Introduktion: Det finns många fördelar med parenteral administrering, exempelvis ger det hög biotillgänglighet och snabb systemisk insättning. Men eftersom kroppens naturliga försvarsbarriärer förbigås kan kontaminerade parenterala läkemedel leda till allvarlig patientskada eller i värsta fall död. För att undvika detta är det viktigt att personalen som iordningställer de parenterala läkemedlen arbetar aseptiskt. Syfte: Att utreda skillnader i säkerhet och kvalité vid iordningställande av parenterala läkemedel när det utförs av sjuksköterskor jämfört med farmaceuter. Metod: En observationsmall utformades innehållande sex olika parametrar som ansågs mäta säkerhet och kvalité vid iordningställande av parenterala läkemedel. Observationsmallen användes för observation av sjuksköterskor och farmaceuter när de iordningställde parenterala läkemedel på fyra olika avdelningar på Akademiska sjukhuset. Statistisk analys utfördes med Pearson´s Chi2-test. P-värden under 0,05 ansågs vara signifikanta. Resultat: Totalt observerades 276 iordningställanden av parenterala läkemedel utförda av 14 sjuksköterskor och 3 farmaceuter. Farmaceuterna utförde fem av de sex parametrarna signifikant fler gånger (p<0,0001) än sjuksköterskorna, med ett genomsnitt på 31,2 procentenheter högre. Det fanns även signifikanta skillnader inom samma yrke. Slutsats: Dessa resultat tyder på att kvalitén och säkerheten är beroende av vilken personal som iordningställer. Vad dessa skillnader beror på kan inte fastställas utifrån denna undersökning. Att farmaceuter fick bättre resultat kan bero på deras breda läkemedelskunskaper, men det går inte att utesluta andra anledningar. Andra faktorer som kan spelat in är de olika typerna av arbetssätt samt vilken typ av avdelning de arbetade på. För att säkerställa dessa resultat bör en mer omfattande studie genomföras med fler observerad personal.

External validation of a tool to assess medication-related admissions in four Swedish hospitals Background The MedBridge trial is a large ongoing clinical trial on medication reviews in elderly patients in Sweden with participating hospitals from Uppsala, Enköping, Västerås and Gävle. A tool for assessing medication-related admissions (MRAs) has been developed and validated in Uppsala: Assessment Tool for identifying Hospital Admissions Related to Medications (AT-HARM10). MRAs is often used as an outcome for medication reviews and similar interventions. Validation of AT-HARM10 outside of Uppsala is therefore warranted. Aim The aim was to externally validate AT-HARM10. This was needed since AT-HARM10 was for the first time used outside Uppsala. Materials and methods The readmissions of elderly patients within the MedBridge trial were collected from all participating hospitals. The assessors in this study were two final-year pharmacy students. First, the assessors assessed the readmissions independently of each other and then a consensus meeting was held where the readmissions were discussed, and a consensus was reached. The outcomes in this study were the assessment time, inter-rater reliability and content validity between the hospitals from Uppsala, Enköping, Västerås, and Gävle. The time was measured every day during the assessment period. The inter-rater reliability was calculated for every consensus meeting. The content validity was based on the questions from AT-HARM10 and was collected for each of the assessed readmissions and compared between the four participating hospitals. The content validity of the distribution of questions U1-P10 between the hospitals was tested with a χ2-test. Results In this study, 1687 unplanned readmissions from 893 patients were assessed. Uppsala University Hospital had 6.6 minutes as total mean assessment time including consensus meeting. The total mean time from Enköping, Västerås and Gävle were 6.48, 6.32 and 6.16 minutes respectively. The strength of agreement between the two assessors was substantial in Uppsala, Västerås and Gävle (ĸ 0.80, 0.79 and 0.76 respectively) and perfect in Enköping (ĸ 0.89). For the content validity were there no differences between the hospitals in the distribution of question U1-P10. Conclusion AT-HARM10 was for the first time used outside Uppsala and has been externally validated with data from the hospitals in Enköping, Västerås, and Gävle. The time needed per admission for the two assessors was low which confirms that it is possible to have final-year pharmacy students as assessors. This information is important both within the MedBridge trial and if the tool would be used in outer clinical studies.

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Introduction Cardiovascular disease (CVD) is the leading cause of death globally and similarly in United Kingdom (UK), accounting for 31% and 45% annual deaths respectively. Workplace environment consists of different elements (e.g.- physical and psychosocial environment, intra and extra organizational settings) and interrelationship of employer and employee, playing an important role on workers’ health. Current study aims to identify the association of different aspects of workplace environment and general wellbeing with maximum workload (MW) in a working population in UK. Method A cross-sectional study has been done including a total of 77,781 working people aged 39 to 72 years old who participated voluntarily in the UK Biobank baseline assessment cohort study. Exposures were selfreported that included information about both physical and psychosocial aspects of workplace environment and general well-being. The outcome variable was maximum workload calculated during electrocardiogram (ECG) stress test. Three different statistical models were tested through ordinal logistic regressions using the SPSS software. Results No/low health satisfaction was associated with reduction in maximum workload and this association was constant in all analytical model, both in crude (B -0.786, 95% CI -0.825, -0.748) and adjusted models (B -0.866, 95% CI -0.910, -0.823). Other variables regarding different aspects of workplace environment and well-being showed no statistically significant result on the adjusted models. Conclusion Health satisfaction may be considered as an important determinant of CVD among middle and old-aged working population. Future research required to establish the result and to formulate preventive measures in workplace for better health outcome of workers.

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