RESUMO
Liquid medication overdose in pediatric patients results in over 70000 visits to the emergency room yearly in the USA. Various studies have demonstrated that the root cause of this high incidence is due to user and device error in dose measurement. The standard measuring cup and syringe suffer from the challenge of accurately measuring and dispensing viscous liquids, which comprise the majority of children's medication formulations. Here, we describe the development of a precision medication dispenser that overcomes challenges associated with viscous fluid flow at low volumes and flow rates, while incorporating various ergonomic and user-friendly features. The device performs with >95% accuracy and 94% precision across the 1-5-mL range of volume, a significant improvement when compared to current commercially available dispensers.
RESUMO
Addressing inaccurate penicillin allergies is encouraged as part of antibiotic stewardship in the inpatient setting. However, implementing interventions targeted at the 10% to 15% of inpatients reporting a previous penicillin allergy can pose substantial logistic challenges. We implemented a computerized guideline for patients with reported beta-lactam allergy at 5 hospitals within a single health care system in the Boston area. In this article, we describe our implementation roadmap, including both successes achieved and challenges faced. We explain key implementation steps, including assembling a team, stakeholder engagement, developing or selecting an approach, spreading the change, establishing measures, and measuring impact. The objective was to detail the lessons learned while empowering others to be part of this important, multidisciplinary work to improve the care of patients with reported beta-lactam allergies.
