***TASK*** the task is to summarize an input biomedical literature in six sentences 
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    Input: BACKGROUND Previous studies found that medication errors result from lack of sufficient information during the prescribing step . Therefore , it is proposed that having a pharmacist available when patients are evaluated during the rounding process may reduce the likelihood of preventable adverse drug events ( ADEs ) . The objectives of this study were to evaluate the impact of having a pharmacist participate with a physician rounding team on preventable ADEs in general medicine units and to document pharmacist interventions made during the rounding process . METHODS A single-blind , st and ard care-controlled study design was used to compare  patients receiving care from a rounding team including a pharmacist with patients receiving st and ard care ( no pharmacist on rounding team ) . Patients admitted to and discharged from the same general medicine unit were included in the study . The main outcome measure of this study was preventable ADEs . Patient records were r and omly selected and evaluated by a blinded process involving independent senior pharmacist specialists and a senior staff physician . Interventions made by the pharmacists in the treatment group were documented . RESULTS The rate of preventable ADEs was reduced by 78 % , from 26.5 per 1000 hospital days to 5.7 per 1000 hospital days . There were 150 documented interventions recommended during the rounding process , 147 of which were accepted by the team . The most common interventions were ( 1 ) dosing-related changes and ( 2 ) recommendations to add a drug to therapy . CONCLUSION Pharmacist participation with the medical rounding team on a general medicine unit contributes to a significant reduction in preventable ADEs AIMS To identify drug usage/withdrawal in surgical patients and the relative risk this imposes on postoperative surgical complications . METHODS A prospect i ve survey of patients ' medicines , oral intake ( food/fluids/ medicines ) and postoperative complications was carried out in the General Surgical Unit , Dunedin Hospital , Dunedin , New Zeal and . RESULTS One thous and and twenty-five general surgical patients aged > /= 16 years , were entered into the study . Half of the patients were taking medicines unrelated to surgery .  On average these patients received 9 different drugs ( range 1 - 47 ) from a selection of 251 , of which 21 % were released in the last 10 years . The mean number of these drugs taken increased with age , vascular surgery and other major procedures . The majority of patients ( 53 % ) were taking drugs for cardiovascular problems . Only 8 % of admissions were on the drugs more traditionally recognized to be of importance to the surgery , i.e. steroids and diabetic therapy . With respect to risk , taking a drug unrelated to surgery was associated with an increased relative risk of a postoperative complication by 2.7 ( 95 % C.I. 1.76 - 4.04 ) compared with those who were not taking any drug . Cardiovascular drugs contributed significantly to this risk ; when they were excluded from analysis , the risk dropped to 1.8 ( 95 % C.I. 1.14 - 2.93 ) . Death may be more common in those taking ACE inhibitors .  Drug withdrawal and complications were analysed and as the time without medicines increased ( range 1 - 42 days ) so did the complication rate ( chi2 = 14.7 , DF = 2 , P = 0.007 ) . Of those patients who were taking a cardiovascular medicine and were without their normal medicines for a period of time postoperatively , 12 % suffered a cardiac complication . CONCLUSIONS Many patients admitted to a general surgical ward , are taking medicines unrelated to surgery . Drug therapy unrelated to surgery is a useful predictor for increased postoperative complications and one for which preventive action can be taken . This study provides evidence that withdrawal of regular medicines may add significant risk to the surgery and further complicate outcome . The longer patients were without their regular medicines the more nonsurgical complications they suffered . Re introduction of patients ' regular medicines early in their postoperative course may decrease morbidity and mortality in- patients Objective . —To develop a new method to improve the detection and characterization of adverse drug events ( ADEs ) in hospital patients . Design . — Prospect i ve study of all patients admitted to our hospital over an 18-month period . Setting . —LDS Hospital , Salt Lake City , Utah , a 520-bed tertiary care center affiliated with the University of Utah School of Medicine , Salt Lake City . Patients . —We developed a computerized ADE monitor , and computer programs were written using an integrated hospital information system to allow for multiple source detection of potential ADEs occurring in hospital patients . Signals of potential ADEs , both voluntary and automated , included sudden medication stop orders , antidote ordering , and certain abnormal laboratory values . Each day , a list of all potential ADEs from these sources was generated , and a pharmacist review ed the medical records of all patients with possible ADEs for accuracy and causality . Verified ADEs were characterized as mild , moderate , or severe and as type A ( dose-dependent or predictable ) or type B ( idiosyncratic or allergic ) reactions , and causality was further measured using a st and ardized scoring method . Outcome Measure . —The number and characterization of ADEs detected . Results . —Over 18 months , we monitored 36 653 hospitalized patients . There were 731 verified ADEs identified in 648 patients , 701 ADEs were characterized as moderate or severe , and 664 were classified as type A reactions . During this same period , only nine ADEs were identified using traditional detection methods . Physicians , pharmacists , and nurses voluntarily reported 92 of the 731 ADEs detected using this automated system . The other 631 ADEs were detected from automated signals , the most common of which were diphenhydramine hydrochloride and naloxone hydrochloride use , high serum drug levels , leukopenia , and the use of phytonadione and antidiarrheals . The most common symptoms and signs were pruritus , nausea and /or vomiting , rash , and confusion-lethargy . The most common drug classes involved were analgesics , anti-infectives , and cardiovascular agents . Conclusion . —We believe that screening for ADEs with a computerized hospital information system offers a potential method for improving the detection and characterization of these events in hospital patients . ( JAMA . 