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An automated dispensing system for improving medication timing in the emergency department

world Journal of Emergency Medicine 2012年第2期3卷 102-107页

作者： Michael J.ward Jeremy S.Boyd Nicole J.Harger John M.Deledda Carol L.Smith Susan M.walker Jeffrey D.Hice kimberly w.hart Christopher J.Lindsell Stewart w.wright Department of Emergency Medicine University of Cincinnati Pharmacy Division University of Cincinnati Air Care and Mobile Care University HospitalUniversity of Cincinnati

BACKGROUND:Numerous medical conditions require timely medication administration in the emergency department(ED).Automated dispensing systems(ADSs)store premixed common doses at the point-of-care to minimize time to administration,but the use of such automation to improved time to medication administration has not been *** vancomycin is a commonly used empiric antimicrobial,we sought to quantify the effect of using an ADS on time to drug delivery in patients presenting to the *** study aimed to determine the efficacy of utilizing an ADS to improve time to administration of vancomycin and determine any negative effects on dosing ***:The institional review board approved the retrospective quality improvement study took place in a single,urban academic tertiary care ED with an annual census of 80 *** subjects were all patients receiving vancomycin for the management of sepsis between March 1 to September 30,2008 and the same time period in *** primary outcome was the proportion of patients who received vancomycin within one hour of bed placement and the secondary outcome was dosing ***:Sixty-three patients had weight and dosing information available(29 before and 34after intervention)and were included in the *** intervention,no patient received vancomycin in less than 60 minutes,while after intervention 14.7%of the patients received it in less than 60minutes(difference in proportions 14.7%,95%CI 0.39%-30.0%,P=0.04).A similar proportion of the patients received correct dosing before and after intervention(44.8%vs.41.2%,difference in proportions 3.7%,95%CI-20.0%-26.7%,P=0.770).CONCLUSION:The use of an ADS may improve the timing of medication administration in patients presenting to the ED without affecting dosing appropriateness.

关键词： Automatic dispensing system Pharmaceutical Process improvement Efficiency

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Acquired segmental colonic hypoganglionosis in an adult Caucasian male:A case report

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world Journal of Gastrointestinal Surgery 2019年第2期11卷 101-111页

作者： Allan MF Kwok Andrew B Still kimberly hart Department of Surgery Wollongong Hospital Department of Anatomical Pathology Wollongong Hospital

BACKGROUND Hypoganglionosis is a rare condition that most often presents with abnormal gastrointestinal transit and usually arises in early childhood or adolescence. Two types have been described(Type I and Type II). The adult-onset form(acquired hypoganglionosis) is extremely uncommon and is thought to arise due to cellular remodelling as a result of chronic inflammation. It differs from Hirschprung's disease in that there is a reduction in ganglion cells in the colonic neural plexuses as opposed to being completely *** SUMMARY A 31 year-old male presented to hospital with recurrent abdominal pain and vomiting over thirteen months. Abdominal computed tomography scans demonstrated thickening and stranding affecting the transverse, descending and sigmoid colon. Endoscopic appearances were non-specific but confirmed a mixed picture of mucosal inflammation and necrosis in various stages of *** investigations were performed to elucidate an underlying aetiology but neither an infective nor ischaemic cause could be proven. Biopsy features were not typical of inflammatory bowel disease. Due to persistence of his symptoms and failure of medical management, a segmental colectomy was performed. Histological examination of the specimen revealed an unexpected finding of segmental hypoganglionosis. Complete surgical excision of the diseased segment of colon was curative and since his operation the patient has had no recurrence of symptoms requiring *** Our case serves to raise awareness of acquired hypoganglionosis as a rare condition that can result from chronic colitis.

关键词： Acquired hypoganglionosis Hirschprung’s disease Adult Ganglion cells Acetylcholinesterase Calretinin Case report

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