Development and application of a closed-loop medication administration system in University of Hongkong-Shenzhen Hospital

Objective： This study aimed to develop and apply a closed-loop medication administration system in a hospital in order to reduce medication administration errors （MAEs）.Methods： The study was implemented in four pilot general wards. We used a before-and-after design to collect oral medication administration times before and after the implementation of the closed-loop medication administration system, evaluated MAE alert logs after the intervention, and conducted a survey of the nurses1 satisfaction with the system in the pilot wards.Results： （a） Nursing time of oral medication administration： before the adoption of the closed-loop medication administration system, the average nursing time was 31.56 ± 10.88 minutes （n = 78）; after the adoption of the system, the time was 18.74 ± 5.60 minutes （n = 54）. Independent sample Mests showed a significant difference between two groups（t= 8.85, P 〈0.00）. （b） Degree of nurses’ satisfaction with the closed-loop medication administration system： 60.00% （n = 42） of nurses considered the system to be helpful for their work and nearly half of the nurses （47.14%, n = 33） believed that the system could facilitate clinical work and reduce workload; 51.43% {n = 36） believed that the system could reduce checking time and enhance work efficiency; 82.86% （n = 58） believed that the system was helpful in improving checking accuracy to reduce MAEs and ensure patient safety. More than 60% of the nurses considered the system to be a method that could help to track MAEs to improve nursing quality, （c） The MAE alert logs during observation period： it revealed only 27 alerts from the repeated scans of 3,428 instances of medication administration.Conclusions： The nurses were satisfied with the closed-loop medication administration system because it improved their work efficiency and reduced their workload. The current investigation was limited by time; therefore, further research is needed to more closely examine the relationship between the system and MAEs.

Strengthening pharmacotherapy research for COVID-19-induced pulmonary fibrosis

The global spread of severe acute respiratory syndrome coronavirus 2 has resulted in a significant number of individuals developing pulmonary fibrosis(PF),an irreversible lung injury.This condition can manifest within a short inter-val following the onset of pneumonia symptoms,sometimes even within a few days.While lung transplantation is a potentially lifesaving procedure,its limited availability,high costs,intricate surgeries,and risk of immunological rejection present significant drawbacks.The optimal timing of medication administration for coronavirus disease 2019(COVID-19)-induced PF remains controversial.Despite this,it is crucial to explore pharmacotherapy interventions,involving early and preventative treatment as well as pharmacotherapy options for advanced-stage PF.Additionally,studies have demonstrated disparities in anti-fibrotic treatment based on race and gender factors.Genetic mutations may also impact therapeutic efficacy.Enhancing research efforts on pharmacotherapy interventions,while considering relevant pharmacological factors and optimizing the timing and dosage of medication administration,will lead to enhanced,personalized,and fair treatment for individuals impacted by COVID-19-related PF.These measures are crucial in lessening the burden of the disease on healthcare systems and improving patients'quality of life.

Effect of Medication Safety Education Program on Intensive Care Nurses’ Knowledge regarding Medication Errors

Background: Medication errors are the iceberg of patient safety in hospitals and leading cause of morbidity and mortality among patients. Objectives: The study aim was to evaluate the effect of an educational program of medication safety on the knowledge of critical care nurses regarding intravenous medication errors. Methods Design: There are one group pretest and posttest designs. Subject: A convenient sample of all registered nurses (52) works in Palestine Medical Complex. Data collection tools: A self-administered knowledge determination questionnaire consists of both qualitative and quantitative statements to measure level of knowledge, used as data collection tool in pre and post educational sessions, with educational booklet as intervention tool. Statistical analysis: Data were analyzed with Statistical Package for the Social Sciences Software Version 18. The results are presented as frequency & percentage as appropriate at alpha level of P < 0.05;inferential statistics were generated. Paired t-test was used to perform the comparisons. Results: There was statistically significant difference in the knowledge level for the intensive care unit’s nurses regarding the intravenous medication administration during pre and post education program. Statistical analysis showed that there was a statistically significant between age, educational degree, critical units/wards, years of nursing experience and previous medication administration education program of the nurses and their knowledge during different phases of program intervention. Conclusion: Educational program on medication safety improves the knowledge of critical care nurses regarding intravenous medication errors. This study recommends that medication errors should be periodically assessed by improving clinical guidelines of medication administration.

Issues within Keratinocyte Growth Factor （KGF） research

As the seventh member of Fibroblast Growth Factor （FGF） family, Keratinocyte Growth Factor （KGF or FGF-7） is observed tp mediate epithelial cell proliferation and differentiation in a variety of tissues. In this article, such following issues within KGF research were reviewed, as （1） KGF functioning pathways： experimental results demonstrated the paracrine pathway of KGF played main role in mesen- chymal-epithelial interactions whereas KGF itself was under the control of a feedback regulation, autocrine provided KGF alternative functioning way particularly in tumourogenesis; （2） KGF in apoptosis： a few of investigations recently illustrated KGF mediated cell survival was based on its mitogenic function via stimulating cell growth, moreover KGF could inhibit the ROS-induced apoptosis through Nrf-2 pathway; （3） KGF during tumourogenesis： high expression of KGF enhanced progression, motility and invasiveness of tumor cells and various cancers, in company with paracrine loop replaced by autocrine loop, meanwhile KGF clearly played the early signal in the progression of breast cancer; （4） Medical application and administration of KGF： KGF had been successfully used in several preclinical models of radiation and chemotherapy-induced mucositis, and developed into commercial medicine （i.e. Palifermin ）, however more effective delivery systems are still under trial.

China National Medical Products Administration approval summary:anlotinib for the treatment of advanced non-small cell lung cancer after two lines of chemotherapy

Background:On May 8,2018,the China National Medical Products Administration(NMPA)approved anlotinib,an orally administered anti-angiogenesis inhibitor,for the treatment of patients with advanced non-small cell lung can-cer(NSCLC)who have progressed after treatment with two or more lines of prior systemic chemotherapy.Main body of the abstract:China NMPA reviewed and inspected a regional double-blinded,placebo-controlled,Phase III trial comparing the overall survival(OS)of NSCLC patients between the anlotinib and placebo arms.A total of 437 patients were randomized(2:1)to receive either anlotinib(n=294)or placebo(n=143)once daily on a 2-week on and 1-week off schedule.Patients with epidermal growth factor receptor(EGFR)or activating anaplastic lymphoma kinase(ALK)genomic tumor aberrations should have disease progression on NMPA-approved therapy.Anlotinib is the first NMPA-approved drug for patients with advanced NSCLC who have progressed on at least two lines of prior systemic chemotherapies in China.The approval was based on a statistically and clinically significant improvement in median OS with anlotinib(9.46 months)compared with placebo[6.37 months;hazard ratio(HR])=0.70,95%confidence interval(CI)=0.55-0.89;two-sided log-rank P=0.002].The confirmed objective response rate(ORR)was 9.2%in the anlotinib arm and 0.7%in the placebo arm.The median duration of response(DoR)was 4.83 months,with a 95%CI of 3.31-6.97 months.The toxicity profile of anlotinib was consistent with that of known anti-angiogenesis inhibitors.Common adverse drug reactions(ADRs)in anlotinib-treated patients included hypertension(67.4%),hand-foot syndrome(43.9%),hemoptysis(14.0%),thyroid stimulating hormone(TSH)elevation(46.6%),and corrected QT interval(QTc)prolongation(26.2%).Short conclusion:Anlotinib demonstrated a clinically significant OS prolongation as a novel therapeutic option for advanced or metastatic NSCLC following at least two lines of chemotherapy.