The Experts below are selected from a list of 213 Experts worldwide ranked by ideXlab platform
Milton Tenenbein - One of the best experts on this subject based on the ideXlab platform.
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Unit Dose packaging of iron supplements and reduction of iron poisoning in young children
JAMA Pediatrics, 2005Co-Authors: Milton TenenbeinAbstract:BACKGROUND: Iron poisoning is a major cause of unintentional poisoning death in young children. The US Food and Drug Administration proclaimed a regulation for Unit-Dose packaging of iron supplements in 1997. OBJECTIVE: To determine whether the requirement for Unit-Dose packaging of iron supplements decreases the incidence of iron ingestion and the incidence of deaths due to iron poisoning in children younger than 6 years. METHODS: This is a preintervention-postintervention study of the US federally mandated requirement for Unit-Dose packaging of iron supplements. The 10 years prior to the intervention were compared with the 5 years after its promulgation. The incidences of iron ingestion and of iron poisoning deaths for children younger than 6 years were obtained from the annual reports of the American Association of Poison Control Centers (Washington, DC). RESULTS: The average number of iron ingestion calls per 1000 of all calls to poison control centers regarding children younger than 6 years decreased from 2.99 per 1000 to 1.91 per 1000 (odds ratio, 1.29 [95% confidence interval, 1.27-1.32]; P<.001). The number of deaths decreased from 29 to 1 (odds ratio, 13.56 [95% confidence interval, 1.85-99.52]; P = .03). CONCLUSIONS: These are the first data that show a decrease in the incidence of nonintentional ingestion of a specific drug by young children and a decrease in mortality from poisoning by this drug after the introduction of Unit-Dose packaging. There was a decrease in the incidence of iron ingestion and a dramatic decrease in the number of deaths due to iron poisoning. This validates Unit-Dose packaging as an effective strategy for the prevention of iron poisoning and iron poisoning deaths in young children. This highly effective intervention should be considered for other medications with a high hazard for morbidity and mortality when taken as an overDose.
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Unit-Dose packaging of iron supplements and reduction of iron poisoning in young children.
JAMA Pediatrics, 2005Co-Authors: Milton TenenbeinAbstract:BACKGROUND: Iron poisoning is a major cause of unintentional poisoning death in young children. The US Food and Drug Administration proclaimed a regulation for Unit-Dose packaging of iron supplements in 1997. OBJECTIVE: To determine whether the requirement for Unit-Dose packaging of iron supplements decreases the incidence of iron ingestion and the incidence of deaths due to iron poisoning in children younger than 6 years. METHODS: This is a preintervention-postintervention study of the US federally mandated requirement for Unit-Dose packaging of iron supplements. The 10 years prior to the intervention were compared with the 5 years after its promulgation. The incidences of iron ingestion and of iron poisoning deaths for children younger than 6 years were obtained from the annual reports of the American Association of Poison Control Centers (Washington, DC). RESULTS: The average number of iron ingestion calls per 1000 of all calls to poison control centers regarding children younger than 6 years decreased from 2.99 per 1000 to 1.91 per 1000 (odds ratio, 1.29 [95% confidence interval, 1.27-1.32]; P
Susan R B Weiss - One of the best experts on this subject based on the ideXlab platform.
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importance of a standard Unit Dose for cannabis research
Addiction, 2020Co-Authors: Nora D Volkow, Susan R B WeissAbstract:Commentary: Recognizing the increasing diversity of cannabis products and their expanded use, Freeman & Lorenzetti propose a standard Unit Dose of 5 mg 9‐tetrahydrocannabinol (THC) to be used for all cannabis products, regardless of method of administration. They argue that a standard Dose would help to guide consumers towards safer patterns of cannabis use. The National Institute on Drug Abuse (NIDA) strongly supports the need for a standardized measure to facilitate research, and this was a key recommendation from NIDA's Cannabis Policy Research Council Workgroup....
Rita Shane - One of the best experts on this subject based on the ideXlab platform.
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evaluating the accuracy of technicians and pharmacists in checking Unit Dose medication cassettes
American Journal of Health-system Pharmacy, 2002Co-Authors: Peter J Ambrose, Frank G Saya, Larry T Lovett, Dale W Adams, Rita ShaneAbstract:The accuracy rates of board-registered pharmacy technicians and pharmacists in checking Unit Dose medication cassettes in the inpatient setting at two separate institutions were examined. Cedars-Sinai Medical Center and Long Beach Memorial Medical Center, both in Los Angeles county, petitioned the California State Board of Pharmacy to approve a waiver of the California Code of Regulations to conduct an experimental program to compare the accuracy of Unit Dose medication cassettes checked by pharmacists with that of cassettes checked by trained, certified pharmacy technicians. The study consisted of three parts: assessing pharmacist baseline checking accuracy (Phase I), developing a technician-training program and certifying technicians who completed the didactic and practical training (Phase II), and evaluating the accuracy of certified technicians checking Unit Dose medication cassettes as a daily function (Phase III). Twenty-nine pharmacists and 41 technicians (3 of whom were pharmacy interns) participated in the study. Of the technicians, all 41 successfully completed the didactic and practical training, 39 successfully completed the audits and became certified checkers, and 2 (including 1 of the interns) did not complete the certification audits because they were reassigned to another work area or had resigned. In Phase II, the observed accuracy rate and its lower confidence limit exceeded the predetermined minimum requirement of 99.8% for a certified checker. The mean accuracy rates for technicians were identical at the two institutions (p = 1.0). The difference in mean accuracy rates between pharmacists (99.52%; 95% confidence interval [CI] 99.44-99.58%) and technicians, (99.89%; 95% CI 99.87-99.90%) was significant (p < 0.0001). Inpatient technicians who had been trained and certified in a closely supervised program that incorporated quality assurance mechanisms could safely and accurately check Unit Dose medication cassettes filled by other technicians.
