Errors in the administration of intravenous medications in hospital and the role of correct procedures and nurse experience.

Background: Intravenous medication administrations have a high incidence of error but there is limited evidence of associated factors or error severity.

Objective: To measure the frequency, type and severity of intravenous administration errors in hospitals and the associations between errors, procedural failures and nurse experience.

Methods: Prospective observational study of 107 nurses preparing and administering 568 intravenous medications on six wards across two teaching hospitals.

Association of interruptions with an increased risk and severity of medication administration errors.

Background: Interruptions have been implicated as a cause of clinical errors, yet, to our knowledge, no empirical studies of this relationship exist. We tested the hypothesis that interruptions during medication administration increase errors.

Methods: We performed an observational study of nurses preparing and administering medications in 6 wards at 2 major teaching hospitals in Sydney, Australia.

The impact of ear, nose and throat surgery on children's subsequent use of health services: An 8-year cohort study.

Aim: High rates of paediatric ear, nose and throat (ENT) surgery persist. Little is known about its impact on health service utilisation. This study investigated whether children who had ENT surgery used more health services prior to surgery (excluding the perisurgery period), and, if so, whether surgery resulted in reduced utilisation.

Impact of an ultrabroadband emergency department telemedicine system on the care of acutely ill patients and clinicians' work.

Objectives: To evaluate whether introduction of an emergency department (ED) telemedicine system changed patient management and outcome indicators and to investigate clinicians' perceptions of the impact of the system on care provided and on their work.

Design: Before-and-after study of use of the Virtual Critical Care Unit (ViCCU), which uses an ultrabroadband connection allowing real-time audiovisual communication between clinicians at distant sites. Semi-structured interviews were conducted with medical and nursing staff at the end of the study.

Computerised order entry systems: sustained impact on laboratory efficiency and mortality rates?

Few studies have attempted to measure the effectiveness of computerised test-order entry systems to reduce test turnaround time and the extent to which improvements are sustained or continue over time. Further, a recent study has raised the possibility that such systems, which require significant work practice change, may be associated with an increase in mortality rates. Our study answered two questions in relation to the introduction of a computerised pathology order entry system in a major Australian teaching hospital: i) are initial improvements in turnaround times achieved in the first 12 months of system use sustained beyond this time; and ii) did mortality rates change following the introduction of the order entry system? We found significant improvements in turnaround times 12 and 24 months following system implementation and no change in average number of tests per patient.

All in a day's work: an observational study to quantify how and with whom doctors on hospital wards spend their time.

Objective: To quantify time doctors in hospital wards spend on specific work tasks, and with health professionals and patients.

Design: Observational time and motion study.

Setting: 400-bed teaching hospital in Sydney.