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To evaluate the effectiveness of targeted interventions in optimising Beyond-Use Date (BUD) management and workload distribution to reduce intravenous (IV) medication errors and improve patient safety in a resource-limited hospital setting.
This study employed a pre- and post-intervention observational design.
A four-month intervention was conducted at a large tertiary hospital in China, following a baseline assessment of IV medication practices. The intervention included the establishment of BUD guidelines, redistribution of staff workloads and targeted training sessions. IV preparation and administration errors were observed in Pharmacy Intravenous Admixture Services (PIVAS) centers and medical wards, and changes in error rates were recorded.
In the PIVAS center, IV preparation errors decreased from 0.19% to 0.12%. Medical wards showed a decrease in administration errors from 38.3% to 30.0%, with improvements noted in areas such as adherence to BUD and storage protocols. The intervention demonstrated significant improvements in medication safety by enhancing BUD compliance and balancing workloads.
The implementation of structured BUD guidelines, workload optimisation, and training significantly reduced IV medication errors, highlighting the effectiveness of management-driven interventions in improving safety practices within hospital settings.
This study underscores the importance of BUD management and balanced workloads in reducing medication errors, contributing to safer and more efficient IV medication administration.
This study addresses the challenge of medication errors in resource-constrained healthcare environments, providing evidence that structured management interventions can enhance patient safety. The findings are relevant to healthcare providers and managers in similar settings.
This study follows the TIDieR and STROBE guidelines for structured reporting.
No patient or public contribution.
We examined whether small incision aortic root replacement could reduce the amount of blood transfusion during operation and the risk of postoperative complications. An extensive e-review of the 4 main databases (PubMed, Cochrane, Web of Science and EMBASE) was carried out to determine all the published trials by July 2023. The search terms used were associated with partial versus full sternotomy and aortic root. This analysis only included the study articles that compared partial and full sternotomy. After excluding articles based on titles or abstracts, selected full-text articles had reference lists searched for any potential further articles. We analysed a total of 2167 subjects from 10 comparable trials. The minimally invasive aortic root graft in breastbone decreased the duration of hospitalization (MD, −2.58; 95% CI, −3.15, −2.01, p < 0.0001) and intraoperative red blood cell transfusion (MD, −1.27; 95% CI, −2.34, −0.19, p = 0.02). However, there were no significant differences in wound infection (OR, 0.88; 95% CI, 0.16, 4.93, p = 0.88), re-exploration for bleeding (OR, 0.96; 95% CI, 0.60, 1.53, p = 0.86), intraoperative blood loss (MD, −259.19; 95% CI, −615.11, 96.73, p = 0.15) and operative time (MD, −7.39; 95% CI, −19.10, 4.32, p = 0.22); the results showed that the microsternotomy did not differ significantly from that of the routine approach. Small sternotomy may be an effective and safe substitute for the treatment of the aorta root. Nevertheless, the wide variety of data indicates that larger, well-designed studies are required to back up the current limited literature evidence showing a benefit in terms of complications like postoperative wound infections or the volume of intraoperative red blood cell transfusion.
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