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Horri J.,Center Detudes Perinatales Of Locean Indien Cepoi | Cransac A.,Pharmacy | Quantin C.,Biostatistique et Informatique Medicales | Abrahamowicz M.,McGill University | And 4 more authors.
Journal of Clinical Pharmacy and Therapeutics | Year: 2014

What is known and objective: The risk of dosage Prescription Medication Error (PME) among manually written prescriptions within 'mixed' prescribing system (computerized physician order entry (CPOE) + manual prescriptions) has not been previously assessed in neonatology. This study aimed to evaluate the rate of dosage PME related to manual prescriptions in the high-risk population of very preterm infants (GA < 33 weeks) in a mixed prescription system. Methods: The study was based on a retrospective review of a random sample of manual daily prescriptions in two neonatal intensive care units (NICU) A and B, located in different French University hospitals (Dijon and La Reunion island). Daily prescription was defined as the set of all drugs manually prescribed on a single day for one patient. Dosage error was defined as a deviation of at least ±10% from the weight-appropriate recommended dose. Results and discussion: The analyses were based on the assessment of 676 manually prescribed drugs from NICU A (58 different drugs from 93 newborns and 240 daily prescriptions) and 354 manually prescribed drugs from NICU B (73 different drugs from 131 newborns and 241 daily prescriptions). The dosage error rate per 100 manually prescribed drugs was similar in both NICU: 3·8% (95% CI: 2·5-5·6%) in NICU A and 3·1% (95% CI: 1·6-5·5%) in NICU B (P = 0·54). Among all the 37 identified dosage errors, the over-dosing was almost as frequent as the under-dosing (17 and 20 errors, respectively). Potentially severe dosage errors occurred in a total of seven drug prescriptions. None of the dosage PME was recorded in the corresponding medical files and information on clinical outcome was not sufficient to identify clinical conditions related to dosage PME. Overall, 46·8% of manually prescribed drugs were off label or unlicensed, with no significant differences between prescriptions with or without dosage error. The risk of a dosage PME increased significantly if the drug was included in the CPOE system but was manually prescribed (OR = 3·3; 95% CI: 1·6-7·0, P < 0·001). What is new and conclusion: The presence of dosage PME in the manual prescriptions written within mixed prescription systems suggests that manual prescriptions should be totally avoided in neonatal units. © 2014 John Wiley & Sons Ltd.

Berthelot-Ricou A.,Center Hospitalier Felix Guyon | Berthelot-Ricou A.,Center Detudes Perinatales Of Locean Indien Cepoi | Berthelot-Ricou A.,Faculte Of Medecine Of Luniversite Daix Marseille | Tur S.,Jean Moulin University Lyon 3 | And 5 more authors.
Journal de Gynecologie Obstetrique et Biologie de la Reproduction | Year: 2014

Conclusion: For single pregnancy, most of the patients with cervical length > 15 mm have fullterm delivery. It seems important to us to develop the use of more efficient predictive markersof risk-premature labor in order to improve the diagnosis and management of TPB.To assess preterm birth rate, in patients admitted for threatened preterm birth(TPB) in a tertiary care maternity center and evaluate our diagnostic and therapeutic tools.Materials and methods: A retrospective cohort study, in a tertiary care maternity center (Mar-seille, France), reviewed all admissions for TPB from January 1 to December 31, 2009.Results: We recorded 224 admissions for TPB (181 single pregnancies and 43 twin pregnan-cies), 43.8% of TPB admissions were from materno-fetal transfer. Preterm birth rate was 44.9%(n = 89), 39% (n = 66) for single pregnancy and 76.6% (n = 23) for twins. The 15 mm thresholdfor transvaginal sonography cervical length (CL) was the most relevant to predict the risk ofpreterm delivery, 77.3% (85/110) of patients with CL > 15 mm having full term delivery. © 2013 Published by Elsevier Masson SAS.

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