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Copyright of Canadian Journal of Hospital Pharmacy / Journal Canadien de la Pharmacie Hospitalière is the property of Canadian Society of Hospital Pharmacists and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Purpose: The objective of this pilot study was to determine the frequency of urination and the concentration of four hazardous drugs (cyclophosphamide, ifosfamide, methotrexate, and fluorouracil) in workers' 24-h urine samples in relation to exposure to traces with hazardous drugs. Methods: The study was conducted in three healthcare centers in the region of Montréal, Quebec, Canada. We recruited healthcare workers (nurses and pharmacy technicians) assigned to the hematology-oncology department. Each participant was asked to collect all urine voided during a 24-h period, to fill out an activity journal documenting tasks performed and to document the use of personal protective equipment. Samples were analyzed for cyclophosphamide, ifosfamide, methotrexate, and alpha-fluoro-beta-alanine (FBAL, the main urinary metabolite of 5-fluorouracil). Drugs were quantified by ultra-performance liquid chromatography-tandem mass spectrometry (positive electrospray MRM mode). Results: Eighteen healthcare workers (10 nurses and 8 technicians) were recruited and provided consent to participate. Urine samples were obtained between 1 September and 30 September 2019. The number of urinations over the 24-h collection period ranged from 3 to 11 per participant. A total of 128 urine samples were analyzed for the 18 workers. All urine samples were negative for the four antineoplastics tested. Conclusion: No traces of cyclophosphamide, ifosfamide, methotrexate, or FBAL were found in the 24-h urine samples of 18 healthcare workers practicing in three healthcare facilities in Quebec. Although it was feasible to collect 24-h urine samples in this research project, it appears unrealistic to do so recurrently as part of a large-scale surveillance program. [ABSTRACT FROM AUTHOR]

Objective The objective of this study was to describe women's satisfaction and perceptions on the postpartum self-administered medication (SAM) program at our institution and on pain relief. Also, we aimed at describing maternal and breastfed infants' adverse events with the use of the postpartum SAM program. Method This prospective 1-group mixed methods survey conducted in a mother-and-child tertiary center included women enrolled in the postpartum SAM program who had a live newborn, understood French or English, and were at least 18 years old. Newborns included cohabited with their mother during their hospitalization and had received breast milk at least once. Data were collected through direct interviews using a questionnaire and through medical charts. Results We included 314 mothers and 263 breastfed newborns in the study. Ninety-seven percent of all users appreciated the SAM. The self-reported median overall improvement of pain was 80% (interquartile range, 70%-90%). However, 18% of users who delivered vaginally and 32% who delivered through caesarean would have preferred traditional drug dispensing by the nurse ( P = .009). Drugs used in the SAM program were generally well tolerated. There were no worrisome adverse drug events reported in newborns' medical charts. Conclusion Results show a 97% rate of satisfaction of the SAM program and a high self-reported pain improvement in a cohort of 314 women using our SAM program. The results suggest that the SAM program should remain a standard practice in our institution. Some recommendations will be drawn to better tailor the SAM program to the needs expressed by the users. [ABSTRACT FROM AUTHOR]

Rationale, aims and objectives: The medication‐use system in hospitals is very complex. To improve the health professionals' awareness of the risks of errors related to the medication‐use system, a simulation of medication errors was created. The main objective was to assess the medical, nursing and pharmacy staffs' ability to identify errors related to the medication‐use system using a simulation. The secondary objective was to assess their level of satisfaction. Method: This descriptive cross‐sectional study was conducted in a 500‐bed mother‐and‐child university hospital. A multidisciplinary group set up 30 situations and replicated a patient room and a care unit pharmacy. All hospital staff, including nurses, physicians, pharmacists and pharmacy technicians, was invited. Participants had to detect if a situation contained an error and fill out a response grid. They also answered a satisfaction survey. Results: The simulation was held during 100 hours. A total of 230 professionals visited the simulation, 207 handed in a response grid and 136 answered the satisfaction survey. The participants' overall rate of correct answers was 67.5% ± 13.3% (4073/6036). Among the least detected errors were situations involving a Y‐site infusion incompatibility, an oral syringe preparation and the patient's identification. Participants mainly considered the simulation as effective in identifying incorrect practices (132/136, 97.8%) and relevant to their practice (129/136, 95.6%). Most of them (114/136; 84.4%) intended to change their practices in view of their exposure to the simulation. Conclusions: We implemented a realistic medication‐use system errors simulation in a mother–child hospital, with a wide audience. This simulation was an effective, relevant and innovative tool to raise the health care professionals' awareness of critical processes. [ABSTRACT FROM AUTHOR]

