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From page 447... ...
Index A patient self-administration, 8384 in pediatric care, 114115, 395396 Accountability prevention of errors in, 8081, 83, 250 performance measurement for, 330 251 state reporting systems for, 92 procedure, 7980 Accreditation research needs, 21 curricula recommendations, 344 responsibility, 79 recommendations for, 22, 329, 335 Adverse drug events (ADEs) See also Joint Commission on costs, 130133, 202 Accreditation of Healthcare definition, 3, 45, 36, 37, 38, 311312 Organizations detection methods, 237239, 241245 Acetaminophen, 31, 83, 115 incidence.
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From page 448... ...
448 INDEX data standardization role, 324 Anesthesia Patient Safety Foundation, 296 recommendations for, 12, 19, 20, 21, Anesthesiology, 296297, 301 192, 274, 275, 288, 310311 Anti-anxiety drugs, 421422 Alerts and alert systems Antibiotic medications, 71, 84, 125, 126, current technology, 287 128, 373, 375 false alerts and overrides, 20, 251252, Anticoagulant therapy, 8889, 125, 249, 293294 270, 313314, 382 intelligent prompting, 295297 Aspirin, 31, 270 scope of, 287 Associated in Process Improvement, 157 severity ranking, 293, 294 Atrial fibrillation, 125, 127, 382 standardization, 288, 293295 Automated dispensing systems See also Computerized drug event effectiveness, 251, 418 monitors; Computerized provider implementation, 334 order entry linkages among automated and Allergic reactions computerized systems, 252, 287 clinical decision support to prevent, 246 overrides of warnings, 252 prescribing errors, 71 purpose, 30, 7778 preventable ADEs in hospitals, 119 Ambulatory care costs of medication errors in, 56, 131, B 132 electronic prescribing in, 14, 253 Bacterial infection prophylaxis, 125, 126. See also Antibiotic medications incidence of medication errors, 108, 112114, 124, 314, 384392, 396 Bar coding, 413 397 alert systems, 287, 293294 error prevention efficacy, 6, 413 information resources in, 206 medical record keeping in, 387388 Food and Drug Administration rules, medication administration in, 429 297298 future prospects, 298299 medication error detection in, 244 medication therapy management in, linkages among automated and 429430 computerized systems, 252, 287 in nursing home medication use, 252253 opportunities for patient consultation, 173174 purpose, 14, 30, 81, 250251 overutilization of medications in, 128 regulatory requirements, 280 research needs, 318, 319 patient monitoring in, 323, 387 pediatric, 396397 standardization, 288, 291, 297299 preventable ADEs in, 5, 124 use interface, 300301 Best Pharmaceuticals Act for Children, 268 prevention research, 319320 research needs, 21, 314, 323 Biologic Licensing Application, 59 strategies for reducing errors in, 428430 Biologic products, 35 Blood and blood products, 35 underutilization of medications in, 127 128 Brand name drugs, 277, 278 American Academy of Pediatrics, 29, 434 Bridges to Excellence, 331 Bronchitis, 128 American Hospital Association, 160 American Medical Association, 410 American Medical Informatics Association, C 343344 American Nurses Association, 410 Cancer treatment, 164 American Society of Health-System Caregivers Pharmacists, 29, 429 error risk, 116, 186 American Society of Hospital Pharmacists, incidence of pediatric medication errors, 410 314315
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From page 449... ...
