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The major methods for detecting medication errors and associated adverse drug- related events are chart review, computerized monitoring, administrative databases, and claims data, using direct observation, incident reporting, and patient monitoring. All of these methods have both advantages and limitations. Reporting discloses medication errors, can trigger warnings, and encourages the diffusion of a culture of safe practice. Combining and comparing data from various and encourages the diffusion of a culture of safe practice sources increases the reliability of the system. Error prevention can be planned by means of retroactive and proactive tools, such as audit and Failure Mode, Effect, and Criticality Analysis (FMECA). Audit is also an educational activity, which promotes high- quality care; it should be carried out regularly. In an audit cycle we can compare what is actually done against reference standards and put in place corrective actions to improve the performances of individuals and systems. Patient safety must be the first aim in every setting, in order to build safer systems, learning from errors and reducing the human and fiscal costs. Keywords: clinical audit, clinical risk management, incident reporting, medication error, patient safety. Medication errors and drug- related adverse events have important implications – from increased length of hospitalization and costs to undue discomfort and disability or increased mortality [1, 2]. Reason has proposed two approaches to considering errors and accidents [3]. First, identify individual problems and deficiencies that can lead to error; second, analyse faulty systems design. Problems with both individuals and systems are responsible for most accidents. View and Download 3Com NBX 100 installation manual online. 3Com NBX 100: Installation Guide. NBX 100 Telephone pdf manual download. Page 1: Installation Guide Installation Guide ® V3000 Analog V3000 BRI V3001R V5000 NBX 100 Release 6.0 Part. Computerized monitoring Computerized monitoring is the modern version of voluntary pharmacist reporting (pharmacy logs) []. Pharmacists detect order errors, rectify them, and fill out a report. Medication errors can thus be intercepted before adverse events occur. Easily find and download software and drivers for your HP products including pcs, laptops, desktops, printers, tablets, apps and services from HP Customer Support. Let HP find my products Identify now HP can identify most HP products and recommend. Mirekusoft Install Monitor XMLFox Visual Studio XML Editor ClickCharts Flowchart Software Free reaConverter Pro Alarm Clock Tipard Android Data Recovery for Mac. This file contains the drivers for the 3Com USB modem product ID 00560500 for Windows This. Shuttle SB81P FB81V1.x Bios 1.02360 KB / Windows AllFixed BIOS cant detect fan speed issue after clear CMOSFixed power LED Brightness function fail issue, when system resume from S3Changed the PCI-E / PCI CLK item string to PCI CLK. GIGABYTE. Get support for your Dell product with free diagnostic tests, drivers, downloads, how-to articles, videos, FAQs and community forums. Or speak with a Dell technical expert by. However, individual problems can also result from defective systems. The frequency and severity of medication errors are not evenly distributed in the population, and there are clusters of patients, drugs, and settings that are associated with higher risks; however, these can generally be attributed to common underlying contributory/latent factors [4, 5]. Detection. In order to build safer systems we must be able to learn from previous errors [6], and detection is the first crucial step. Scientific societies and surveillance agencies, reviews, original studies, and case reports may warn us to be on the alert and promote knowledge of risks and improved performance. For this purpose, reports, alerts and recommendations are available on the web, issued by national and federal healthcare systems, regulatory agencies, and non- profit- making organizations [the Food and Drug Administration (FDA), European Medicines Agency (EMEA), United States Pharmacopeia (USP- MEDMARX), UK – National Health Service (NHS), Veterans Health Administration (VHA), Australian Patient Safety Foundation (APSF), Joint Commission on the Accreditation of Healthcare Organizations (JCAHO)][7, 8]. The approaches used to detect errors are likely to be different in research and routine care, given the available resources [9]. In order to prevent medication errors and reduce the risks of harm, organizations need tools to detect them [1. Any system must then be able to analyse errors and identify opportunities for quality improvement and system changes. The major methods for detecting adverse events are chart review, computerized monitoring, incident reporting, and searching claims data. Medication errors are mainly detected by means of direct observation, voluntary reporting (by doctors, pharmacists, nurses, patients, and others) and chart review. Research applies combined methods. The advantages and limits of the main methods are summarized in Table 1; here are notes on the most interesting ones [1. Detection methods used to investigate medication errors and adverse events. Chart review. Chart review is retrospective and based on practice sources (medical charts and laboratory data, prescription data, and administrative data) [2, 1. It can be improved by using computerized data, such as electronic medical records, computerized physician order entry (CPOE), and computer- integrated triggers. Chart review is the most precise approach for detecting adverse events, but is less good at detecting medication errors. Cases are evaluated independently by two or more experts. Good planning is required for definitions, inclusion criteria, and triggers. The downsides of this method are the difficulty in training reviewers (nurses, pharmacists, students, research assistants) and the resources needed, both fiscal and human. Furthermore, the results depend on the quality of documentation and reviewers' abilities to capture triggers. Computerized monitoring. Computerized monitoring is the modern version of voluntary pharmacist reporting (pharmacy logs) [1. Pharmacists detect order errors, rectify them, and fill out a report. Medication errors can thus be intercepted before adverse events occur. If CPOE is in use, prescription and dispensing errors may be readily detected [1. Advanced software implementation supports integration of laboratory and clinical data with Clinical Decision Support Systems (CDSS), providing detection and prevention of adverse events. CPOE systems improve safety, but need to be used in combination with CDSS. Implementation of information technology is costly and necessary for safety, but it can also give rise to new, unknown risks. Administrative databases. Administrative databases screen International Classification of Diseases, 9th revision codes, for statistical purposes. Patient safety indexes and adverse event- adjusted rates are elaborated from a combination of discharge data. However, adverse events are poorly detected, because of the lack of clinical data. Claims data. The value of screening of claims data is limited by the underlying reasons for litigation, which are sometimes frivolous, and by the involvement of small numbers of local claims. Events often still need to be confirmed, and about one- third of claims lack evidence of errors. Claims data have a positive predictive value for adverse events of about 5. Direct observation. Direct observation is the only method available for detecting errors of administration of medications. A trained nurse observes drug administration, registers each action, and then compares what was done with the original physician orders. The observer must be trained and visits different units in sequence. Reporting systems. Reporting systems derive from procedures in high- reliability organizations. However, their application to health systems is quite difficult. Reports submitted to management or legal services can cause misunderstanding and carry a connotation of blame. Furthermore, reports may concern different organizations, according to the field of application, causing multiplication and incorrect analysis. The Royal College of Anaesthetists was the first to use an incident reporting system in the UK in 1. Nowadays, every health system requires reporting, either directly (the VHA in the USA, the Ministero della Salute in Italy), or by specific agencies [Australian Institute of Medical Scientists in Australia, National Report Learning System (NRLS) in the UK]. The Joint Commission in the USA (formerly the Joint Commission on the Accreditation of Healthcare Organizations) analyses reports from accredited care settings, and issues alerts and recommendations based on integrated data analysis. National Patient Safety Goals (NPSGs) are then elaborated, with subsequent practice suggestions and improved standards of quality to be fulfilled. In the UK the National Patient Safety Agency (NPSA) has developed the first comprehensive NRLS and has set up the Patient Safety Observatory to compare and combine data from the NRLS with other sources of information, such as litigation bodies, industry, healthcare organizations, and patients. Drug- related reports are also collected by specific surveillance agencies (USP- MEDMARX, FDA, EMEA, Italian Pharmaceutical Agency (AIFA)). Major organizations are now trying to integrate a wider database, as latent failures and system errors are widespread and often repetitive [6, 7, 1. There are two safety- oriented levels of reports: Incident reporting Where this is in place, it is obligatory and restricted to severe unexpected events/deaths (sentinel event list). A timely narrative report of the incident must be sent, with root cause analysis, to the central organization, which issues regular statistical reports, capturing both adverse events and medication errors and raising concerns about quality improvement. Voluntary reporting Voluntary reporting must be anonymous, confidential, and blame- free. A simple structured form is required to help reporting and analysis. Feedback, regular reports, and the implementation of corrective actions are all necessary [1. Near misses and medication errors are usually reported, but rarely adverse events [1. An increasing number of reports does not necessarily betoken poor practice, but is related to improved capture of events. The advantages of voluntary reporting are the discovery of active and latent systems failures, evidence of the critical nature of processes, the correction of contributory factors, and the diffusion of a culture of safety [1. Every experience underlines the existence of common barriers to physician involvement in reporting of errors, in fact this is minimal compared with the nurses' involvement [1.
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You'll also find cafes for casual outdoor dining, fusion and international restaurants, bar- restaurants, and 3 new establishments that have been awarded the prestigious Michelin star. Be aware that many Greek restaurants do not accept credit cards. Aegli. This chic bistro in the Zappeion Gardens serves fine international cuisine, with specialties including oysters and tenderloin with ginger and coffee sauce. Watch a movie at the open- air cinema, or celebrate with delicious crème brûlée at a table under the trees. Bar Guru Bar. A favorite Athenian destination with excellent Thai- Asian dishes in an exciting setting. The bustling bar that serves great Thai martinis and jazz swings until 4am on the top floor. The Burmese chicken with caramelized onions and coconut milk is highly recommended. Kalliste. Elegant Greek cuisine with a modern twist, this refuge of a restaurant is housed in a beautiful 1. Milos. An absolute must for any seafood lover, featuring fresh catches sent straight from the fishing boats then exquisitely prepared. Expensive but worth it. El Pecado. Exceptional Spanish and South American cuisine in sexy bar- restaurant surroundings. Enjoy excellent empanadas, chocolate soufflés, fine wines, the murals, the music, and a jumping scene. Socrates Prison Taverna. Close to the Acropolis, with loads of atmosphere, excellent grilled chicken, roast lamb, and other meats and vegetables, delicious mezedes, great wine, and outdoor tables. Spondi. Spondi earned its second Michelin star in 2. French- inspired gourmet dishes that are beautifully presented in the stone- walled dining room or outside in the pretty shaded courtyard. Taverna Sigalas. This fun taverna on the Plaka has been run by the same family for a century and serves hearty stews, moussaka, gyros, and other Greek fare to the accompaniment of Greek Muzak. Tellis. You'll find budget décor and budget prices at this popular restaurant, which serves gigantic portions of amazing Greek fare such as grilled lamb chops, oven- roasted lemon potatoes, and salads. Nightlife in Athens is sophisticated and varied—from bars, bar- restaurants, lounges, and nightclubs to theater, opera, dance, and concerts. At the clubs, the real action doesn't begin until around midnight. The downtown hotels house some of the city's most happening bars, and you'll find a lively scene and music at the many terrific bar- restaurants. Welcome to Hellenic Private Tours. My name is Frank Kotsiopoulos and as the manager of Hellenic Private Tours, I welcome you to Athens - Greece, the land of democracy. Loipon, g n mn leme k pl pl, h avril exei kataplhktikh fwnh k teleia tragoudictria ein. Opoios gouctarei g avril, n tn akouei, opoios dn gouctarei, uparxoun k alloi g.Athens with children. Children are children and they always will be whether they live in a big town or in the country. Piraeus, which roughly means 'the place over the passage', has been inhabited since the 26th century BC. In prehistoric times, Piraeus was a rocky island consisting. To