Doctor's Orders Research Articles

Comprehensive Treatment of Fragility Fractures of Distal Radius, an Opportunity for Prevention the Deterioration of Bone Health and Reduction of other Fractures with Higher Morbidity and Mortality

Report goal: Fragility fractures of distal radius, are the most common fractures of upper extremities in adults and elderly, with higher incidence in females. Are low energy fractures, result of a fall from standing height or less. Such patients have higher incidence of osteoporosis and increased risk of other serious fractures. Research results: From the questionnaire filled by orthopedic doctors, fragility fractures of distal radius are most frequent in patients 50-60 years old female. 54% of doctors order DEXA scan, 60 % refer patients for osteoporosis evaluation and treatment; 36% treat osteoporosis. From patient questionnaire, such patient were mostly 51-70 yo female, 6.5% had family history of fragility fracture, 97% did not have knowledge about osteoporosis, 3% had high education level, 73% did not report social-economical issues, 45% did not have other medical problems. Summary: Fragility fractures of distal radius occur earlier comparing to other fragility fractures. The orthopedic doctor should recommend DEXA scanning, refer or treat osteoporosis to prevent further deterioration of patient bone health and reduce the risk of other fragility fractures with a higher morbidity and mortality.
 
 Received: 23 September 2022 / Accepted: 28 November 2022 / Published: 20 December 2022

Just What the Doctor Ordered: Missed Ordering of Venous Thromboembolism Chemoprophylaxis Is Associated With Increased VTE Events in High-risk General Surgery Patients.

To define the impact of missed ordering of venous thromboembolism (VTE) chemoprophylaxis in high-risk general surgery populations. The primary cause of preventable death in surgical patients is VTE. Although guidelines and validated risk calculators assist in dosing recommendations, there remains considerable variability in ordering and adherence to recommended dosing. All adult inpatients who underwent a general surgery procedure between 2016 and 2019 and were entered into Atrium Health National Surgical Quality Improvement Program registry were identified. Patients at high risk for VTE (2010 Caprini score ≥5) and without bleeding history and/or acute renal failure were included. Primary outcome was 30-day postoperative VTE. Electronic medical record identified compliance with "perfect" VTE chemoprophylaxis orders (pVTE): no missed orders and no inadequate dose ordering. Multivariable analysis examined association between pVTE and 30-day VTE events. A total of 19,578 patients were identified of which 4252 were high-risk inpatients. Hospital compliance of pVTE was present in 32.4%. pVTE was associated with shorter postoperative length of stay and lower perioperative red blood cell transfusions. There was 50% reduced odds of 30-day VTE event with pVTE (odds ratio: 0.50; 95% CI, 0.30-0.80) and 55% reduction in VTE event/mortality (odds ratio: 0.45; 95% CI, 0.31-0.63). After controlling for relevant covariates, pVTE remained significantly associated with decreased odds of VTE event and VTE event/mortality. pVTE ordering in high-risk general surgery patients was associated with 42% reduction in odds of postoperative 30-day VTE. Comprehending factors contributing to missed or suboptimal ordering and development of quality improvement strategies to reduce them are critical to improving outcomes.

Pharmaceutical Regulation in Niger in 2021: Significant advances with the Harmonization Process

The pharmaceutical sector is governed in Niger by a number of scattered texts. After the independence, it was only in 1988 that the National Council of the Order of Medical doctors, Pharmacists and Dentists (CNO/MPCD) got created, then in 1995, the adoption of the national pharmaceutical policy (NPP). The NPP laid the foundations for the development of specific pharmacy and drug legislation and led to the adoption of the law and its subsequent implementing texts. This article aims to make an inventory, an analysis of texts relating to pharmacy and medicine in Niger, areas for improvement with regards to the application of these texts and the contributions of community texts in strengthening national regulations and the preservation of public health.

Doctors' and Nurses' Knowledge and Perceived Barriers Regarding Acute Oxygen Therapy in a Tertiary Care Hospital in Nigeria.