INDEX 449 right to refuse treatment for dependents, Clear RxTM, 198 191 Clinical decision-support systems, 26, 30, training and support for, 186 85, 122 Case management, pharmaceutical, 432 current state, 232 433 effectiveness, 6, 414417 Causes of medication errors and adverse for electronic prescribing, 247248 events future prospects, 232 areas of evaluation for improving care, implementation, 253255 33 intelligent prompting, 295297 in care transitions, 255 overrides of warnings, 251252, 293 communication-related, 1718, 182 rationale, 232 183, 234, 274, 275 recommendations for, 16, 26, 228 in computerized order entry, 74 standardization, 335 in drug administration process, 8183 user interface, 300 overutilization, 125, 128129, 274275, See also Alerts and alert systems 384 Clinical trials in pharmaceutical industry, 266267 considerations in prescribing, 71 in pharmacy practice, 75, 76, 77, 7879 disclosure of results, 5758, 271274 in prescribing process, 7174 informed consent rules, 159 research needs, 2, 317 new drug development process, 5556 risk/benefit information, 17 registration site, 271, 272 scope of, 37, 43, 51, 70 regulatory oversight, 63 systemic context, 45, 184187 shortcomings of current health system, transcription of prescription, 7576, 17, 5657, 267271 378, 394 Clinical unit, 222228 underutilization, 125, 126128, 234 ClinicalTrials.gov, 271272 235, 382384 Cochrane Collaboration, 13 user interface-related, 299301 Cognitive processing See also Dosage errors; Nonadherence drug labeling and, 19, 274 Center for Health and Health Care in medication information leaflet design Schools, 434 considerations, 195196, 274 Centers for Disease Control and Prevention patient with impairment, 185 adverse event reporting system, 9394 research needs, 318 National Center for Health Marketing, technology interface design, 20, 288, 206207 299302 Centers for Medicare and Medicaid Services Colds, 128 comparative performance reports, 331 Comorbodity drug formularies, 66 adverse event risk, 86 electronic prescribing rules, 336 research needs, 17, 269 information dissemination role, 207 Complementary and alternative medications recommendations for, 12, 21, 22, 192 consumer health attitudes and beliefs, 193, 310311, 312, 329, 333334 189190 role of, 33 definition, 35 Certification Commission on Health drug interactions, 116 Information Technology, 254255 error prevention strategies, 435438 Chart review, 241242 information access for consumers and Chemical name, 275 providers, 182 Chemotherapy error incidence, 113 medication error rate, 108, 116, 316 Chronic Care Model, 157158 patient self-prescribing, 7475 Chronic coronary disease, 125 research needs, 21, 316 Claims data, 341 utilization, 31, 32, 189
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From page 450... ...
450 INDEX Compliance. See Nonadherence Continuity of Care Record, 322 Computerized drug event monitors, 30, 85 Coronary artery disease, 128 86, 242243, 251 Cost of care Computerized point-of-care reference computerized order entry, 253 information, 13, 229232 considerations in treatment planning, 70 Computerized prescribing.
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From page 451... ...
INDEX 451 Depression treatment, 125, 127, 382, 422 medication-use system, 6670, 89, 90 Diabetes patient self-monitoring, 88 number of pharmaceutical agents, 51 Dietary Supplement Health and Education opportunities for intervention, 53, 67 Act. See Complementary and principles for safe practice in, 5051, 53 alternative medications stages of drug development and delivery, Dietary supplements.
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From page 452... ...
452 INDEX shortcomings of current system, 1112, drug labeling and packaging oversight, 179, 181183 19, 6062, 193194, 195, 196, 274 See also Information resources 275, 279280 Electronic ADE detection, 242243 drug manufacturing and distribution Electronic health records oversight, 63 certification, 254255 drug name selection process, 278, 280 data standards, 289 drug safety activities, 3233, 5153 error risk, 372373 error reporting systems, 89 implementation trends, 334335, 2044 information dissemination role, 29, 207, purpose, 203204, 222, 253 312 standardization, 336 in new drug development, 51, 55, 56, Electronic prescribing, 30 5860 decision support rules, 247248 recommendations for, 12, 19, 21, 192 implementation challenges, 1314 193, 274275, 310311 linkages among automated and Formularies computerized systems, 252, 287 characteristics of current system, 66 in nursing homes, 14, 252 cost of drugs and, 187 in outpatient care, 253 definition, 66, 129 oversight and implementation, 33 effects on safety, 129 potential for error, 248 effects on utilization, 129 rationale, 13, 30, 246, 247 Free drug samples, 18, 19, 6566, 179, 275, recommendations, 16, 228229, 246 285287, 387 regulatory restrictions, 247 standardization, 335 state regulation, 336 G Emergency departments cost of admissions related to prior Generic drugs ADEs, 130131 free samples, 285287 naming conventions, 275277, 278 medication error rates, 114115, 397 overutilization of antibiotics in, 128 Geriatric medicine pediatric, 114115, 397 adherence, physical impairment and, 184185 Errors of omission, 5, 26, 28, 36, 69, 108 clinical knowledge base, 268269 cost of care, 187 F drug information access and utilization, 181 Failure modes and effects analysis, 278 health system trends, 32 Fatigue, provider, 31, 419 medication regulation in nursing homes, Federal government 419423 adverse event reporting and surveillance multidisciplinary team approach to care, system, 9294 250 information technology role, 334 patient monitoring in, 86 patient rights guarantees, 159160 psychotropic medications, 398399, recommendations for, 1113 419423 role in preventing medication errors, 2 risk of medication error, 17, 57, 86, See also Regulation and oversight; 313314, 398399 specific agency or department See also Nursing homes Fever treatment, 116 Food and Drug Administration adverse event reporting system, 59, 92 H bar coding rules, 297298 clinical trials oversight, 159 Hand-offs. See Transition between care settings
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From page 453... ...
