIONS: Implementing education, revisions to patient-controlled analgesia policies and procedures, and capnography monitoring with patient-controlled analgesia pause is associated with significantly lower rates of severe ADRs and shorter opioid treatment duration.

Effect of preprinted order form on epoetin alfa prescribing.

PURPOSE: The effect of a required preprinted order form on the prescribing of epoetin alfa was evaluated. SUMMARY: An initial drug-use evaluation (DUE) was conducted in January 2004 to determine how closely prescribing guidelines for epoetin alfa were being followed. A preprinted order form was then developed and approved by the medical staff, with use required for all adult epoetin alfa orders. A follow-up DUE was conducted in January 2006 to assess the effects of the preprinted order form on prescribing patterns. Expenditures for epoetin alfa for 12 months before and after implementation of the preprinted order form were also calculated. Data for 45 and 44 patients were reviewed for the initial and follow-up DUEs, respectively. Smaller doses were ordered at more frequent intervals and epoetin alfa was prescribed more often by nephrologists and less frequently by surgeons and critical care intensivists after implementation of the preprinted order form. Use of epoetin alfa according to hospital guidelines improved from 44% to 73% (p = 0.0089). Significantly more patients' ferritin and transferrin saturation values were measured postimplementation of the order form (p = 0.0176). In addition, the annual expense for epoetin alfa was reduced by $151,042, a 36% reduction from baseline. CONCLUSION: Implementation of a required preprinted order form increased the frequency of appropriate prescribing of epoetin alfa in a community teaching hospital.