Class of 2014 Abstract / Specific Aims: To assess older adults’ knowledge of medications associated with an increased risk of falls and to evaluate the impact of pharmacist counseling on knowledge of medication-related fall risk. Subjects: Community-dwelling adults 60 and older. Methods: Data were collected using an online questionnaire consisting of 15 knowledge-based items to determine awareness of medication-related fall risk, four items to determine pharmacist counseling experience, fall history, and number of medications taken, and two items to collect demographic information (age and gender). Main Results: Two hundred and six community-dwelling older adults (mean age = 69.07 years, SD = 5.59) participated in the study by completing all or part of the questionnaire. The number of older adults who reported having fallen within the last five years was 90 (43.7%). The knowledge-based portion of the questionnaire was completed in its entirety by 162 older adults (80 males, 81 females, one unreported gender; mean age = 68.7 years, SD = 5.12). One hundred and nineteen of 162 (73.5%) questionnaire respondents scored below 70% on the knowledge assessment (mean score 49.3%, SD = 26.8). The 12 respondents (7.6%) who reported having received counseling from a pharmacist regarding medication-related fall risk scored significantly higher on the knowledge assessment compared to the 145 respondents who did not (mean score 61.66% versus 48.09%, p = 0.01). Conclusion: A majority of community-dwelling older adults lacked knowledge of medications associated with an increased risk of falling. However, those who had been counseled by a pharmacist demonstrated greater awareness of medication-related fall risk. Thus, pharmacist counseling of older adults regarding medications and fall risk should be promoted.

Medication reconciliation is a systematic and comprehensive review of medication regimens during care transitions aiming to prevent adverse drug events. Poorly executed transitions negatively impact patient welfare and cause financial burden. Medication-related problems (MRPs) experienced during transitions to an assisted living facility (ALF) were evaluated. Data was collected from pharmacy records for transitions to an ALF over three months, including demographics, medications, potentially inappropriate medications, and MRPs. MRPs were categorized and summarized using descriptive statistics. Forty-five patients (71% female) experienced 59 transitions. Average age was 85.6 years. Median length of stay away from the ALF was three days. There were averages of 18.3 pre-transition medications, 12.5 medications in the discharge orders and/or upon ALF admission, and 15.9 final medications. 979 MRPs were identified, mostly no indication documented, followed by underuse, overuse, and non-adherence. Many of the identified MRPs are potentially preventable. Interventions are needed to reduce MRPs during ALF transitions.

Bakgrund: Läkemedelshanteringsfel är en ledande orsak till patientskador i hälso- och sjukvårdssystem över hela världen och utgör ett betydande hot mot patientsäkerheten. Läkemedelshanteringsfel är mer vanligt förekommande på intensivvårdsavdelningar än på lägre vårdnivåer. Det dominerande sättet att arbeta med patientsäkerhet inom hälso- och sjukvård är genom avvikelserapportering och analysering av negativa händelser. Vid efterföljande analys och uppföljning av negativa händelser kan en förbättrad patientsäkerhet uppnås. Syfte: Att beskriva innehållet i de avvikelser beträffande läkemedelshanteringsfel, som rapporterats in på en intensivvårdsenhet under år 2023. Metod: En retrospektiv registerstudie. Datamaterialet analyserades med beskrivande statistik och kvalitativ manifest innehållsanalys. Resultat: Fem kategorier framkom under analysförfarandet: Hållbarhet, ordination, iordningställande, administrering och dokumentation. I kategorin administrering identifierades flest avvikelser. Slutsats: Resultatet i denna studie visar övergripande att ingen avvikelse ledde till en vårdskada men att samtliga var undvikbara. Den kategori som innehöll flest avvikelser var Administrering vilket är ett fynd som stärks av tidigare forskning som visar på att administreringsfasen är den mest kritiska i läkemedelshanteringen. Varför avvikelserna inträffade vore intressant att få svar på, något som kan ges som förslag till vidare forskning. Forskare inom säkerhet hävdar dock att det inte alltid är helt lätt att förstå orsakerna eftersom hälso- och sjukvården är ett komplext sociotekniskt system. / Background: Medication errors are a leading cause of patient injury in healthcare systems worldwide and represent a significant threat to patient safety. Medication errors are more common in intensive care units than at lower levels of care. The dominant way of working with patient safety in healthcare is through deviation reporting and analysis of negative events. In subsequent analysis and follow-up of adverse events, improved patient safety can be achieved. Aim: To describe the content of the deviations regarding medication handling errors, which were reported to an intensive care unit during the year 2023. Method: A retrospective registry study. The data material was analyzed with descriptive statistics and qualitative manifest content analysis. Results: Five categories emerged during the analysis procedure: Durability, prescription, preparation, administration and documentation. Most incident reports were identified in the category administration. Conclusion: The results of this study show overall that no deviation led to a medical injury, but that all were avoidable. The category that contained the most deviations was Administration, which is a finding that is reinforced by previous research that shows that the administration phase is the most critical in drug management. Why the deviations occurred would be interesting to get an answer to, something that can be given as a suggestion for further research. However, security researchers argue that it is not always easy to understand the causes because healthcare is a complex socio-technical system.

Abstract Background Reconstruction of continuity defects following osteonecrosis in multimorbid patients is challenging. In all cases of the predescribed palliative treatment method for alloplastic mandible reconstruction, plate fractures were detected in follow-up. We hypothesized that a modification could avoid these fractures, leading to stable long-term results. Methods This retrospective study compares the original method with a modification using single, laser-sintered CAD–CAM plates instead of manually bent miniplates. The predescribed shuttering technique was used to reconstruct the mandible in its original shape with bone cement. Results Uneventful wound healing was observed in 86% of the cases after modification of the method. No implant or plate fracture occurred. Conclusions The presented method should be considered as a treatment option for mandible reconstruction in elderly, multimorbid patients in palliative situations. The results of this study suggest that the modification of the method leads to significantly improved long-term stability. Donor site morbidity is avoided with this method of palliative surgery.

The topic of this work is the administration of medicine following a face-to-face and telephone madication-related orders at hospitals. The methods used in the theoretic part of this work included both discussions with representatives of health care providers and the analysis of documents. Based on the description and analysis of the set-up of verbal madication-related orders as featured in the accreditation standards of four healthcare accreditation organisations and internal rules of five hospitals, the author of this work seeks to identify any possible risk elements of verbal orders, and to propose ways how to modify such parts of standards and rules so as to make the verbal ordination less risky. Whether or not the verbal medication-related orders at hospitals is a lege artis procedur depends first of all on the situation in which the verbal order is issued, on the authorization or qualifications of health employees who are involved in the implementation of such verbal order, and on the strict observance of procedures concerning the communication (including its recording into the medical documentation). Although verbal madication-related order represents risk arising from the ordinance's communication, forensic, or specialist consequence, no greater attention has been paid to them so far. There...