INDEX 453 Health care providers incidence of medication errors and access to information, 181, 231232 ADEs, 12, 4, 5, 108111, 118122, actions to improve medication safety, 8 125, 313, 323, 367376 10 opportunities for patient consultation, attitudinal barriers to providerpatient 174176 partnership, 187189 performance assessment, 341 disclosure of errors to patients, 160 psychiatric, 399 162, 177179 research needs, 318319 drug industry marketing to, 65 strategies for preventing medication effective clinical units, 222228 errors and ADEs, 6, 318319, 409 handwriting, 74 419 information needs, 229231 underutilization of medications in, 125, integration of complementary and 126127 alternative medications, 189190 Human factors design interpersonal skills, 171173, 178 drug labeling, 19, 274 medication reconciliation, 1415, 168 medication information leaflets, 195 169 196, 274 multidisciplinary teams, 248250 significance of, 50 opportunities for patient consultation, technology interface, 20, 288, 299302 173176 Hypertension management, 127, 268 patient education role, 171173 performance measurement, 330331 public opinion, 151152, 153 I recommendations for, 22, 248, 329 reporting behaviors, 152 Ibuprofen, 31 Incidence of medication errors and ADEs scope of, 38 workforce development, 342344 adherence-related errors, 86, 114, 179, See also Education and training of 390391 in ambulatory care, 108, 112114, 124, medical personnel; Nursing; Pharmacy practice; Prescribing 314, 384392, 396397 practice; Providerpatient partnership areas of evaluation for improving care, 33 to prevent medication errors; Psychiatric care in chronic illness, 86 Health maintenance organization drug in complementary and alternative medication use, 108, 116, 316 formularies, 66 Health Plan Employer Data and current estimates, 12, 28, 116118 Information Set, 341 data sources, 105108 definition of medication error and, 311 Hearing impairment, 185 Heart failure, 125 detection methods, 4 Hemodialysis, 113 in drug administration, 4, 28, 110112, 114115, 369371, 376378, 395 Heparin, 270 Home care, 85, 389390, 433. See also 396 Ambulatory care; Transition between in emergency care, 114115, 397 errors of omission, 28, 108, 373376 care settings Hormone replacement therapy, 267268 in geriatric medicine, 86, 398399 Hospital Incident Reporting Ontology, 340 in home care pharmacy, 389390 in hospitals, 12, 4, 5, 108111, 118 Hospitals computerized order entry in, 253254 122, 125, 313, 323, 367376 costs of ADEs in, 130132 in mail-order pharmacy, 388389 measurement methodologies, 109 drug repackaging, 77 in medication-use process, 109
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From page 454... ...