1991;266:2847 - 2851 ABSTRACT BACKGROUND The epidemiology of adverse drug events ( ADEs ) and medication errors has received little evaluation outside the U.S. and Europe , and extrapolating from these data might not be valid , especially regarding selecting and prioritizing solutions . OBJECTIVE To assess the incidence and preventability of ADEs and medication errors in Japan . DESIGN The Japan Adverse Drug Events ( JADE ) study was a prospect i ve cohort study . PATIENTS A cohort of 3,459 adults admitted to a stratified r and om sample of seven medical and eight surgical wards and three intensive care units in three tertiary care hospitals over 6 months . MAIN MEASURES We measured ADE and medication error rates from daily review s of charts , laboratories , incident reports , and prescription queries by on-site review ers ; presence of a signal was considered an incident . Two independent physicians review ed incidents to determine whether they were ADEs or medication errors and to assess severity and preventability . KEY RESULTS We identified 1,010 ADEs and 514 medication errors ( incidence : 17.0 and 8.7 per 1,000 patient-days , respectively ) during the study period . Among ADEs , 1.6 % , 4.9 % and 33 % were fatal , life-threatening and serious , respectively . Among ADEs , 14 % were preventable . The rate per admission was 29 per 100 admissions , higher than in U.S. studies because associated with of the long length of hospital stay in Japan ( mean , 17 days ) . CONCLUSIONS The epidemiology and nature of ADEs and medication errors in Japan were similar to other countries , although more frequent per admission . Solutions that worked in these countries might thus improve medication safety in Japan , as could shortening hospital length of stay BACKGROUND Numerous studies have shown that specific computerized interventions may reduce medication errors , but few have examined adverse drug events ( ADEs ) across all stages of the computerized medication process . We describe the frequency and type of inpatient ADEs that occurred following the adoption of multiple computerized medication ordering and administration systems , including computerized physician order entry ( CPOE ) . METHODS Using explicit st and ardized criteria , pharmacists classified inpatient ADEs from prospect i ve daily review s of electronic medical records from a r and om sample of all admissions during a 20-week period at a Veterans Administration hospital . We analyzed ADEs that necessitated a changed treatment plan . RESULTS Among 937 hospital admissions , 483 clinical ly significant inpatient ADEs were identified , accounting for 52 ADEs per 100 admissions and an incidence density of 70 ADEs per 1000 patient-days . One quarter of the hospitalizations had at least 1 ADE . Of all ADEs , 9 % result ed in serious harm , 22 % in additional monitoring and interventions , 32 % in interventions alone , and 11 % in monitoring alone ; 27 % should have result ed in additional interventions or monitoring . Medication errors contributed to 27 % of these ADEs . Errors associated with ADEs occurred in the following stages : 61 % ordering , 25 % monitoring , 13 % administration , 1 % dispensing , and 0 % transcription . The medical record reflected recognition of 76 % of the ADEs . CONCLUSIONS High rates of ADEs may continue to occur after implementation of CPOE and related computerized medication systems that lack decision support for drug selection , dosing , and monitoring CONTEXT Pharmacist review of medication orders in the intensive care unit ( ICU ) has been shown to prevent errors , and pharmacist consultation has reduced drug costs . However , whether pharmacist participation in the ICU at the time of drug prescribing reduces adverse events has not been studied . OBJECTIVE To measure the effect of pharmacist participation on medical rounds in the ICU on the rate of preventable adverse drug events ( ADEs ) caused by ordering errors . DESIGN Before-after comparison between phase 1 ( baseline ) and phase 2 ( after intervention implemented ) and phase 2 comparison with a control unit that did not receive the intervention . SETTING A medical ICU ( study unit ) and a coronary care unit ( control unit ) in a large urban teaching hospital . PATIENTS Seventy-five patients r and omly selected from each of 3 groups : all admissions to the study unit from February 1 , 1993 , through July 31 , 1993 ( baseline ) and all admissions to the study unit ( postintervention ) and control unit from October 1 , 1994 , through July 7 , 1995 . In addition , 50 patients were selected at r and om from the control unit during the baseline period . INTERVENTION A senior pharmacist made rounds with the ICU team and remained in the ICU for consultation in the morning , and was available on call throughout the day . MAIN OUTCOME MEASURES Preventable ADEs due to ordering ( prescribing ) errors and the number , type , and acceptance of interventions made by the pharmacist . Preventable ADEs were identified by review of medical records of the r and omly selected patients during both preintervention and postintervention phases . