Journal of evaluation in clinical practice
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Around one-third of medication errors resulting in death within 48 h involve insulin therapy. Despite a growing number of interventional strategies that have been published over the past decade, it remains unclear which of these interventions is effective in reducing insulin errors. Therefore, the study aimed to synthesize interventions to reduce the frequency of insulin errors in either home or health care settings. ⋯ While the strategies might be effective in reducing insulin administration errors in the home settings, computerized protocols, continuing education and the manual validation of insulin products appear to be the most effective strategies for reducing such insulin errors in healthcare settings. Understanding these findings may help clinicians and patients to decrease the number of insulin errors administration.
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Medically trained health professionals have been central to the development of policy responses to the coronavirus 2019 (COVID-19) crisis. In their multiple roles-as clinicians, public health leaders, members of scientific advisory boards, and also as media pundits and health professionals-they have helped shape discourses of science-based policy options during the first 2 years of the pandemic. In particular, health professionals as a collective voice insisted on the necessity of society-wide measures of social control to curb the morbidity and mortality of the virus. ⋯ To illustrate these tensions, we discuss the public fallout between vocal members of the OSAT, an ad hoc biomedical-led organization, and the Government of Ontario in light of the disagreement on the scope of 'stay home' orders to manage the third wave of the pandemic in the Spring of 2021 and, more recently, the mass protest against mass-scale public health measures in Ottawa, Canada. We argue that while decision making under emergency conditions is a difficult task, the legitimacy of the social contract between medicine and society depends on medical experts' judicious exercise of public health ethics principles. We offer a set of recommendations for building a more collaborative response to future health crises.
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RATIONALE, AIMS AND OBJECTIVES: Emergency department (ED) clinicians account for approximately 13% of all opioid prescriptions to opioid-naïve patients and variability in the rates of prescribing have been noted among individual clinicians and different EDs. This study elucidates the amount of variability within a unified health system (the U.S. Military Health System [MHS]) with the expectation that understanding the sources of variability will enable health system leaders to improve the quality of decision making. ⋯ Among ED encounters of Army soldiers at military treatment facilities, there was substantial variation among providers in prescribing opioid prescriptions that were not explained by patient case-mix. These results suggest that programmes and protocols to address less than optimal prescribing in the ED should be initiated to improve the quality of care.