454 INDEX in nursing homes, 108, 111112, 122 consumer access, 205 123, 313314, 376384 consumer behavior, 75 in over-the-counter drug use, 108, 116, consumer demand, 165166 315 current publishing system, 271272 overutilization errors, 125, 128129, current technologies, 286287 384 data standards, 20, 287, 288 patient monitoring errors, 86, 371, 373, design considerations, 195196 378 drug labeling and packaging, 1719, 183 in pediatric care, 4, 108, 114115, 314 drug risk/benefit information, 17 315, 393398 goals, 205 in pharmacy practice, 28, 113114, 367, government role, 334 369, 376, 388389, 394395 integration of technologies, 287 in prescribing, 71, 109110, 112113, international comparison studies, 323 114115, 314, 367369, 373376, Internet, 1112, 198200 385387, 393394 interoperable medication data, 233236 preventable adverse drug events, 5, 118 medication information leaflets, 1112, 125, 109110 183, 192, 193196 in primary care, 86 for medication reconciliation, 1415, in psychiatric care settings, 108, 115 168169 116, 315, 398400 minimum functionality standards for research needs, 2, 3, 21, 118, 313316, technology, 22, 329, 334336 400 in new drug development process, 54 in school health care, 112, 391 patient safety educational materials for in self care, 114, 390391 providers, 343 underutilization errors, 125, 126128, for patient self-prescribing, 7475 382384 for pharmacists, 76, 79, 234 in use of over-the-counter drugs, 108, pharmacy database, 76, 287 116, 315 point-of-care reference information, 13, variation across facilities, 4, 117 229232 Industry, pharmaceutical, 38 for preventing drug administration communication of drug information, 17 errors, 83 18, 183, 266267 proposal for national registry, 272274 drug formularies, 66 provider access systems, 231232 free sample distribution, 18, 19, 6566, provider needs, 229231 179, 275, 284286, 387 publication bias, 272 manufacturing oversight, 63 recommendations for improving, 1213, potential sources of medication error in, 16, 20, 192193, 228229, 274275, 51, 266 287288 product recalls, 51 research to enhance consumer use and recommendations for, 1819, 20, 274 comprehension, 312 275, 287288 reward for investment in, 331 role in improving medication safety, shortcomings of current system, 1112, 150, 266267 1718, 181183, 267, 271272 stages of drug development and standardization of health information distribution, 50, 51 technology, 1920, 31, 289293 See also Marketing and distribution of structure and scope of national drugs; Research and development, medication safety system, 205207 new drug technology interface design, 299302 Informatics, 50 technology training for providers, 343 Information resources 344, 427 clinical data, 267271 telephone helpline, 12, 192, 200203
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From page 455... ...
INDEX 455 See also Alerts and alert systems; L Educational interventions; Surveillance and reporting Labeling and packaging Informed consent, 159 black box warnings, 61 Institute for Healthcare Improvement, 25 consumer use and understanding, 75 26, 157, 168169 container labels, 196198 Institute for Safe Medication Practice, 29, drug interaction data, 87 89, 91, 240, 245, 341, 410 drug samples, 387 Insurance over-the-counter medications, 61, 438 barriers to providerpatient partnership, recommendations for, 1819, 274275 184 regulatory oversight, 6062, 193194, cost of care as cause of nonadherence, 195, 196, 278279 186187 shortcomings of current system, 1718, drug formularies, 66, 129, 187 194, 196198, 275, 276277, 278 Intensive care units 280 incidence of drug administration errors, as source of medication error, 45, 77, 371 79, 267, 275 medication error rates in, 110 strategies for improving, 198, 280, 281 patient monitoring in, 85 282 International comparison, 323 See also Unit-of-use packaging Internet Leapfrog Group, 297, 331, 335 clinical trial data, 271, 272 Legal environment consumer health behaviors, 198199 barriers to reporting, 339 National Library of Medicine programs, Internet pharmacies, 64 199200 patient rights, 7 online pharmacies, 64, 199 right to refuse treatment, 191 quality of health information on, 1112, state-mandated adverse event reporting, 199 89, 9192 recommendations for, 12, 192 Lehman, Betsy, 27 Intravenous medication Libraries, 206 administration errors, 110, 370, 371 Lidocaine hydrochloride, 279 causes of error in, 299300 Long-term care error prevention technologies, 251 cost of medication errors in, 5, 132 See also Smart intravenous pumps patient monitoring in, 85 preventable ADEs in, 5, 112, 125 See also Nursing homes J Joint Commission on Accreditation of M Healthcare Organizations, 2526 data standardization activities, 324, 340 Mail order pharmacies National Patient Safety Goals, 31, 222, error incidence, 388389 225226, 337 legal status, 64 patient rights oversight, 159, 160 operations, 64 reconciliation standards, 169 research needs, 314 Sentinel Event Policy, 2930, 91, 410 Managed care organization drug formularies, 129 Marketing and distribution of drugs K distribution system, 6364 free drug samples, 1819, 19, 6566, Katrinahealth.org, 233234 179, 275, 284286
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From page 456... ...