Objective The objective of this article was to critically evaluate the causes of adverse drug events during the nurse medication administration process in paediatric care units in order to identify and prioritize interventions that need to be implemented. Methodology This is a failure mode, effects and criticality analysis (FMECA) study. A multidisciplinary committee composed of nurses, pharmacists, physicians and risk managers evaluated through consensus the process of administering medications at the Centre hospitalier universitaire de Sainte-Justine. By mapping the process, all the failure modes were identified and associated with at least one cause each. Using a summary grid, each failure mode was evaluated by rating frequency (from 1 to 9), likelihood of failure detection (from 0 to 100%) and severity (from 1 to 9) using adapted versions of already published scales. Results A 10-member committee was set up, and it met eight times between January and April 2010. In the two specialized paediatric units selected ( n = 38 beds), an average number of approximately 20 000 drug doses was administered monthly from about 400 non-proprietary names. Through consensus, the committee identified 16 processes and 53 failure modes. While frequency and severity were based on perceptions that could be objectivized with local data and scientific documentation, the likelihood of detection was mainly based on individual perception. Conclusion FMECA is a useful approach to improve the medication process. [ABSTRACT FROM AUTHOR]

Objective The main objective of this pilot study is to compare the professional ethical thinking of Quebec pharmacy residents and French pharmacy interns. The secondary objective is to compare the professional ethical thinking of Quebec pharmacy residents and first year French pharmacy interns. Setting Hospital pharmacy residents from Quebec, Canada and pharmacy interns from France. Methods This is a cross-sectional, descriptive, web-based survey. Main outcome measure For this study, professional ethical thinking was defined as the level of agreement/disagreement with statements about pharmacy ethics/dilemmas. Results A total of 208 usable questionnaires were completed (response rate 91% in Quebec and 11% in France). There were no significant differences between Quebec residents and French interns for 29/43 items (67%). However, there were significant differences in their level of agreement with 14/43 items (33%) surveyed by our questionnaire. The differences related to the following themes: economic aspects (four statements), pharmaceutical care, code of ethics, evaluation, clinical research (two statements each) and training and education, dispensing medications (one statement each). There were statistically significant differences between the two groups in terms of exposure to ethics during academic training and experiential practice. There were significant statistical differences between the two groups of first year pharmacy respondents for 11 statements (26%), with only two out of 11 statements being different from those reported in the overall comparison. Conclusion Published data on the professional ethical thinking of pharmacy residents and interns remain limited. We believe the higher exposure of Quebec residents to ethics during academic courses and experiential/practical training may have contributed to a higher level of agreement with some ethical statements. [ABSTRACT FROM AUTHOR]

Rationale, aims and objectives Ensuring the safety of the medication process is a major world health concern. Within this framework, a field study of compliance at various stages of the medication process in health care units was conducted. The objective of our study was to compare compliance at the moment of drug administration at the patient's bedside before and after implementing certain measures (self-study activities for the nursing staff, publication of the findings of the preliminary study and identification of priorities for action, among others). Methods This is an observational study aimed at comparing compliance at various stages of the medication process in terms of dose verification, preparation and administration, on ward, before and after the implementation of corrective measures. Compliance was evaluated using an observational checklist that included 36 criteria. The evaluation was conducted on inpatients in nine health care units and the Emergency Care Unit of a university hospital centre. Compliance rates were calculated for each evaluated criterion separately and by category. The degree of significance and corresponding changes between 2007 and 2008 were also measured. Results The compliance rate for all the applicable criteria used on the checklist showed a significant increase from 16% in 2007 to 28% in 2008. A significant increase was also observed in the compliance rates for drug verification (91% vs. 76%) and drug preparation on wards (50% vs. 23%), particularly with regard to entering drug names and a second identifier on the label. Conclusions Compliance rates at various separately evaluated stages in 2008 were relatively satisfactory. There is, however, room for improvement in total compliance. The introduction of simple tools and adapted communication strategies led to a sizeable improvement in the medication process at our facility. [ABSTRACT FROM AUTHOR]

Copyright of Canadian Journal of Ophthalmology is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Investigates the availability of antidotes in Quebec hospitals before and after dissemination of guidelines. Reasons for deficient stocking of antidotes; Outcomes of a written survey mailed to the pharmacy directors of hospitals that were members of the Quebec Hospital Association; Recommendations for minimum stocking of antidotes in hospitals; Factors that could contribute to an increase in antidote stocking.