Oxygen may cause serious consequences when administered wrongly. This study aimed to assess doctors' and nurses' knowledge of acute oxygen therapy and perceived delivery barriers. We conducted a cross sectional study among 202 healthcare providers (134 doctors and 68 nurses) in a Nigerian hospital. The validated Acute Oxygen Therapy Questionnaire (AOTQ), which consisted of 21 knowledge assessment questions, was self administered by participants. Provider's knowledge was classified as good if the score was≥80% and poor if < 60%. Overall, 26.7% (37.3% doctors and 5.9% nurses) had good knowledge of acute oxygen therapy (AOT), 35.9% were aware, and 19.3% used the AOT guidelines. The commonest source of knowledge on oxygen therapy was medical /nursing school (75.2%). The participants' mean knowledge score was 14.75 ± 2.83(possible score of 0-21). Doctors in postgraduate (PG) training obtained the highest score (15.96±2.48) among the participants (F=12.45, df=4, p<0.001). Most doctors (62%) and 23.5% of nurses considered oxygen as a drug. More doctors (52.2%) than nurses (14.7%) believed that a doctor's order was mandatory before oxygen administration, contrary to guidelines recommendations. Most nurses did not know that breathlessness does not always signify hypoxemia and that asymptomatic anemia was not an indication for oxygen. Concerning oxygen prescription, 39.7% of nurses and 64.2% of doctors knew that it should be prescribed to achieve a target saturation range rather than a fixed dose. In acute oxygen delivery in COPD, doctors and nurses exhibited poor knowledge of the appropriate device and flow rate. The reported barriers to oxygen delivery were: a shortage of oxygen supply, inadequate delivery devices, power outages and out of pocket costs. A significant proportion of doctors and nurses had poor knowledge of acute oxygen therapy, poor awareness and infrequently used AOT guidelines, and reported pertinent delivery barriers that warrant educational and administrative interventions.

THE TOTAL POWER OF THE HEART AS A PROMISING PARAMETER FOR ASSESSING THE FUNCTIONAL STATE OF THE PATIENT DURING AN OBJECTIVE STRUCTURED CLINICAL EXAMINATION: GNOSEOLOGY, CLINICAL SIGNIFICANCE

This study reveals the clinical value of the parameter of the total power of the heart in assessing the functional state of the patient. The article is devoted to the expediency of using the method of short recording of heart rhythm variability in Objective Structured Clinical Examination.&#x0D; The purpose of the study was to investigate the total power in patients with noncommunicable diseases based on the results of recording a short record of heart rhythm variability as a promising parameter for assessing the functional state during an Objective Structured Clinical Examination.&#x0D; Materials and methods. An analysis of the total power was carried out based on the data of the short record of heart rhythm variability in 229 people. 43 persons were comorbid patients with coronary heart disease, 111 persons were young functionally healthy non-athletes, 75 persons were professional young athletes.&#x0D; Results. The diagnostic value of the parameter of the total power of the heart was proved. 23% and 21% of patients with non-stationary heart rhythm in the background and orthostatic modes were found. A decrease in total power of various degrees was established in patients, in contrast to control groups.&#x0D; Conclusions. 1) The total power of cardiac activity is a promising, diagnostically valuable parameter for assessing the patient's functional state during an Objective Structured Clinical Examination. 2) Now all the conditions have been formed for the widespread introduction of the method of short recording of heart rhythm variability in the practice of internal medicine doctors.3) The method of short recording of heart rhythm variability can be recommended for use in the clinical examination of patients as a device for improving the individual work of a doctor in order to determine the individual characteristics of the functioning of the heart, determine the risk of cardiac death, and early preclinical diagnosis of emerging pathology.

