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[Review of parenteral nutrition practices in four university hospital's pharmacies in Auvergne-Rhône-Alpes region]. ANNALES PHARMACEUTIQUES FRANÇAISES 2023:S0003-4509(23)00003-2. [PMID: 36702238 DOI: 10.1016/j.pharma.2023.01.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 12/11/2022] [Accepted: 01/19/2023] [Indexed: 01/25/2023]
Abstract
OBJECTIVES To carry out an assessment of parenteral nutrition (PN) practices in hospital pharmacies of the Auvergne-Rhône-Alpes region in order to explore a harmonisation of practices and a collaboration between the different centres. METHODS Status of practices was carried out on the basis of an observational study inspired by the survey of the General Inspectorate of Social Affairs. It was carried out in Auvergne-Rhône-Alpes region in four university hospital pharmacies with a production unit of PN. It focused on the different stages of the PN process: prescription, formulation, compounding and quality control. It also covered the support processes such as the quality assurance system and the management of premises and equipment. RESULTS Most preparations made in the region are individualized parenteral nutritional admixtures for paediatric and neonatal hospitalization departments. The production units of PN of each centre are located in premises in compliance with Good Preparation Practices. However, compounding equipment and raw materials used are heterogeneous in the four centres. All centres control the quality of their finished preparations. But, the performance of analytical control is disparate in terms of equipment and specifications. CONCLUSION This assessment explains the similarities and differences in PN practices between various university hospitals in the Auvergne-Rhône-Alpes region and thus makes possible to provide a collective regional work to harmonise practices.
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Abbassi A, Hasni N, Ben Hamida EB. Impact of computerized physician order entry system on parenteral nutrition medication errors in a teaching neonatal intensive care unit. ANNALES PHARMACEUTIQUES FRANÇAISES 2022; 80:819-826. [PMID: 35568248 DOI: 10.1016/j.pharma.2022.05.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 05/10/2022] [Indexed: 11/17/2022]
Abstract
OBJECTIVES Parenteral nutrition (PN) offers a quality therapeutic option when enteral feeding is non-tolerated or impossible. However, it can be associated with an increased risk of medical errors, especially in sensitive populations such as newborns. This study aimed at determining the impact of the implementation of a computerized physician order entry (CPOE) system on PN medication errors in the neonatology department in the largest teaching hospital in Tunisia. Materiel & Methods: The frequency of medication errors in PN, in a teaching neonatal intensive care unit, was prospectively reviewed by a pharmacist between December 2018 and March 2019 in a two-phase interventional study (pre and post locally developed CPOE System implementation). RESULTS Implementation of CPOE system decreased PN order errors from 379 to 147 representing a 61.1% reduction. The decreases on PN order errors per stage, i.e. prescribing and preparation, were form 207 to 22 (89.4%), and from 117 to 66 (43.6%) respectively. Mean nutrients intakes were in conformity to the recommended daily intakes during the CPOE phase of the study. CPOE is a protective tool against prescription and preparation errors. It significantly impacted all items of the ordering process. CONCLUSIONS In addition to the rigorous application of the recommendations, the CPOE system allows to reduce the risk of PN medication errors. This improves the safety and quality of medicines in newborns.
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Affiliation(s)
- A Abbassi
- Department of Pharmacy, Charle-Nicolle Hospital, 1006 Tunis, Tunisia.
| | - N Hasni
- College of Pharmacy, 5000 Monastir, Tunisia.
| | - E B Ben Hamida
- Neonatal intensive care unit, Charles-Nicolle Hospital, 1006 Tunis, Tunisia.
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Florence AT. Pharmaceutical Technology in Practice: A Personal View. PHARMACEUTICAL TECHNOLOGY IN HOSPITAL PHARMACY 2018. [DOI: 10.1515/pthp-2018-0013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
This opinion piece argues that the collective knowledge of drugs and medicines, their nature, formulation and manufacture, their delivery and evaluation is unique to pharmacy and it reasserts the fact that science underpins the clinical use of medicines. It argues this from a personal standpoint of an academic pharmaceutical technologist and recounts examples from the author’s own experience.
