The Safety And Effectiveness Of Hospital E-prescribing Systems: A Controlled Time Series Study
Funder
National Health and Medical Research Council
Funding Amount
$740,460.00
Summary
Prescribing errors represent a significant public health issue internationally. In the US over 770,000 people are harmed or die each year in hospitals as a result of adverse drug events. In Australia 2% of hospital patients experience harm or death due to medication errors. The risk of these errors is rising each year with the increased intensity of medical care, use of complex and potent drug regimens and the increasing age and severity of hospital patients. Electronic prescribing systems are b ....Prescribing errors represent a significant public health issue internationally. In the US over 770,000 people are harmed or die each year in hospitals as a result of adverse drug events. In Australia 2% of hospital patients experience harm or death due to medication errors. The risk of these errors is rising each year with the increased intensity of medical care, use of complex and potent drug regimens and the increasing age and severity of hospital patients. Electronic prescribing systems are believed to significantly reduce the number of errors which occur and reduce harm to patients as a result. No studies have demonstrated that these systems result in reducing prescribing errors that cause harm to patients. Alarmingly, anecdotal evidence from overseas suggests that use of electronic prescribing systems introduces new types of errors. This is consistent with a growing body of scientific research which suggests that individuals' decision-making may be significantly influenced by information generated by a computer, resulting in new types of errors. The aim of this project is to undertake a controlled time series study to assess the safety and effectiveness of two electronic prescribing systems to reduce prescribing errors in Australian hospitals. The study will compare error rates before and after the introduction of the systems. In addition, the study will be the first to focus on measuring new types of errors that may result from system use and to investigate how computer use influences clinicians' decision-making. This study will provide critical information about the effectiveness and safety of these systems which are being introduced into Australian hospitals. Unlike other medical interventions, which require stringent safety testing before use with patients, there are no minimum safety requirements for electronic prescribing systems. The data from this study is urgent in developing recommendations to ensure the safety of electronic prescribing systems for Australia.Read moreRead less
Investigation Of A New Electronic Portal Imaging Device For Radiation Therapy Dose Delivery Verification
Funder
National Health and Medical Research Council
Funding Amount
$408,101.00
Summary
In external beam radiotherapy highly complex radiation fields are used to deliver high doses of radiation to the tumour while sparing normal tissues. Inaccurate treatment could result in poor patient outcome or damage to normal tissues. We aim to investigate a novel imaging device to measure the dose accuracy of these fields. This work has the potential to make a significant and fundamental difference to existing verification techniques for radiotherapy treatments to ensure patient outcomes.
Evaluation Of A Novel Electronic Decision Support Tool For Cardiovascular Risk Management - The TORPEDO Study
Funder
National Health and Medical Research Council
Funding Amount
$587,175.00
Summary
The TORPEDO study will test a new electronic decision support system that will help health professionals and patients navigate through the complexities of current clinical guidelines for treatments to help prevent heart attack, stroke and related conditions. The study will be conducted in 60 practices over 12 months, and if the system is found to be useful, this may prove to be helpful in the day-to-day management of all Australian adults when visiting their doctor.
The Use Of Electronic Portal Imaging Devices For The Dosimetric Verification Of Complex Radiotherapy Treatments
Funder
National Health and Medical Research Council
Funding Amount
$260,949.00
Summary
The prognosis for someone diagnosed with cancer is much better than commonly believed. If detected early, malignant tumours are generally well localised. During these early stages of tumour growth high doses of radiation therapy can with a high probability, eradicate a cancer but come with the cost of causing unacceptable damage to normal tissue. A specific goal of improving the technology of radiation therapy is to reduce the probability of damage to normal tissue. Achieving this goal may allow ....The prognosis for someone diagnosed with cancer is much better than commonly believed. If detected early, malignant tumours are generally well localised. During these early stages of tumour growth high doses of radiation therapy can with a high probability, eradicate a cancer but come with the cost of causing unacceptable damage to normal tissue. A specific goal of improving the technology of radiation therapy is to reduce the probability of damage to normal tissue. Achieving this goal may allow delivery of higher doses with an associated increase in the chance of controlling the tumour. One of the challenges in radiation therapy is that tumours do not come in shapes that are easy to treat. Tumours extend into cavities and push aside healthy organs growing into complex 3D shapes. The careful shaping of the radiation beams to deliver dose distributions that match the 3D shape of the target is known as 3D conformal radiotherapy (3DCRT). Intensity Modulated Radiotherapy (IMRT) is an advanced form of 3DCRT that allows the delivered dose to be closely tailored to the shape of complex tumour volumes while sparing neighbouring healthy tissues. One of the consequences of increasing the conformality of radiation therapy is an increased sensitivity to errors in the preparation and execution of the treatment. If the maximum gain in the treatment outcome using 3DCRT and IMRT techniques is to be achieved then it is crucial that the correct volume is treated to the correct dose on each day of the treatment. This requires new improved methods and techniques for verifying the daily delivery of the treatment. In this project we aim to develop the use of online digital imaging devices for measuring the delivered dose during treatment. This will increase the confidence with which these new conformal radiotherapy techniques can be delivered allowing their true potential for improving patient treatment outcomes to be realised.Read moreRead less
An Examination Of The Causes Of Mortality Following Imprisonment In New South Wales Using Data-linkage.