Occurrence and types of medication error and its associated factors in a reference teaching hospital in northeastern Iran: a retrospective study of medical records

BackgroundMedication errors are categorized among the most common medical errors that may lead to irreparable damages to patients and impose huge costs on the health system. A correct understanding of the prevalence of medication errors and the factors affecting their occurrence is indispensable to prevent such errors. The purpose of this study was to investigate the prevalence and types of medication errors among nurses in a hospital in northeastern Iran.MethodsThe present descriptive-analytical research was conducted on 147 medical records of patients admitted to the Department of Internal Medicine at a hospital in northeastern Iran in 2019, selected by systematic sampling. The data were collected through a researcher-made checklist containing the demographic profiles of the nurses, the number of doctor's orders, the number of medication errors and the type of medication error, and were finally analyzed using STATA version 11 software at a significance level of 0.05.ResultsBased on the findings of this study, the mean prevalence of medication error per each medical case was 2.42. Giving non-prescription medicine (47.8%) was the highest and using the wrong form of the drug (3.9%) was the lowest medication error. In addition, there was no statistically significant relationship between medication error and the age, gender and marital status of nurses (p > 0.05), while the prevalence of medication error in corporate nurses was 1.76 times higher than that of nurses with permanent employment status (IRR = 1.76, p = 0.009). The prevalence of medication error in the morning shift (IRR = 0.65, p = 0.001) and evening shift (IRR = 0.69, p = 0.011) was significantly lower than that in the night shift.ConclusionEstimating the prevalence and types of medication errors and identified risk factors allows for more targeted interventions. According to the findings of the study, training nurses, adopting an evidence-based care approach and creating interaction and coordination between nurses and pharmacists in the hospital can play an effective role in reducing the medication error of nurses. However, further research is needed to evaluate the effectiveness of interventions to reduce the prevalence of medication errors.

Baker’s Cyst in Left Popliteal Fossa: A Case Report

INTRODUCTION: A popliteal cyst, also called a Baker cyst, is a benign uncontrolled swelling of the gluteus medius sac in the popliteal fossa at the back of the knee described this excess fluid and subsequent sac formation outside of the kneecap in the commencement.A Baker's (popliteal) cyst is a swelling of the knee's gastrocnemius-semimembranous bursa, which connects to the back of the synovial membrane. It commonly presents as a painless swelling in the popliteal fossa. Adults almost always develop an edema as a result of pathological changes to the knee joint. Sometimes, the cyst enlarges to the position in which it ruptures, releasing synovial fluid into the surrounding tissues and present physiologically as acute thrombophlebitis. Popliteal cyst infection is a rare complication that is often related to septic arthritis. Popliteal joint cysts, also known to as Baker's cysts, are sporadically together with intra-articular knee conditions like osteoarthritis and dislocated patella. Anatomically, the borders of the cyst resemble synovial tissue, and there may be chronic, non-specific inflammation. Even if they are not visible in the knee joint, osteocartilaginous loose bodies may be present within the cyst.CLINICAL FINDING: Pain in the back of knee were the main complaints of a 48-year-old female admitted to Tertiary Rural Hospital.DIAGNOSTIC EVALUATION: Chest x-ray and blood test including all tests are done. Were all performed as part of the physical evaluation to prevent acute and chronic post-surgical discomfort following Excision of Bakers cyst.THERAPEUTIC INTERVENTION: Post operative treatment advised 6 hours iv fluids normal saline, ringer lactate 500ml, antacids, antiemetic, analgesic given frequently advised as the first line of treatment following excision of baker cyst . It gives superior pain relief and allows for a speedier recovery.OUTCOMES: Patient condition was poor.CONCLUSION: Baker cyst is a benign uncontrolled enlargement of the bursa in the popliteal fossa at the back of the knee that is diagnosed in the hospital on the IPD based on the patient having symptoms of swelling and pain in the back of knee. Based on a patient admitted to Tertiary Rural Hospital for diagnostic tests are done as per doctor order blood test, surgery of the excision of cyst . To reduce acute and chronic post-surgical pain after excision baker cyst. Post operative medications advised.

