Evaluation of errors in preparation and administration of intravenous medications in critically ill patients.

BACKGROUND: Intravenous medications have greater complexity and require multiple steps in their preparation and administration, which is considered a high risk for patients. OBJECTIVE: To determine the incidence of intravenous medications preparation and administration errors in critically ill patients. METHODS: This was an observational, cross-sectional, prospective study design. The study was performed in Wad Medani Emergency Hospital, Sudan . RESULTS: All nurses working at the study setting were observed over nine days. During the study period, a total number of 236 drugs were observed and evaluated. The total error rate was 940 (33.4%), of which 136 (57.6%) errors with no harm, 93 (39.4%) errors with harm and 7 (3%) of errors associated with mortality. 17 different drug categories were involved, in which antibiotic was the highest error rate 104 (44.1%) and 39 different drugs were involved, in which metronidazole was the most drug involved 34 (14.4%). The total error rate was associated with nurse experience, OR (95% CI); 3.235 (1.834-5.706), and nurse education level, OR (95% CI); 0.125 (0.052-0.299). CONCLUSION: The study reported high frequency of IV medications preparation and administration errors. Nurse education level, and experiences were influenced the total errors.

Validation of the Arabic Version of General Medication Adherence Scale (GMAS) in Sudanese Patients with Diabetes Mellitus.

OBJECTIVE: The aim of this study was to validate the Arabic version of General Medication Adherence Scale (GMAS) in Sudanese patients with type 2 diabetes mellitus (T2DM). METHODS: A 3-month cross-sectional study was conducted among patients with T2DM at Al-Daraja Health Center, located in Wad Medani, Sudan. A convenient sample of patients was selected, and the study sample size was calculated using the item response ratio. Factorial, known group, and construct validities were determined. Internal consistency and reliability were also determined. RESULTS: Responses were provided by 500 patients. The average medication adherence score was 30 (median 31). The normed fit index (NFI) was 0.950, the comparative fit index (CFI) was 0.963, the incremental fit index (IFI) was 0.963, and the root-mean-square error of approximation (RMSEA) was 0.071. The results from these fit indices indicated a good model. Factorial, known group and construct validities were all established. A significant association was found between adherence score and age (P = 0.03) since a larger proportion of older patients were found to have high adherence compared to patients in other age groups. The reliability (α) of the questionnaire was 0.834. CONCLUSION: The Arabic version of GMAS was validated in Sudanese patients with T2DM making it a suitable scale to be used in this population.

The role of supportive supervision using mobile technology in monitoring and guiding program performance: a case study in Nigeria, 2015-2016.

BACKGROUND: Supportive supervision is one of the interventions that fosters program improvement by way of imparting knowledge and skills to health workers. The basic challenge in supportive supervision is the availability of data in real time for timely and effective feedback. Thus, the main objective of this study was to determine the contribution of real-time data collection during supportive supervision for timely feedback and generation of evidence for health intervention planning. METHODS: We analyzed supportive supervision records collected through handheld devices employing the open data kit (ODK) platform from July 2015 to June 2016. Supervision was conducted across the country by 592 World Health Organization (WHO) officers. The availability of real-time data and the distance of health facilities to the community were analyzed. RESULTS: During the study period, 90,396 health facilities were supervised. The average time spent during supervision varied from 1.53 to 3.78 h across the six geopolitical zones of the country. The average interval between completion of the supervisory checklist and synchronization with the server varied from 3.9 h to 7.5 h. The average distance between the health facility and a ward varied from 5 to 24 km. CONCLUSION: The use of handheld devices for supportive supervision provided real-time data from health facilities to state and zonal levels for analysis and feedback. Program officers used the findings to rectify process indicators in time for a better outcome.

Pharmacy education instruction: Preference and practices, Saudi students' perception.

