Low Tidal Volume Ventilation Use in Acute Respiratory Distress Syndrome.

Objective: Low tidal volume ventilation lowers mortality in the acute respiratory distress syndrome. Previous studies reported poor low tidal volume ventilation implementation. We sought to determine the rate, quality, and predictors of low tidal volume ventilation use.

Counting matters: lessons from the root cause analysis of a retained surgical item.

Background: Retained surgical items (RSIs), such as a sponge, instrument, or needle, after a surgery or invasive procedure is an uncommon but potentially serious event associated with significant morbidity and mortality. A 27-year-old woman was discovered to have a retained vaginal sponge a week after she underwent the repair of a vaginal tear following normal vaginal delivery. The retained sponge was removed with no further complications.

Barcode medication. Administration implementation in an acute care hospital and lessons learned.

Bar code medication administration (BCMA) systems ensure the five "rights" during medication administration: right patient, drug, dose, route and time. Implementing BCMA is a vital component of a medication safety strategy. Implementing BCMA is a complex project that involves many disciplines, each with unique workflow implications.

Medication errors: prevention using information technology systems.

1. Given the high frequency of medication errors with resultant patient harm and cost, their prevention is a worldwide priority for health systems. 2.

Medication errors: problems and recommendations from a consensus meeting.

Here we discuss 15 recommendations for reducing the risks of medication errors: 1. Provision of sufficient undergraduate learning opportunities to make medical students safe prescribers. 2.

Reducing medication errors and improving systems reliability using an electronic medication reconciliation system.

Background: Medication reconciliation (MedRecon) has been a Joint Commission National Patient Safety Goal since 2006. However, there is scant literature on the evaluation of electronic MedRecon systems in reducing medication errors and on improving reliability of the MedRecon process.

Methods: An electronic MedRecon system was designed and implemented in an acute inpatient care facility.

Evaluation of an electronic medication reconciliation system in inpatient setting in an acute care hospital.

Background: Medication reconciliation (MedRecon) is being implemented in many healthcare facilities as a means to reduce medication errors. However, there is scant literature on the evaluation of electronic MedRecon systems.

Objective: To evaluate the rate and type of discrepancies between a patient's home medication history and admission orders and to analyze factors affecting their occurrence using an electronic MedRecon system.

Literature based discovery of gene clusters using phylogenetic methods.

Biomedical literature can offer valuable information for organizing genes associated with the etiology and pathogenesis of disease. In this study, we demonstrate the utility of existing phylogenetic methods for organizing 375 genes associated with Breast Cancer using the MeSH annotations from over 35,000 Medline articles. Specifically, we compare the clustering (using the Colless Imbalance Index, Ic) of distance-based methods, which are used by popular phylogenetic clustering algorithms, and a character- based method (Maximum Parsimony) that is commonly used for phylogenetic studies.

Factors associated with improved completion of computerized clinical reminders across a large healthcare system.

Objective: To analyze the relationship of completion rates for a standardized set of computerized clinical reminders across a large healthcare system to practice and provider characteristics.

Methods: The relationship between completion rate for 13 standardized reminders at 49 primary care practices in the VA New England Healthcare System for a 30-day period and practice characteristics, provider demographics and, via survey, provider attitudes was analyzed.

Results: There was no difference in clinical reminder completion rate between staff physicians versus nurse practitioners/physician assistants (87.

Adherence to computerized clinical reminders in a large healthcare delivery network.

Objective: To evaluate clinicians' adherence with clinical reminders (CRs) across multiple ambulatory practice settings in an integrated health care network.

Materials And Methods: Adherence rate to 15 CRs, integrated into a computerized patient record system, was evaluated for 451 clinicians in 49 clinics from eight Veterans Affairs (VA) medical centers.

Results: Overall, mean rate of adherence to CRs for all clinics was 86.

A systematic critique of diabetes on the world wide web for patients and their physicians.

Purpose: The web, a widely accessed medium for patients to obtain health information, has special relevance for patients with diabetes. This paper critiques the publicly available web sites for diabetes, and it establishes criteria for excellence in these sites.

Methods: A web search for diabetes mellitus based on Google, Yahoo, and the directory Mendosa provided the basis for the study.

Information and communication technology in cardiovascular disease prevention in developing countries: hype and hope. Report of the International Collaboration on Information Use in Cardiovascular Health Promotion in Developing Countries.

Information can be an important tool in promoting a prevention strategy to address the emerging epidemic of cardiovascular disease in developing countries. Advances in information and communication technology offer new promises for global access to information and for global mobilization to prevent and control cardiovascular disease. This is especially true for health professionals, whose needs in areas such as networking, exchange of expertise and access to relevant advances remain unfulfilled.

Return on investment analysis for a computer-based patient record in the outpatient clinic setting.

While the computer-based patient record (CPR) is considered essential technology for improving efficiency and quality of health care, the high cost of CPR implementation has been a major barrier to widespread acceptance of these systems. This paper describes a framework to evaluate the costs and benefits of implementing CPR systems in outpatient clinical settings. Return on investment (ROI), a measurement of the difference between the costs of and benefits from an investment, is one method to evaluate the economic implications of CPR.