456 INDEX industry spending on promotion, 64, 65 computerized drug event monitors, 30, marketing effects, 65 8586, 242243, 251 in overall drug system, 51 errors in nursing homes, 112, 378 promotional techniques, 6465 errors in pediatric care, 396 regulatory review, 62, 63 goals, 2, 15, 84, 8687 shortcomings of current system, 66 intelligent prompting systems, 295297 Medical rounds, 6, 413, 417 methods and technologies, 84, 85 Medicare observation of medication adverse event risk, 86 administration, 243244 claims data, 341 patient self-monitoring, 8789 electronic prescribing rules, 336 pharmacist role, 8586 medication therapy management in, preventable ADEs related to, 371, 373 333334 provider knowledge for, 87 outpatient preventable adverse drug recommendations for, 16, 228 events, 5 research needs, 322323 prescription drug benefit, 32, 33 responsibility, 84 provider performance assessment, 341 scope, 8485 See also Centers for Medicare and See also Alerts and alert systems; Medicaid Services Computerized drug event monitors; Medicare Modernization Act, 335 Surveillance and reporting Medicare Prescription Drug Improvement Monoamine oxidase inhibitors, 88 and Modernization Act, 176 Mortality, 25, 28 Medication administration record, 81 Multidisciplinary team approach to care, Medication errors 248250 case examples, 27, 4349, 152153 Myocardial infarction, 125, 126, 127, 382 cause for concern, 1, 2628 costs.
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From page 457... ...
INDEX 457 Near miss, 311312 O New Drug Application, 59, 270271 Nonadherence Official title of medication, 277 causes of, 179, 184 Off-label use, 71, 268 cognitive impairment and, 185 Omnibus Budget Reconciliation Act, 419 consumer health attitudes and beliefs 420, 421422, 423 and, 189 Organizational psychology, 50 cost of care and, 186187 Orphan drugs, 77 costs of, 6 Osteoporosis, 125, 127, 382 definition, 179 Outpatient care. See Ambulatory care drug side effects as cause of, 186 Overdose incidence, 86, 114, 179, 390391 case example, 4345 interventions to prevent, 434 in self-administration of drugs, 83 physical impairment as cause of, 184 See also Dosage errors 185 Over-the-counter medications providerconsumer communication and, consumer role in improving safety, 8 182 definition, 35 Nursing disease and drugdrug interactions, adequate staffing, 30 116, 315316 case example of medication error, dosing errors, 83 4345 incidence of medication errors, 108, drug administration procedure, 7980 116, 315 drug effect monitoring responsibility, 84 label warnings, 61, 438 education programs for nurses, 342 patient self-prescribing, 7475 educational interventions in nursing regulatory review, 60 homes, 423, 424425 research needs, 21, 315316 home health care, 390 scope of, 51 interpersonal skill training, 172 self-monitoring when using, 8788 observation of medication strategies for error prevention, 435438 administration, 243244 utilization, 31 strategies for improving medication safety, 80, 222, 225 workload issues, 82 P Nursing homes Pain management, 125, 127, 382384 automated and computerized Patient-centered care medication-use technologies for, 14, attitudinal barriers to, 188189 252253 characteristics of organizational culture costs of medication errors in, 131 based on, 188 drug administration in, 376378 conceptual model, 157158 incidence of medication errors and consumer empowerment in, 158162, ADEs, 108, 111112, 122123, 313 163164 314, 376384 consumer expectations, 153 overutilization errors, 384 essential elements, 153155, 156 research needs, 319 goals for, 143150 strategies for preventing medication provider responsibilities, 166 errors and ADEs, 6, 319, 419427 quality of communications in, 155, 172 underutilization of medications in, 127, 173 382384 rationale, 155157 workforce education, 423425 self-management support in, 157158 See also Long-term care See also Providerpatient partnership to prevent medication errors
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From page 458... ...
