A survey about label enhancement methods for parenteral medication in European hospital pharmacies

Purpose Unclear labeling has been recognized as an important cause of look-alike medication errors. Little is known about which labeling practices are currently used in European hospitals. The aim of this article is to obtain an overview of the labeling practices for parenteral medications, in relation to national guidelines, in the Netherlands, Germany, and the UK. Methods An online survey was conducted using the Qualtrics® software. The survey was distributed to hospital pharmacists in the Netherlands, Germany, and the UK. The results were downloaded from Qualtrics and exported to Microsoft Excel. Data were categorized into groups and analyzed descriptively. Results In total, 104 responses were received. The response rate was 63% (n = 48) in the Netherlands and 11% (n = 41) for Germany; for the UK, 15 responses were received. In general almost 90% of the respondents followed the National guidelines concerning labeling of pharmacy-prepared parenteral products. The use of label enhancement techniques was relatively low in all countries. On average, the use of “Tall Man” lettering was 19%, the use of color coding was 29%, and the use of a barcode on the label was 27%. Conclusion Label-enhancement methods for parenteral medication in hospital pharmacies do not seem to be widely implemented and acknowledged in European hospitals, but response rates were limited for two countries. Greater standardization in conjunction with research for evidence-based enhancement techniques is needed to guide improvement in labeling practices across Europe.

Medical equipment trends during the UK military exercise SAIF SAREEA 3 in Oman

IntroductionEx SAIF SAREEA 3 was a joint British-Omani military exercise involving approximately 5500 British personnel deployed to Oman over a 6-month period. Role 1 medical care was provided by medical treatment facilities (MTFs) deployed with medical equipment as per the UK 300 medical module.MethodRetrospective analysis was undertaken of prospectively collected equipment usage data from two Role 1 MTFs in Duqm (MTF 1) and Muaskar Al Murtafa (MTF 2) camps over a period of 6–8 weeks. Data were analysed alongside routinely collected epidemiological data (EPINATO) during the deployment. Equipment used in addition to the module was also recorded.ResultsMTF 1 used 50 out of the 179 different items from the module over the 8-week period. MTF 2 used 45 out of the 179 different items from their module over the 6-week period. The most commonly used items across the sites were non-sterile examination gloves, plastic aprons, tympanic thermometer probe covers, disinfectant wipes and self-adhesive plasters. Extramodular items (blunt fill needle, water pump sprayer, Jelonet gauze and stool specimen pot) accounted for 5% of all equipment used in MTF 1.ConclusionThe study showed that the 300 module accommodates 95% of Role 1 patients’ needs but highlights the requirement for dedicated equipment for the treatment of heat casualties if deemed likely and blunt fill/filter needles for the administration of parenteral medication. Commanders must perform a thorough medical estimate and risk assessment prior to deployment to ensure that the 300 medical module is likely to provide the necessary equipment and supplement the module if required.

A QUALITATIVE STUDY ON EXPERIENCES OF PARENTERAL MEDICATION ADMINISTRATION AMONG B.Sc.(N) 2nd YEAR STUDENTS IN CLINICAL AREAS OF SELECTED NURSING COLLEGES, KANPUR, UP.

This present study is a Qualitative study on experiences of parenteral medication administration among B.Sc.(N) 2 year students in clinical areas of selected Nursing colleges, Kanpur, UP. Objectives of the study was to elicit the experiences of nd parenteral medication administration among B.Sc.(N) 2 year students in clinical areas, to explore the experiences of parenteral medication nd administration among B.Sc.(N) 2 year students in clinical areas. In this research study, the Qualitative Research Approach with nd Phenomenological research design was used. 10 samples of B.Sc. (N) 2 year students were selected by convenient sampling technique. Selfstructured open ended questionnaire was used to collect data regarding student nurses experience of administering parenteral medication. The study result shows that the majority of the students feel happy and excited whenever they were asked to give injection. Students stated that they feel nervous before giving IV injection and condent before giving IM injection. Most of the student agreed that they feel happy & condent after giving IM injection and satised & condent after giving IV injection. Every student conrmed that they were able to reassure patient who deny taking injection from student nurses. Student shared the hurdles they faced while giving IM and IV injection. Majority of the student told about theory and practice gap. Students self evaluation by the students shows that their skill has been improved

Pre-filled syringes in developed and developing region: An insight into Regulatory considerations

A Pre-filled syringe is a disposable syringe that is supplied already loaded with the substance to be injected. It is a unit dose of parenteral medication to which a needle has been fixed by a producer. They are small which make them easy to carry and are dependable for delivering a precise dose of medication. These reasons are leading to growth of parenteral medication in pharmaceutical market. The intent of this review article is to provide information on regulatory guidelines involved in submission approach for marketing authorization of pre-filled syringe in developed region (USA, EU) and developing region (India). It also further explains about complexities associated with Pre-filled syringes in terms of regulations, submission approaches and quality development considerations in developing region. There is a need to develop an effective regulatory framework to make regulations of Pre-filled syringes more comprehensive for regulatory bodies. A harmonized forum to be made through which single application can be made and single review process can be followed to avoid deviations in regulatory pathways.

A 9-year-old girl presented with jaundice, abdominal distension, hematemesis, melena and pleural effusion

This article has no abstract. The first 100 words appear below: A 9-year-old girl of non-consanguineous parents presented at the outpatient department with the history of jaundice and abdominal distension for 20 days and respiratory distress for 7 days. She also complained of bloody vomiting without any melena. The mother gave the history of abdominal pain for 2 days which was diffuse in nature. Her menarche had not started yet. Her younger sister is healthy. She had no history of fever, constipation, family history of liver disease, sib death, contact with known tuberculosis patient, blood transfusion or parenteral medication. On examination, she was afebrile, moderately pale, dyspnea and leukonychia. Bilateral pedal edema was present.

The pharmacological management of acute behavioural disturbance: Data from a clinical audit conducted in UK mental health services

Background: A quality improvement programme addressing prescribing practice for acutely disturbed behaviour was initiated by the Prescribing Observatory for Mental Health. Method: This study analysed data from a baseline clinical audit conducted in inpatient mental health services in member trusts. Results: Fifty-eight mental health services submitted data on 2172 episodes of acutely disturbed behaviour. A benzodiazepine alone was administered in 60% of the 1091 episodes where oral medication only was used and in 39% of the 1081 episodes where parenteral medication (rapid tranquillisation) was used. Haloperidol was combined with lorazepam in 22% of rapid tranquillisation episodes and with promethazine in 3%. Physical violence towards others was strongly associated with receiving rapid tranquillisation in men (odds ratio 1.74, 1.25–2.44; p<0.001) as was actual or attempted self-harm in women (odds ratio 1.87, 1.19–2.94; p=0.007). Where physical violence towards others was exhibited, a benzodiazepine and antipsychotic was more likely to be prescribed than a benzodiazepine alone (odds ratio 1.39, 1.00–1.92; p=0.05). The data suggested that 25% of patients were at least ‘extremely or continuously active’ in the hour after rapid tranquillisation was administered. Conclusion: The current management of acutely disturbed behaviour with parenteral medication may fail to achieve a calming effect in up to a quarter of episodes. The most common rapid tranquillisation combination used was lorazepam and haloperidol, for which the randomised controlled trial evidence is very limited. Rapid tranquillisation prescribing practice was not wholly consistent with the relevant National Institute for Health and Care Excellence guideline, which recommends intramuscular lorazepam on its own or intramuscular haloperidol combined with intramuscular promethazine. Clinical factors prompting the use of rapid tranquillisation rather than oral medication may differ between the genders.