The Report of a Surgical Residual Langas Inside the Renal Pelvis 16 Years after Surgery “Case Report”

Background &amp; Objective: Gossypiboma is the meaning of a residual foreign body such as gas in the abdomen following surgical operation, which is a rare complication of surgery. Residual of a foreign body causes mass, fistula, abscess and, obstruction after surgical operation. Computed tomography (CT) scan is a very useful method in the diagnosis of Gossipiboma. In patients who referred with abdominal pain and unexplained manifestations after surgery, Gossypiboma should be considered.&#x0D; Case presentation: A retrospective case study was performed in the year 2020 in a patient with a history of open kidney stone surgery in Hospital of Zabol. A 60-year-old male patient who referred with complaint of neck pain to an orthopedic doctor, which due to a history of kidney stone, the doctor orders an ultrasound of the kidneys. In the ultrasound, a number of stones are observed in the right kidney of this patient. After performing CT scan and Intravenous pyelography (IVP), a foreign body is identified inside the renal pelvis. In the following, the history taken from the patient, the history of open kidney stone surgery during 16 years ago in this patient is determined. During this period, the patient did not have any symptoms, including infection or pain in the mentioned area.&#x0D; Conclusion: In patients with a history of surgery who are referred with abdominal pain or mass, the residual foreign body should be included in the list of differential diagnoses.

Nursing Effect of Health Monitoring System on Elderly Patients with Osteoporosis.

Health monitoring can provide scientific and reasonable care for elderly users, professionally monitor the health parameters of the human body, and timely understand the user's own physical condition. By installing sensors with different functions in the rooms where the elderly often move and by installing vital signs sensors on their bodies, the data detected by the sensors are collected and analyzed in real time. Nursing refers to the fact that nursing staff must strictly follow the nursing system and operating procedures in the nursing work, accurately implement the doctor's orders, implement the nursing plan, and ensure that the patient is physically and mentally safe during treatment and recovery. Osteoporosis is a systemic bone disease in which bone density and bone quality are decreased due to various reasons, and the microstructure of bone is destroyed, resulting in increased bone fragility, which is prone to fractures. Osteoporosis is divided into two main categories: primary and secondary. Primary osteoporosis is divided into postmenopausal osteoporosis (Type I), senile osteoporosis (Type II), and idiopathic osteoporosis (including adolescent forms). This paper aims to study the healthcare effect of health monitoring system on elderly patients with osteoporosis, expecting to use the health monitoring system to provide more scientific care for the elderly and reduce the pain caused by osteoporosis. This paper proposes a study from the users of the elderly health monitoring products and the elderly home health products and analyzes the influencing factors of the usability design of the elderly home health monitoring system. This paper designs the overall framework of the elderly health monitoring system and designs the main components and application functions of the system. The experimental results in this paper show that there are 20 patients with osteoporosis due to lack of light, accounting for 16%. There are 10 patients with osteoporosis due to excessive coffee intake, accounting for 8%. There are 90 people who normally eat eggs, accounting for 75%, and 66 people who eat meat normally, accounting for 55%. According to the data, the health monitoring system can effectively control the diet of patients with osteoporosis.

Marcello Musto, The Last Years of Karl Marx, 1881-1883: An Intellectual Biography. Translated by Patrick Camiller. Stanford, CA: Stanford University Press, 2020. ISBN 9781503612525.

In the final years of his life, Marx suffered repeated attacks of bronchitis and other illnesses. On doctor's orders, he spent weeks on end convalescing by the sea, forbidden to exert himself. In the past, most biographers have passed over this period of Marx's life very briefly, treating it as barren and unproductive. They can be forgiven for doing so, they had little to go on. Marx published very little in these years, and only a few of his letters were known. This situation has changed dramatically in recent years.

Code Sepsis: Using an Escape Room as a Creative Teaching Strategy to Engage Nursing Students in Learning Diagnosis and Interventions in Sepsis Care Management

Objective: To engage students in a flipped classroom activity utilizing an escape room to teach the importance of systemic inflammatory response syndrome criteria recognition, sepsis diagnostics, the anticipation of medical doctor orders, and the implementation of nursing interventions for the care of a sepsis patient. To escape the room, students must work together to answer a series of questions to solve all of the puzzles and open the locks. Methods: A total of 32 fourth-semester students over three semesters participated in the sepsis escape room. Groups were randomly assigned as students came into the simulation room. Students were oriented to the room, given the objectives of the activity, and provided a patient scenario to start the escape room. During the activity, students completed a variety of math equations, puzzles, and advanced nursing skills to progress through the room. Students were timed while completing these activities; the goal, to escape the room in less than an hour. Results: Students were actively engaged and involved in the escape room learning activity. All groups completed the sepsis escape room under one hour. After the escape room, a debrief was conducted, and a survey was given to all the students. Survey results and discussion revealed that the escape room was a more meaningful and engaging learning activtity for new material versus traditional lecture. Conclusion: The escape room is a valuable learning activity to teach sepsis diagnosis and treatment for fourth-semester nursing students. The application of an escape room could be modified and used for any level of nursing student or any disease process.