Scott J. Mason - One of the best experts on this subject based on the ideXlab platform.
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White Paper on Hospital Pharmacy Unit-Dose Acquisition and the Case for the Third-Party Repackaging Option
2020Co-Authors: Russell D. Meller, Jennifer A. Pazour, Sarah Root, Lisa M. Thomas, Scott J. Mason, William W. ChurchillAbstract:Our research team from the Center for Innovation in Healthcare Logistics (CIHL) was asked to develop better logistical strategies for securing medications in Unit-Dose form to support the best practice of barcode-enabled point-of-care (BPOC) administration. To aid us in our research, a CIHL strategic partner, the VHA hospital network, was utilized to provide in-depth background on hospital pharmacy strategic, tactical and operational methods. One of the pharmacy directors from the VHA network was able to also provide specific, case-study data. Together we designed and administered a survey to provide a more complete view of the landscape [12]. This white paper discusses the current state-of-practice, including the options available for securing medications in Unit-Dose form, as well as the options available for repackaging in the pharmacy. We then discuss the third-party repackaging option, including its positives and negatives. Our overall recommendation is to work towards the third-party option and so we discuss the challenges that need to be overcome for this to become a widespread practice. Finally, the impact of current and expected pedigree requirements on this issue are discussed.
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Survey of Hospital Pharmacy Directors: Assessment of the Current State of Unit-Dose Acquisition
The Journal of pharmacy technology, 2020Co-Authors: Scott J. Mason, Jennifer A. Pazour, Russell D. Meller, Lisa M. Thomas, Sarah RootAbstract:Background: Many hospitals are in the planning stage of barcode point-of-care (BPOC) implementation. One of the challenges that hospital pharmacies face in BPOC implementation is Unit-Dose acquisition. Objective: This article presents the results of a survey of hospital pharmacy directors to assess the current state of Unit-Dose acquisition to support bedside barcode-enabled dispensing practices. Methods: An online survey was administered over 2 months and was available from September to November 2008. The University of Arkansas Institutional Review Board approved the survey before it was disseminated. The survey was developed in collaboration with 2 hospital pharmacy directors. Ninety-one valid survey responses were representative in terms of the distribution of hospital size compared with previous surveys of the American Society of Health-System Pharmacists. Though there were 91 total respondents, not all provided responses to all of the survey questions. Thus, some of the figures, tables, and text refer to fewer than 91 respondents. Results: The results of interest to pharmacy technicians indicated that most hospitals today are able to purchase at least 40% of their medications in Unit-Dose packaging directly from the manufacturer. For medications that cannot be acquired in Unit-Dose packaging, 85% of the hospitals surveyed perform repackaging operations in-house. However, 87% of the hospitals that use a high-speed oral solid repackager only use this equipment, at most, 4 hours per day. Our survey results showed that only 8% of the hospitals surveyed used a third-party repackager to acquire Unit-Dose medications, compared with 85% of hospitals that are either currently using or in the planning phase of using BPOC. Conclusions: The survey found that most hospital pharmacy directors choose to repackage medications in-house, despite the high cost of repackaging equipment and a relatively low utilization of that equipment. Hospitals indicated that cost and turnaround time were the 2 issues of greatest concern when considering outsourcing Unit-Dose medication repackaging to a third-party repackager.
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SELECTING AND ALLOCATING REPACKAGING TECHNOLOGY FOR Unit-Dose MEDICATIONS IN HOSPITAL PHARMACIES
International Journal of Innovation and Technology Management, 2013Co-Authors: Jennifer A. Pazour, Sarah Root, Russell D. Meller, Lisa M. Thomas, Scott J. MasonAbstract:To increase patient safety and support bedside-point-of-care medication administration, millions of Unit-Dose medications are dispensed in hospitals and health systems daily. Because not all medications are available in Unit-Dose form directly from the manufacturer, hospitals must repackage medications in Unit-Dose form themselves. We develop a mathematical model that simultaneously determines which level of technology is warranted and how each medication that is not delivered to the pharmacy in Unit-Dose form should be repackaged subject to multiple constraints. This model has been integrated into a free Excel-based tool available to pharmacy directors. We test our model with data based on small, medium, and large hospitals and conduct sensitivity analyses to gain further insight. We illustrate how the results from our model can aid in incorporating qualitative aspects into technology selection. Our results show that a semi-automated repackaging system is the most economical technology alternative for most hospital pharmacy in-house repackaging operations. This result, however, is sensitive to the number of Unit-Dose medications to repackage and the available labor.
Nora D Volkow - One of the best experts on this subject based on the ideXlab platform.
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importance of a standard Unit Dose for cannabis research
Addiction, 2020Co-Authors: Nora D Volkow, Susan R B WeissAbstract:Commentary: Recognizing the increasing diversity of cannabis products and their expanded use, Freeman & Lorenzetti propose a standard Unit Dose of 5 mg 9‐tetrahydrocannabinol (THC) to be used for all cannabis products, regardless of method of administration. They argue that a standard Dose would help to guide consumers towards safer patterns of cannabis use. The National Institute on Drug Abuse (NIDA) strongly supports the need for a standardized measure to facilitate research, and this was a key recommendation from NIDA's Cannabis Policy Research Council Workgroup....
