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| 1 | An automated dispensing system for improving medication timing in the emergency department显示文摘BACKGROUND:Numerous medical conditions require timely medication administration in the emergency department(ED).Automated dispensing systems(ADSs)store premixed common doses at the point-of-care to minimize time to administration,but the use of such automation to improved time to medication administration has not been studied.Since vancomycin is a commonly used empiric antimicrobial,we sought to quantify the effect of using an ADS on time to drug delivery in patients presenting to the ED.The study aimed to determine the efficacy of utilizing an ADS to improve time to administration of vancomycin and determine any negative effects on dosing appropriateness.METHODS:The institional review board approved the retrospective quality improvement study took place in a single,urban academic tertiary care ED with an annual census of 80 000.Study subjects were all patients receiving vancomycin for the management of sepsis between March 1 to September 30,2008 and the same time period in 2009.The primary outcome was the proportion of patients who received vancomycin within one hour of bed placement and the secondary outcome was dosing appropriateness.RESULTS:Sixty-three patients had weight and dosing information available(29 before and 34after intervention)and were included in the study.Before intervention,no patient received vancomycin in less than 60 minutes,while after intervention 14.7%of the patients received it in less than 60minutes(difference in proportions 14.7%,95%CI 0.39%-30.0%,P=0.04).A similar proportion of the patients received correct dosing before and after intervention(44.8%vs.41.2%,difference in proportions 3.7%,95%CI-20.0%-26.7%,P=0.770).CONCLUSION:The use of an ADS may improve the timing of medication administration in patients presenting to the ED without affecting dosing appropriateness. | Michael J.Ward Jeremy S.Boyd Nicole J.Harger John M.Deledda Carol L.Smith Susan M.Walker Jeffrey D.Hice Kimberly W.Hart Christopher J.Lindsell Stewart W.Wright | 2012 | World Journal of Emergency Medicine2012，3，2： | 6 |
| 2 | The association Between Unsystematic Security Returns and the Magnitude of Earnings Forecast Errors显示文摘 | Beaver W.H R.Clark W.Wright | | 0，，02： | 1 |
| 3 | Differential effects of internal tagging depending on depth treatment in Atlantic salmon:a cautionary tale for aquatic animal tag use显示文摘Electronic tags are widespread tools for studying aquatic animal behavior;however,tags risk behavioral manipulation and negative welfare outcomes.During an experiment to test behavioral differences of Atlantic salmon Sal mo salar in different aquaculture cage types,including ones expected to elicit deeper swimming behavior,we found negative tagging effects depending on whether cages were depth-modified.In the experiment,data storage tags implanted in Atlantic salmon tracked their depth behavior and survival in unmodified sea-cages and depth-modified seacages that forced fish below or into a narrow seawater-or freshwater-filled snorkel tube from a 4 m net roof to the surface.All tagged individuals survived in unmodified cages;however,survival was reduced to 62%in depth-modified cages.Survivors in depth-modified cages spent considerably less time above 4 m than those in unmodified cages,and dying individuals in depth-modified cages tended to position in progressively shallower water.The maximum depth that fish in our study could attain neutral buoyancy was estimated at 22 m in seawater.We calculated that the added tag weight in water reduced this to 8 m,and subtracting the tag volume from the peritoneal cavity where the swim bladder reinflates reduced this further to 4 m.We conclude that the internal tag weight and volume affected buoyancy regulation as well as the survival and behavior of tagged fish.Future tagging studies on aquatic animals should carefully consider the buoyancy-related consequences of internal tags with excess weight in water,and the inclusion of data from dying tagged animals when estimating normal depth behaviors. | Daniel W.WRIGHT Lars H.STIEN Tim DEMPSTER Frode oPPEDAL | 2019 | Current Zoology2019，65，6： | 0 |
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