Association Between Different DVT Prevention Methods and Outcomes of Septic Shock Caused by Intestinal Perforation in China: A Cross-Sectional Study.

IntroductionSeptic shock, largely caused by intestinal perforation, is the most common critical illness in intensive care unit (ICU). As an important quality control strategy in ICU, deep vein thrombosis (DVT) prevention is routinely used in the treatment of septic shock. Nevertheless, the effects of DVT prevention on septic shock are not fully revealed. This study was thus designed to investigate the effects of DVT prevention on septic shock caused by intestinal perforation in China.MethodsA total of 463 hospitals were enrolled in a survey, led by the China National Critical Care Quality Control Center (China NCCQC) from January 1, 2018 to December 31, 2018. The association between DVT prevention, including pharmacological prophylaxis and mechanical prophylaxis, and outcomes, such as prognosis, complications, hospital stays, and hospitalization costs, was determined in the present study.Main ResultsNotably, the increased rates of DVT prevention were not associated with the onset of complications in patients with septic shock caused by intestinal perforation (p > 0.05). In addition, even though increased DVT prevention did not affect hospital stays, it significantly decreased the discharge rates without doctor's order in patients with septic shock caused by intestinal perforation (p < 0.05). Nevertheless, it should be noted that the rates of pharmacological prophylaxis but not mechanical prophylaxis were significantly associated with the costs of septic shock caused by intestinal perforation (p < 0.05). Although increased total rates of DVT prevention and the rates of mechanical prophylaxis did not reduce the mortality in patients with septic shock caused by intestinal perforation, the higher frequent intervention using pharmacological prophylaxis indicated the lower mortality of these patients (p < 0.05).ConclusionsDVT prevention by any means is a safe therapeutic strategy for treating septic shock caused by intestinal perforation, and pharmacological prophylaxis reduced the mortality of patients with septic shock caused by intestinal perforation.

Add-on-LUCAS2™ resuscitation at NEF Innsbruck

StudienzielZiele sind die Verlaufsanalyse und der Vergleich mit ausschließlich manuell reanimierten Patienten sowie die Erfassung der Einflussfaktoren bei Patienten, bei denen die mechanische Thoraxkompressionshilfe Lund University Cardiac Assist System (LUCAS2TM) als Add-on-Therapie am Notarzteinsatzfahrzeug (NEF) Innsbruck verwendet wurde.Material und MethodikRetrospektive Verlaufsdatenanalyse von Patienten im Studienzeitraum 01.01.2014 bis 31.12.2019 des NEF Innsbruck aus dem Deutschen Reanimationsregister (GRR), bei denen LUCAS2™ nach notärztlicher Anordnung als Add-on-Therapie verwendet wurde.ErgebnisBei 653 Reanimationen kam es zu 123 Add-on-LUCAS2™-Anwendungen (18,8 %). Von allen Patienten überlebten 16,2 % die ersten 30 Tage. Mithilfe der Add-on-LUCAS2TM Anwendung überlebten 7,3 % (9/123) aller Add-on-LUCAS2™-Reanimationen bzw. 1,4 % (n = 9) aller CPRs. Bei 8/9 Add-On-LUCAS2™-„30 Tage-Überlebenden“ war der Herz-Kreislauf-Stillstand (HKS) beobachtet, und eine Laien-CPR wurde durchgeführt. Als Primärrhythmus wiesen 8/9 Kammerflimmern auf.Im Vergleich zur ausschließlich manuellen CPR wurde eine Add-on-LUCAS2™-Reanimation hoch signifikant (p < 0,001) häufiger bei jüngeren, bei männlichen Patienten, in der Öffentlichkeit, bei schockbarem Erstrhythmus und beim Transport eingesetzt sowie signifikant häufiger bei beobachteten HKS (p < 0,05).Die 30-Tage-Mortalität bei additiver Lysetherapie betrug 100 %.DiskussionDurch die Verwendung der Add-on-LUCAS2™-CPR kann eine prozentuelle Erhöhung der Überlebensrate erzielt werden und erscheint somit vorteilhaft (1,4 % in dieser Studie). Durch diese kann bei Patienten mit günstigen Prognosefaktoren eine hochwertige HDM auch bei technisch aufwendiger Bergung (Drehleiter, Stiegenhaus, Transport im RTW) durchgeführt und somit ein Transport ermöglicht werden. Jedoch kommt es dabei zu einer höheren Aufnahmerate unter CPR und somit zur Verlagerung der Therapiezielentscheidung in den Schockraum.