AIM/BACKGROUND: The methods of instruction in pharmacy education are crucial and meant to suit the professional development and encompass the advanced variety of services and functions provided by the pharmacists to serve individual patients. The aim of this study was to determine the students' opinions on the adopted and preferred methods of instruction in pharmacy colleges in Kingdom of Saudi Arabia. METHODS: Opinions of Saudi pharmacy students regarding the adopted methods of learning were measured using a pretested questionnaire combined with Likert-type scales. RESULTS: Three hundred pharmacy students were interviewed. Direct type of lecturing was dominant (53.7%). The most frequently used language of instruction was combined English and Arabic (48.8%), that was mostly preferred by 52.5% of the students. Handouts were the most adopted post-lecture learning method (48.3%), while only 5.9% used student's self-written notes. A cocktail of traditional and electronic aids was used as admitted by 68.7% and 59.3% of the students who preferred this lecture delivery method. Almost half (49.3%) of the students agreed of having a routine fair guidance and support when referring to their lecturers. CONCLUSION: The study outcomes had revealed a practical guidance to be considered for instituting preferred modes of instruction to upgrading students' capacities for better understanding and acquiring academic and professional skills.

Saudi school students' knowledge, attitude and practice toward medicines.

The current study was aimed to assess Saudi school students' knowledge, attitude and practice about medicines. A pretested self-administered questionnaire was used anonymously among 15-20 year-old adolescents attending tertiary schools in Taif City, KSA. A total of 1022 students completed the questionnaires. Only 15.4% of the respondents knew the medicines' uses. Most of the students 79.6% affirmed that they used to take medicines after consulting physicians, and 45.1% of the students thought that tablet size affects the medicine's efficacy. More than half of the students knew that high temperatures affect the efficacy of medicines, there was a significant difference between rural and urban areas (P = 0.005). Physicians (50.6%) and community pharmacists (15.7%), were the main students' reliable sources of information about medicines. The majority of the students 70.5% were interested in learning more about medicines. The younger students ⩽18 years wish to learn more than the older ones (P < 0.014). The study showed that Saudi school students aged 15-20 years old have poor knowledge, misconception and negative attitudes about medicines. Low level of knowledge may expose adolescents to health-related problems. Educational efforts are important to improve students' practice toward medicines.

The approach to a patient with a bleeding disorder: for the primary care physician.

Normal Hemostasis requires the interaction of platelets and the clotting cascade with normal blood vessels and supporting tissues. Bleeding problems and easy bruising are commonly encountered clinical problems. Assessment of these patients is a multistep evaluation process that involves a complete detailed history, thorough physical examination and relevant laboratory evaluation. Many disorders are usually relatively straight forward to diagnose, but in other disorders, patients may have "hidden" signs and symptoms making diagnosis more difficult. A meticulous approach must be used to plan the first steps of management.

Attitudes of medical laboratory technology graduates towards the internship training period at king faisal university.

OBJECTIVES: The objective of this present survey was to look into the attitudes of medical laboratory technology (MLT) graduates towards the internship training period of the MLT Department, College of Applied Medical Sciences, King Faisal University. MATERIAL AND METHODS: A self-administered questionnaire was designed and distributed for this purpose. The study period was from December 1(st) 2002 - 31(st) December 2004. Two-hundred questionnaires were distributed to recent graduates, and 115 were returned completed. RESULTS: All respondents agreed with the importance and necessity of the internship period, and felt it should not be reduced or eliminated. The most favorite laboratory where they liked to work was microbiology (70%). They all agreed that evaluation report with hospital staff and laboratory set up were vital in achieving the goals of the internship period. The majority stressed the significance of safety precautions and the application of theoretical knowledge before performing technical assignments. CONCLUSION: The respondents had very positive attitudes towards the internship-training period stressing its importance. The most favorite laboratory rotations were in rank order: Microbiology, Serology followed by Histotechnology, Hematology, Blood Banking and finally Clinical Chemistry. The majority of graduates had a very positive attitude also towards medical laboratory technology as a profession.

Prevalence of antibodies to human T-lymphotropic viruses types I and II among healthy blood donors.