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Benlabed M, Perez M, Gaudy R, Genay S, Lannoy D, Barthélémy C, Odou P, Lebuffe G, Décaudin B. Clinical implications of intravenous drug incompatibilities in critically ill patients. Anaesth Crit Care Pain Med 2018; 38:173-180. [PMID: 29680262 DOI: 10.1016/j.accpm.2018.04.003] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2017] [Revised: 01/06/2018] [Accepted: 04/05/2018] [Indexed: 10/17/2022]
Abstract
OBJECTIVE The aim of this review is to analyse the clinical consequences of intravenous drug incompatibilities in critically ill patients, especially the incidence of organ dysfunctions and mortality. METHODS A review of literature was conducted according to the PRISMA statement in June 2017, using Medline, ISI Web of Science and Clinicaltrials.gov. DATA EXTRACTION Eligible studies were case reports and randomised controlled trials (RCTs) that assessed the effects of drug incompatibilities in critically ill patients on morbidity or mortality as primary or secondary outcomes, or adverse events. Two investigators independently reviewed the eligibility of the study from abstracts or manuscript data. DATA SYNTHESIS Twelve articles met the selection criteria. The six articles reporting RCTs concern only four RCTs. RCTs were single-centre studies comparing infusion with or without filter. One of them included adult patients. The others included paediatric and neonatal intensive care unit patients. Primary endpoints were SIRS, organ failure, overall complication rate, bacteraemia, sepsis, phlebitis and length of stay. The results are mixed with one RCT reporting a reduction in SIRS, organ failure and overall complication rate, two studies in disagreement over the occurrence of sepsis and one study reporting no impact on length of hospital stay. The six articles on case reports show different drug incompatibility situations. They report pulmonary toxicity. CONCLUSION Little data is available on this topic. Infused particles may induce organ failure, in particular pulmonary toxicity and SIRS. Further studies are needed to establish a link between the level of exposure to drug incompatibilities and clinical implication.
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Affiliation(s)
- Malik Benlabed
- Groupe de recherche sur les formes injectables et les technologies associées (GRITA), University Lille, EA 7365, 59000 Lille, France
| | - Maxime Perez
- Groupe de recherche sur les formes injectables et les technologies associées (GRITA), University Lille, EA 7365, 59000 Lille, France; Pharmacie, CHU de Lille, 59000 Lille, France
| | - Romain Gaudy
- Groupe de recherche sur les formes injectables et les technologies associées (GRITA), University Lille, EA 7365, 59000 Lille, France
| | - Stéphanie Genay
- Groupe de recherche sur les formes injectables et les technologies associées (GRITA), University Lille, EA 7365, 59000 Lille, France; Pharmacie, CHU de Lille, 59000 Lille, France
| | - Damien Lannoy
- Groupe de recherche sur les formes injectables et les technologies associées (GRITA), University Lille, EA 7365, 59000 Lille, France; Pharmacie, CHU de Lille, 59000 Lille, France
| | - Christine Barthélémy
- Groupe de recherche sur les formes injectables et les technologies associées (GRITA), University Lille, EA 7365, 59000 Lille, France
| | - Pascal Odou
- Groupe de recherche sur les formes injectables et les technologies associées (GRITA), University Lille, EA 7365, 59000 Lille, France; Pharmacie, CHU de Lille, 59000 Lille, France
| | - Gilles Lebuffe
- Groupe de recherche sur les formes injectables et les technologies associées (GRITA), University Lille, EA 7365, 59000 Lille, France; Pôle d'anesthésie-réanimation, CHU de Lille, 59000 Lille, France
| | - Bertrand Décaudin
- Groupe de recherche sur les formes injectables et les technologies associées (GRITA), University Lille, EA 7365, 59000 Lille, France; Pharmacie, CHU de Lille, 59000 Lille, France.
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