Just What the Doctor Ordered: Medicinal Alcohol, Opioid Prescriptions, and the Accessibility of Folk Devils

ABSTRACT A critical component in the formation of moral panics rests on the successful construction of folk devils. The successful construction of folk devils in a moral panic has often relied on both the media and the general public vilifying those who occupy a lower social status, depicting these vilified individuals as culpable for specific social problems. This paper conducts a historical comparison between the prescription of medicinal alcohol during prohibition and the prescription of opioids during the opioid epidemic to address the question of when, and under what conditions, respected professionals get blamed for a social problem and labeled deviant. Both periods were marked by similar behavior of doctors, where some doctors prescribed these substances for profit. However, doctors during prohibition were not depicted as folk devils, nor did a moral panic ensue regarding their medicinal alcohol prescribing practices. During the opioid epidemic, pain management doctors were depicted as folk devils supporting the moral panic surrounding prescription opioids. This paper expands upon moral panics theory by demonstrating that the accessibility of folk devils influences the successful establishment of a moral panic.

In Case You Haven't Heard…

A body positivity website has created “Don't Weigh Me” cards for patients who find stepping on the scale at the doctor's office stressful, CNN Health reported Dec. 22, 2021. The cards, created by California‐based More‐Love.org, are available for a small fee. The cards read: “Please don't weigh me unless it's (really) medically necessary,” adding “If you really need my weight, please tell me why so that I can give you my informed consent.” The website states, “Because we live in a fatphobic society, being weighed and talking about weight causes feelings of stress and shame for many people. Many people feel anxious about seeing the doctor, and will avoid going to the doctor in order to avoid the scale. We want to support you in requesting healthcare that is free of weight bias. Getting weighed is an informed choice that we get to make with our doctor. We don't have to automatically step on the scale just because someone asks us to.”

Case Report on Fibroid Uterus

Uterine fibroids are also known as leiomyomas or myomas are muscular tumors that can form on the uterus. They seldom become malignant, and having them does not increase your risk of uterine cancer. Fibroids come in a variety of sizes, shapes, and locations. They can be found inside your uterus, on the surface, or in the uterine wall. They may also have a stalk or stem-like structure that connects them to the uterus.&#x0D; Main symptoms and/or important clinical findings: Constipation, backache, or leg discomfort since 4 month, monthly bleeding for more than a week since 4 month, pelvic pressure or discomfort since 4 month, frequent urination since 4 month, difficulties emptying the bladder.&#x0D; Nursing perspectives: fluid replacement that has been administered, i.e. DNS and RL checked vital signs and blood pressure every hour, kept an intake and output chart, and made sure the patient had enough rest and sleep. Medication was administered in accordance with the doctor's orders.

Reasons why referring doctors order renal ultrasound contrast studies.