Funder
National Health and Medical Research Council
Funding Amount
$205,500.00
Summary
Prisoner populations are characterised by poor health status including infectious diseases, injury, risk taking behaviours (eg. smoking and self-harm), mental illness, and substance abuse. Serosurveys of blood borne viruses such as hepatitis C and hepatitis B conducted in Australian and overseas prison settings have found that over one third of inmates have been exposed to these viruses with higher rates detected in injecting drug users and female inmates. Few attempts have been made to examine ....Prisoner populations are characterised by poor health status including infectious diseases, injury, risk taking behaviours (eg. smoking and self-harm), mental illness, and substance abuse. Serosurveys of blood borne viruses such as hepatitis C and hepatitis B conducted in Australian and overseas prison settings have found that over one third of inmates have been exposed to these viruses with higher rates detected in injecting drug users and female inmates. Few attempts have been made to examine the causes of mortality among prisoners following release from detention. Most interest has focused on overdoses in the period immediately following release; the aim of this study will examine all causes of death among individuals exposed to the correctional environment and compare these to death rates for NSW. Correctional centres house a largely male (94% in NSW) population with backgrounds of disadvantage in all areas, including Indigenous Australians, people of lower socio-economic status, those with a mental illness, and the intellectually disabled. There are currently over 21,000 (June 2001) prisoners detained in Australian correctional centres with approximately 39% housed in NSW. Fifteen percent of the NSW prisoners are Indigenous but comprise only 2% of the general population. The aims of this project will be to: (1) Identify all causes of death among ex-prisoners in NSW for the period 1985 to 2001; (2). Compare death rates in the study group with those in the NSW community; (3) Correlate pre-release health information contained in medical records with specific causes of death; (4) Compare causes of mortality among various sub-groups eg. injecting drug users, the mentally ill, violent offenders, and the intellectually disabled; (5) Examine causes of mortality between Indigenous and non-Indigenous inmates; and (6) use this information to develop pre-release programmes aimed at reducing excess mortality among this group.Read moreRead less
The Impact Of Electronic Medication Administration Records (e-MAR) On Medication Administration Safety And Nurses' Work
Funder
National Health and Medical Research Council
Funding Amount
$735,675.00
Summary
The demands on health systems, both nationally and internationally, are growing, exacerbated by an ageing population and health workforce shortages. The incorporation of information technology into new health care delivery models promises both improvements in the safety and efficiency of care delivery. Medication errors are one of the most significant safety issues for health care systems. Medication management occupies a significant amount of nurses' time, and is also fraught with error potenti ....The demands on health systems, both nationally and internationally, are growing, exacerbated by an ageing population and health workforce shortages. The incorporation of information technology into new health care delivery models promises both improvements in the safety and efficiency of care delivery. Medication errors are one of the most significant safety issues for health care systems. Medication management occupies a significant amount of nurses' time, and is also fraught with error potential. One-third of all medication errors that cause patient harm arise from medication administration errors (MAEs). Electronic medication administration records (e-MARs) provide the potential to make the administration of medications safer for patients by reducing error rates, and also by allowing nurses to more efficiently manage medication tasks. However there is very limited research from Australia or overseas which has examined whether they computerised system work and in fact reduce error rates or save nurses time. In this project we will conduct prospective, controlled observational studies to determine the effectiveness of an electronic medication administration record (e-MAR) to reduce MAEs and the amount of time nurses spend in the medication administration process. The project will apply innovative data collection tools using PDA software purpose-built for these studies which have undergone extensive pilot testing in clinical settings. The results will have important implications for hospitals across Australia and internationally as they consider the implementation of e-MARs. This research will provide the first comprehensive data of medication administration errors in Australia against which future preventative error strategies can be evaluated. The results will provide the evidence needed to develop recommendations about how to reduce MAEs and improve the design of e-MARs.Read moreRead less
Improving Outcomes Of Radiotherapy Treatments Through In-vivo Dosimetric Verification
Funder
National Health and Medical Research Council
Funding Amount
$379,855.00
Summary
Radiotherapy remains an important non-surgical treatment for over 50 % of cancer patients. This project aims to develop methods that will enable the optimisation of the patients' treatment as it progresses by non-invasively measuring the radiation dose delivered each day. This will increase the likelihood of curing the patient as well as reducing the side effects experienced due to the treatment. This will improve the patients' quality of life post-treatment.
This study will follow up over 12,000 men aged 65-83 years who have previously completed a questionnaire about their medical, social, family and occupational history and lifestyle and have undergone a simple physical examination (height, weight, waist, girth at the hips and blood pressure). The first aim is to determine which of these factors predicts serious ill-health from heart disease, stroke and certain cancers in old age. In addition, we will test the hypothesis that risk factors for heart ....This study will follow up over 12,000 men aged 65-83 years who have previously completed a questionnaire about their medical, social, family and occupational history and lifestyle and have undergone a simple physical examination (height, weight, waist, girth at the hips and blood pressure). The first aim is to determine which of these factors predicts serious ill-health from heart disease, stroke and certain cancers in old age. In addition, we will test the hypothesis that risk factors for heart disease also predict the development of dementia because it seems that part of dementia in some patients is explained by their having suffered multiple small strokes. Finally, we will examine the relationship between development of dementia and previous major surgery as there is growing evidence that major surgical operations in older patients can be followed by confusion and impairment of thinking that may never recover fully. The overall aim is to discover preventable factors for several of the leading causes of ill-health in old age.Read moreRead less
Reliability Of An Online Geriatric Assessment Procedure
Funder
National Health and Medical Research Council
Funding Amount
$343,822.00
Summary
This study will examine the reliability, safety and cost of a novel new method of providing geriatrician assessment to older people in hospital. Nurses consult with the patient and enter their findings on a web-based software system that enables the geriatrician to review, report and make recommendations over the internet.