458 INDEX Patient rights Pharmacy practice clinical significance, 7, 158 alert systems, 287 current standards, 78, 159160 ambulatory care, 388389 to disclosure of adverse events, 7, 160 bar-coding technology in, 250251 162, 177179 case management service, 432433 informed consent, 159 communication of drug information, 17 pharmacy consultation, 176 18, 182 provider responsibility, 810 continuing education, 337, 338 recommendations, 11, 162 database systems, 76, 287 right to refuse treatment, 191 drug distribution system, 6364 in treatment planning, 159 drug industry marketing to, 6465 Patient Safety: Achieving a New Standard effective technologies, 14 for Care, 26 electronic prescribing and, 247 Patient Safety and Quality Improvement free samples, 18, 19, 6566, 179, 275, Act, 91, 244245, 339, 340 284286, 387 Patient Safety Event Taxonomy, 324, 340 in hospitals, 119120, 367, 369 Pediatric medicine incidence of medication errors in, 28, caregiver error in fever treatment, 116 113114, 119120, 367, 369, 376, clinical knowledge base, 268 388389, 394395 emergency care, 397 information kiosks, 205206 immunizations, 396397 information leaflets, 1112, 183, 192, incidence of medication error, 4, 108, 193196 114115, 314315, 393398 information resources, 76, 79, 234 medication error risk, 17 Internet and mail-order pharmacies, 64, patient monitoring, 396 388389 pharmacy practice, 77, 114 medical school training, 342 prescribing practice, 393394 medication therapy management, 333 research needs, 320321 334, 426 strategies for medication error multidisciplinary team approach to care, prevention, 320321, 435 248 surrogate decision-making, 191 in nursing homes, 376 People's Medical Society, 29 observation of medication Performance measurement, 341 administration, 244 pathways to quality improvement, 330 overrides of automated warnings, 251 331 252, 293 pay-for-performance systems, 331333 participation in medical rounds, 6, 417 Personal health record patient education in, 6, 75, 78, 176 consumer self-management and, 312 patient monitoring, 8586 313 pediatric, 394395 current state, 203204 pediatric medicine, 77, 114 essential components, 204205 point-of-care reference information, 13, interoperable medication data, 233236 229232 minimum data set, 12, 193, 312 prescription audits, 244245 rationale, 203204 prescription refills, 320, 337 recommendations for, 12, 16, 193, 228 process components, 35, 7679 reconciliation in care transitions, 1415, recommendations for, 16, 228 168169 recommendations for oversight, 22, 329 types of, 204 research needs, 320 vendor responsibilities, 12 risk/benefit analysis, 17 See also Electronic health records sources of error in, 75, 76, 77, 7879 Pharmacy benefits manager, 64 state pharmacy boards, 336338
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From page 459... ...
INDEX 459 strategies for improving medication provider profiling and feedback, 425 safety, 6, 3031, 7678, 222, 224 426 225, 417418, 431433 recommendations for improving transcription of prescriptions, 7576, mediation safety, 16, 228229, 246 378, 394 research needs, 320 working environment, 431432 responsibility, 70 workload, 176 strategies for improving medication See also Automated dispensing systems; safety, 222, 223, 318, 428429 Computerized provider order entry; transcription of prescription, 7576 Prescribing practice types of prescribing errors, 7174 Pictograms, 195196 underutilization, 125, 126128 Placebo studies, 57 See also Computerized provider order Point-of-care reference information, 13, entry; Pharmacy practice 229232 Preventable adverse drug events Poison control centers, 202203 in ambulatory care, 124 Postmarket surveillance of new drugs, 34, costs, 5, 130133 5960 definition, 37, 38 Potassium chloride, 279 in hospitals, 118122, 125 Prescribing practice incidence, 5, 109110, 118125 in ambulatory care, 314, 385387, 428 in long-term care, 125 429 measurement methodology, 119120, assessment of patient medication history, 123 74 in nursing homes, 122123, 313314 bar-coding technology in, 250251 Prevention of medication errors best practices, 70 in ambulatory care, 319320, 428430 clinical decision making, 71 areas of evaluation for improving, 3334 educational intervention in prescription in care transitions, 8, 1415, 321322, writing, 428429 427428 electronic. See Electronic prescribing clinical decision-support system errors of omission, 373376 effectiveness, 6, 414417 in home care settings, 389390 computerized order entry effectiveness, in hospitals, 119120, 367369 6, 414417 inappropriate use, 71 consumer actions, 163166 incidence of medication errors in, 71, cost/benefit studies, 317318 109110, 112113, 114115, 119 criteria for evaluating strategic 120, 314, 367369, 373376, 385 approaches, 34 387, 393394 in drug administration, 8081, 83, 250 intelligent prompting systems, 295297 251 interoperable medication data, 233236 drug effect monitoring, 8489, 251 knowledge base for, 71, 181, 230 drug formulary effectiveness, 129 length of providerpatient visits and, drug namerelated efforts, 278 184 effective clinical unit characteristics, off-label use, 71 222228 oral orders, 74, 76, 113, 247, 318, 388 effective use of technologies for, 14, 16, overrides of automated warnings, 251, 250255 293 evaluation of current efforts, 106 overutilization, 125, 128129 financial incentives, 22, 329 patient involvement, 70 future prospects, 317 patient self-prescribing, 7475 in home care setting, 433 in pediatric care, 320, 393394 in hospitals, 6, 318319, 409419 prescriber handwriting, 74
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From page 460... ...
