Articles related to PATIENT SAFETY

Delve into the changes in the updated Beers criteria and their implications for medication use in older patients. The American Geriatrics Society (AGS) has recently revised the Beers criteria. Significantly, these guidelines advise physicians to be cautious when prescribing medications like warfarin and sodium-glucose cotransporter-2 (SGLT2) inhibitors for patients over 65. Importantly, warfarin is now a drug to avoid in initial therapy for venous thromboembolism or nonvalvular atrial fibrillation unless alternatives are contraindicated or face significant usage barriers. The Beers criteria are organized into five distinct categories. These include potentially inappropriate medications, ones that might be inappropriate for patients with certain conditions, medications requiring careful usage, potential drug-drug interactions, and medications needing renal function-based dosage adjustments. An expert panel sifted through evidence from June 1, 2017, to May 31, 2022, to create these updates. These guidelines apply to patients aged 65 years and older in most care settings in the US, excluding hospice and end-of-life care situations. Among the notable changes since 2019 is the inclusion of warfarin. For older patients using warfarin long-term, continuation might be reasonable if they show well-controlled international normalized ratios and no adverse effects. Additional drugs introduced since 2019 include ticagrelor and SGLT2 inhibitors (use […]

The case involves a 73-year-old patient, Ms. B, who had a history of rheumatoid arthritis and was taking prednisone for adrenal insufficiency caused by a pituitary tumor. She was treated by an internist, Dr. R, for various ailments over a period of four years. In November 2016, Ms. B was diagnosed with severe community-acquired pneumonia and admitted to the hospital, where she was treated with levofloxacin. After being discharged, she continued taking levofloxacin and suffered an acute rupture of the gluteus medius tendon, resulting in significant disabilities. Ms. B filed a lawsuit against Dr. R, alleging negligence and failure to inform her about the risks and contraindications of the medication. Dr. R sought a summary judgment to have the case dismissed but was denied by the court. The court ruled that a Boxed Warning on a medication, such as the one associated with levofloxacin, can create a triable issue of fact regarding a physician’s departure from accepted medical practice. Dr. R claimed he was unaware of the risks and relied on the hospitalists’ choice of medication, but the court found that he should have been knowledgeable about the specific risks and suitability of the medication for his patient. The case […]

Do you understand how to protect your patients and team from biofilm that can build in dental unit waterlines (DUWLs)? Take this quiz to see how well you understand this critical safety issue.

A federal science panel has recommended revisions to a National Toxicology Program (NTP) report on the potential associations between fluoride and IQ. The NTP Board of Scientific Counselors unanimously voted to adopt the findings and recommendations of a working group that assessed the report. The systematic literature review, which has been ongoing for several years, aims to summarize the existing research on the relationship between fluoride exposure and neurodevelopmental and cognitive health. The panel identified potential biases in the study and suggested revisions to the meta-analysis based on reviewer comments. The American Dental Association (ADA) expressed concerns about the report’s methodology and transparency, urging the NTP not to publish it until the concerns are addressed. The draft report claims that higher fluoride exposure is associated with lower IQ in children, but several studies published after the study period ended in 2020 have questioned the methodology used and the strength of the conclusions. The BSC Working Group recommended that the NTP acknowledge potential publication bias and make improvements to the clarity and language used in the report. The recommendations will be forwarded to the NTP director for further consideration.

Combining alcohol and caffeine is more likely to cause drinkers to underestimate their level of intoxication. The practice among young people leads to more reports of unprotected or unwanted sex, DUI, riding with intoxicated drives, and alcohol-related injury. The combination can also increase blood pressure, raising the risk of stroke and heart attack in at-risk populations.

By capitalizing dissimilar letters, tall man writing helps distinguish between distinctive letter characters of similar medicine names that may be mistaken for one another. Since 2008, the ISMP has kept a list of medicine names in uppercase and bolded tall man letters. The organization surveyed 298 healthcare professionals between October and December 2022 to assist in updating the list, and the findings showed that tall man letters were frequently used: 74% of respondents consistently utilize tall man letters for organization-defined drug names in all necessary circumstances, and 80% of respondents said their facility employs tall man letters in all settings and across multiple facilities.