find a great concentration of nightlife in one spot, head to the Gazi neighborhood. Since large clubs in Athens have steep cover charges and drink prices to match, ask at your hotel for a good recommendation. Where should I go shopping? You can find finely crafted silver and gold jewelry, ceramics, hand- woven rugs, and leather goods in Athens, though you may not find great bargains unless you're shopping during the sale months of January and August. Greek wine and spirits, olive oil, honey, worry beads, and small ceramic plaques make affordable souvenirs. Prices are as marked, and haggling is frowned upon. The mile- long, pedestrianized Ermou Street is the center of Athens' prime shopping district, where the fashion- conscious flock to buy jewelry, shoes, and fashions at trendy retail chains and small boutique shops. Plaka—the picturesque historic neighborhood at the base of the Acropolis—is where you'll find a labyrinth of pedestrian streets teeming with bazaar- style souvenir shops that carry everything from T- shirts, trinkets, sandals, and reproductions of antiquities, to ceramics, textiles, and jewelry of varying quality. Head to the Monastiraki neighborhood's flea market on Sunday for retro clothing, antiques, and other unexpected finds. The Center of Hellenic Tradition in Athens is an outlet where you can shop for good quality traditional Greek art, including icons, pottery, ceramics, wood carvings, embroideries, weavings, and prints. On the slopes of Mount Likavitos, in the Kolonaki area, you'll find many of Athens' most exclusive boutiques. Don't miss the gloriously expensive shops along the pedestrian streets of Tsakalof and Anagnostopoulou. When are the local events? Athens Carnival. Feb - Mar. Central Square is the epicenter of this traditional festival, where performers often wear folk costumes sporting bells and entertain audiences with Greek dancing, mandolin tunes, and more. Clean Monday. The first day of Lent. Rich pageantry, colorful kites, and music fill the air, and visitors have the opportunity to savor delicacies such as octopus, shrimp, bread, olives, and sweet halvah while sipping wine and dancing to traditional Greek music. Easter. Church bells and hymns can be heard all over the city during Holy Week, culminating in the spectacular Greek Orthodox Epitaph procession and candle vigil on Good Friday. Lycabettus (Likavitos) Festival. Summer. Pop musicians perform at the outdoor amphitheater near the top of Mount Likavitos. Athens Festival. Early June through mid- July. Features exciting music, theater, and dance performances by famous Greek and foreign artists—on the slopes of the Acropolis and in other impressive venues—to celebrate all forms of artistic expression. Athens International Dance Festival. The first 2 weeks in July. Dance enthusiasts enjoy dynamic performances during this contemporary dance festival at the Technopolis arts complex in the Gazi neighborhood. The August Full Moon. August. On the night of the August full moon, the city opens its monuments and archeological sites to the public for free, and stages moonlit concerts and other free events. Athens Marathon. November. The original marathon, which begins in the town of Marathon itself and ends at the Panathenaic Stadium in Athens. Travel tidbits. The Acropolis. The Acropolis, home to the Parthenon, Greece's most famous temple, is an absolute must- see. But crowds and heat can distract you from the site's sheer magic, so time your visit after 5pm in the summer, when the crowds have thinned and the late- afternoon light paints the white marble a warm, rich honey. Greek Theater. For an unforgettable experience, attend a Greek tragedy or comedy under the stars at a magnificent ancient theater: the Odeion of Herodes Atticus theater, on the slopes of the Acropolis, or the theater at Epidaurus (2 hours outside Athens, bus excursions available). It's a thrill to sit beneath Greece's night sky in a place where audiences have watched performances for thousands of years. The Grand Promenade. Stroll this unique paved footpath as it winds around the base of the Acropolis. On one side of the path, you'll be able to view an amazing cross- section of Athenian history—marble temples, Byzantine churches, ancient theaters, and neoclassical museums. The other side of the path bustles with sidewalk cafes, galleries, renovated mansions, and rotating outdoor art installations. Good to Know. Eleftherios Venizelos International Airport ATHApril - mid- June and September - mid- October. November - March. Euro. Greek. Athens is 8 hours ahead of Central Standard Time. |
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