460 INDEX interoperable medication data for, 233 consumer empowerment for, 158162, 236 163164 lessons from other industries, 323324 consumer role, 8, 163166 in medication-use system, 67 current state, 152153 multidisciplinary team approach for, goals, 67 248250 knowledge needs for, 181183 in nursing homes, 6, 319, 419427 length of providerpatient visits, 184 obstacles to, 10 patient rights, 78 opportunities for intervention in drug provider role, 810, 166179 system, 53 rationale, 2 patient monitoring, 8587 recommendations for, 11, 162163 patient self-monitoring for, 8788 strategies for strengthening, 151, 153 in pediatric care, 320321, 435 154 in pharmacy practice, 6, 3031, 7678, Psychiatric care 222, 224225, 417418, 431433 drug formularies, 129 in prescribing, 71, 222, 223, 318, 428 geriatric medicine, 398399 429 medication errors in, 108, 115116, provider education and training for, 313314, 315, 398400 342344 medication regulation in nursing homes, in psychiatric care, 321, 435 419423 recent efforts, 2526, 2931 prevention strategies, 321, 435 reconciliation for, 1415, 168169 research needs, 21, 269, 321 regulatory system recommendations, 22, stigma and discrimination in, 190191 329 Public opinion, 151152, 153 research needs, 2, 2021, 317322 risk/benefit information for, 17 role of state pharmacy boards, 336338 Q in self-administration of drugs, 8384, Quality improvement pathways, 330333 435438 in self-care, 433434 setting-specific strategies, 221222 R stakeholder motivations, 67 stakeholders, 3839, 50, 150 Race/ethnicity, consumer health attitudes strategic approaches, 6, 10, 2829, 150 and beliefs, 189 systemic change for, 143145, 221 Reconciliation See also Preventable adverse drug events; barriers to implementation, 169 Providerpatient partnership to in care transitions, 255 prevent medication errors characteristics, 168 Program of All-Inclusive Care for the effectiveness, 168, 428 Elderly, 250 electronic data management in, 15, 169 Proton pump inhibitors, 129 goals, 168 Providerpatient partnership to prevent implementation, 169, 255, 428 medication errors, 153154 process, 14, 168169 attitudinal barriers to, 187191 rationale, 14 barriers to, 179191 use of interoperable information systems characteristics of reformed health care in, 236 system, 143149 Record keeping communication skills for, 172173, 182, consumer medication list, 2, 8, 164165, 183 234 concept of patient-centered care in, 153 Continuity of Care Record, 322 158 electronic, 14
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From page 461... ...