To determine the indications for CEUS for renal mass evaluation. This retrospective, single-center, IRB-approved, HIPAA compliant study analyzed data from 303 consecutive patients scheduled for a renal CEUS to determine the indications for the examination. A chart review was performed from 05/01/2020 through 05/31/2021 on all patients who received a renal CEUS. The patient demographics were extracted as well as the motivating factor for ordering the examination. From the 303 patients, 114 were referred because of an indeterminate mass seen on CT and 28 were referred for long-term follow-up of a mass defined as benign or malignant was identified on CT. 9 patients were referred for a CEUS follow-up due to an indeterminate mass on MRI and 6 patients were referred for long-term follow-up of a mass defined as benign or malignant on MRI. 34 patients were referred for follow-up for characterization of a lesion seen on unenhanced ultrasound. 48 patients and 21 patients were referred for long-term follow-up of a previously observed benign or malignant lesion, respectively, seen on CEUS. CEUS was ordered in 21 patients to follow-up a partial nephrectomy and 5 patients for follow-up of a thermal ablation. 7 patients were referred because of a clinical finding. The main reason for a renal CEUS referral is to characterize a mass which could not be characterized on CT or MRI. Another main indication is for long-term follow-up of lesions to decrease radiation dose. Referrals due to inability to receive CT or MRI contrast or renal insufficiency were minor indications.

Construction of Clinical Pathway Information Management System under the Guidance of Evidence-Based Medicine.

This study focuses on clinical pathways guided by evidence-based medicine (EBM). With the clinical pathway as the center, the subjective and objective medical knowledge of medical staff are collected, and a clinical pathway management system guided by EBM is established through a unified process; user demand analysis; main considerations; implementation, evaluation, and monitoring of the clinical path; and dictionary maintenance, to help hospitals fully regulate medical behaviors. Next, the study displays the path access prompt box, area 1 management page, table management page, exit prompt box, mutation record page, doctor order interface, revocation of execution, and monitoring interface, and the system designed is compared with the Beijing Shankang Technology (ASK) clinical data management system in terms of user experience. The results showed that the reporting rate of medical adverse events in the system in this study was 0.21%, and the work efficiency was increased by 14%. In terms of users' satisfaction, the hospital managers' satisfaction was 84 ± 5.36%, and it was 95 ± 4.72% for medical staff and 88 ± 4.91% for system administrators, superior to the ASK system; the differences were statistically significant (P < 0.05). In conclusion, the clinical pathway information management system is in line with the working environment of medical staff, and the synchronous monitoring and management of medical quality are achieved through digital means, which can reduce the occurrence of medical adverse events and improve the work efficiency of medical staff.

Robustness of Supersaturated Design to Study the Causes of Medical Errors

Background. In the modern contemporary, there are obvious demands for accurate interpretations of the worldwide problem, which is medication errors (MEs) due to various serious negative events that effect patient health. Most parts of the world considered health as significant issue for centuries. Recently, investigators have examined the effects of writing physician orders from the nurse’s viewpoint and represent that 100% of ambiguous writing of doctor orders related directly to MEs. Objective. The aim of our work is to investigate the major causes of (MEs) in the Saudi Arabia population from multiple aspects. Methods. An online review gave quantitative information from 450 members. Respondents were heedlessly parceled into two conditions (Yes+, No−) and mentioned to respond to one of two plans of the explanations behind the medical errors. Fourteen determining factors in the predesign have been chosen. Entire data were collected relevant to the study purpose and the content of the questionnaire written suitably to the participants with no ambiguous terms to analyze obtained data accurately using supersaturated plans and regression methods utilizing the SPSS program to decide the real causes of the medical errors. Results. The findings indicated that often failures in the care process can be traced back to poor documentation and a lack or inadequacy of procedures; the limitations of integrated health systems between the doctor and pharmacists, human problems when standards of care, policies, processes, or procedures are not properly or effectively followed, inadequate use of technology in healthcare facilities, and unclear line of prescription from the doctor are factors that contributed to the medical errors. Conclusion. The Saudi Arabian government needs to foster a functional arrangement to examine these reasons for medical errors and make a move. Future investigations could break down the information utilizing edge plans technique.

New Prescriptions After Hospitalization: A Bitter Pill or Just What the Doctor Ordered?

New Prescriptions After Hospitalization: A Bitter Pill or Just What the Doctor Ordered?