OBJECTIVE: To assess the prevalence of human T-cell lymphotropic virus type I and type II antibodies in blood donors donating blood for various reasons in a University hospital and to compare the results with other reports from the Kingdom of Saudi Arabia (KSA), and elsewhere. METHODS: A 7-year retrospective review of blood bank records for results of serological tests at the King Fahd Hospital of the University, Al-Khobar, KSA, from January 1995 to December 2001 was conducted. The study included review of blood donor questionnaire cards as well as extraction of any other relevant information. RESULTS: The results showed that the total number of blood donor units drawn during the 7- year period was 23493 units. A total of 50 units were found repeatedly reactive by enzyme immunoassay screening test (0.2%). Only 12 (0.05%) were confirmed reactive by western blot test and 4 were found to be indeterminate. Nine (0.04%) of the confirmed samples were from Saudi nationals. All 3 non-Saudi confirmed reactive donors were Indian nationals, while the 4 indeterminate cases, 2 were Saudis and 2 were Egyptians. A statistical estimate of the maximal risk of finding a positive donor in this donor population subgroup is in the order of 0.05%. The number of Saudi blood donors during this study was 16434 (80.3%) and non-Saudi donors was 4027 (19.7%). CONCLUSION: Based on these results it is shown that the prevalence of this virus is still low among blood donors in the Eastern region of Kingdom of Saudi Arabia.

Medical laboratory technology program at king faisal university: a 10-year experience.

This paper documents the evolution of the Medical Laboratory Technology (MLT) program established in 1989 (1408/1409 H) at the College of Medicine and Medical Sciences, King Faisal University. The rationale, objectives, the general outline of the program as well as methods of instruction and evaluation are discussed. The internship period and future plans are also addressed. Two hundred and seventy (270) students had been enrolled in the program since its inception until September 2000. Ten batches (138 graduates) have already successfully graduated. One hundred and fifteen (83.3%) graduated technologists are employed in the different health sectors and educational institutions in the Kingdom.

Formulation and release behavior of diclofenac sodium in Compritol 888 matrix beads encapsulated in alginate.

Sustained-release polymer beads containing diclofenac sodium (DNa) dispersed in Compritol 888 and encapsulated in calcium alginate shell were prepared utilizing 2(3) factorial design. The effect of sodium alginate concentration, drug: Compritol 888 weight ratio and CaCl2 concentration on drug content (%), time for 50% and 80% of the drug to be released, and mean dissolution time (MDT) were evaluated with analysis of variance (ANOVA). An increase in the level of all these factors caused retardation in the release, and t50%, t80%, and MDT were increased. The drug release was dependent on the pH of the release media. A formula that gives a release comparable to commercial products was prepared.

Severe hepatic fibrosis in Schistosoma mansoni infection is controlled by a major locus that is closely linked to the interferon-gamma receptor gene.

Lethal disease due to hepatic periportal fibrosis occurs in 2%-10% of subjects infected by Schistosoma mansoni in endemic regions such as Sudan. It is unknown why few infected individuals present with severe disease, and inherited factors may play a role in fibrosis development. Schistosoma mansoni infection levels have been shown to be controlled by a locus that maps to chromosome 5q31-q33. To investigate the genetic control of severe hepatic fibrosis (assessed by ultrasound examination) causing portal hypertension, a segregation analysis was performed in 65 Sudanese pedigrees from the same village. Results provide evidence for a codominant major gene, with.16 as the estimated allele A frequency predisposing to advanced periportal fibrosis. For AA males, AA females, and Aa males a 50% penetrance is reached after, respectively, 9, 14, and 19 years of residency in the area, whereas for other subjects the penetrance remains <.02 after 20 years of exposure. Linkage analysis performed in four candidate regions shows that this major locus maps to chromosome 6q22-q23 and that it is closely linked (multipoint LOD score 3.12) to the IFN-gammaR1 gene encoding the receptor of the strongly antifibrogenic cytokine interferon-gamma. These results show that infection levels and advanced hepatic fibrosis in human schistosomiasis are controlled by distinct loci; they suggest that polymorphisms within the IFN-gammaR1 gene could determine severe hepatic disease due to S. mansoni infection and that the IFN-gammaR1 gene is a strong candidate for the control of abnormal fibrosis observed in other diseases.