INDEX 461 errors in ambulatory care settings, 387 pediatric care, 320321 388 prevention strategies, 21, 317322 medication administration record, 8, 81 recommendations for, 21, 310311 recommendations, 11, 16, 162, 228 technology implementation, 319 See also Electronic health records; Research and development, new drug Personal health record Biologic Licensing Application, 59 Regional Health Information Organizations, clinical trials, 5557 322 conflicts of interest in, 57 Regulation and oversight current state, 55, 5657, 58 clinical trials, 63, 159 disclosure of results, 5758, 271274 drug labeling and packaging, 19, 6062, effectiveness review, 59 193194, 195, 196, 274275, 279 expansion to new indications, 270 280 fast track approval, 55, 59 drug manufacturing and distribution, generics, 60 6364, 6566 goals, 5455 drug marketing activities, 62, 6465 information management in, 54 electronic prescribing, 33, 247, 336 manufacturing controls, 63 guiding principles, 329330 marketing materials review, 62 information technology standards, 334 New Drug Application, 59 336 over-the-counter products, 60 medication therapy management, 333 in overall drug system, 51 334 placebo studies, 57 new drug review, 5859 postmarket studies, 34, 5960, 270, 272 patient rights, 159, 160 product labeling, 6062 pharmacy practice, 22, 329 regulatory oversight, 5862 for process improvement, 330333 risk assessment, 58 psychotropic drug use in nursing homes, safety oversight, 5153 419423 scope of activities in, 54 recommendations, 22, 329 shortcomings of current system, 58, 62, See also Food and Drug Administration; 270271 Joint Commission on Accreditation stages, 55 of Healthcare Organizations; Respiratory tract infections, 128129 Surveillance and reporting Rewarding Results, 332 Religious beliefs, 191 Rofecoxib. See COX-2 inhibitors Renal dysfunction, 17, 269 Reporting.
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From page 462... ...
462 INDEX patient-centered Chronic Care Model, Substance use/abuse, 190191 157158 Surrogate decision-making, 176177, 186, patient education for, 171, 427 191 physical impairments to, 185186 Surveillance and reporting self-monitoring, 8789 administrative databases, 341 self-prescribing, 7475 chart review for, 241242 strategies for preventing medication computerized drug event monitors, 30, errors in, 419, 433434 8586, 242243, 251 trading/sharing of drugs among confidentiality in, 91 consumers, 190, 391 cost/benefit analysis of systems for, 324 See also Consumer role in preventing current practice in disclosing errors, 152 medication errors; Nonadherence; current programs, 89 Over-the-counter medications data analysis, 245 Side effects, 186 drug utilization review in ambulatory Smart intravenous pumps care, 430 alert systems, 293294 effectiveness, 91 application, 85, 251 federal systems, 59, 9294 effectiveness, 6, 418 feedback for reporters, 341342 medication errors related to, 299300 goals, 15, 237, 245 research needs, 318, 319 institutional systems, 89, 91 Special populations interoperable medication data, 234, 236 research needs, 17 measurement of medication error See also Geriatric medicine; Pediatric incidence and, 109 medicine medication administration errors, 243 St. John's Wort, 116 244 Standardization methods, 15, 237239 alert systems, 288, 293295 obstacles to, 91, 339 bar codes, 288, 290, 297299 practice-related errors, 340341 data standards, 20, 287, 288, 324 prescription audits, 244245 drug labeling, 280 rationale, 15, 89, 338339 drug names and abbreviations, 18, 19, recommendations for, 16, 22, 228229, 44, 274, 289293 236, 329 health information technology, 1920, self-reports for, 237 31, 334336 significance of, 237 interoperable medication data, 233234 standardization of requirements, 89, medication error terminology, 311312, 339340 324 state-mandated, 89, 9192 medication information leaflets, 12, 192, strategies for improving current systems, 195, 200 239240 patient rights, 78, 159160 strategies to encourage reporting, 339 pediatric dosages, 320 voluntary systems, 15, 2930, 89, 92, reporting system, 89, 339340 239, 240241 State governments See also Monitoring, patient electronic prescribing laws, 336 informed consent rules, 159 mandatory reporting systems, 89, 9192 T medication error reduction actions, 334 patient rights guarantees, 159160 Take with Care, 29 pharmacy boards, 336338 TargetTM stores, 198 Tavistock Group, 160 recommendations for, 22, 329 Statins, 129, 315316 Telephone helpline effectiveness, 200201
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From page 463... ...
INDEX 463 establishing national system of, 202203 current practice, 7778, 80, 282283 future challenges, 202 definition, 18, 282 providers, 201 forms of, 282 recommendations for, 12, 192 future prospects, 283284 services, 201202 rationale, 18, 283, 284 Telephone pharmacy orders. See Prescribing recommendations, 19, 274275 practice, oral orders U.S.
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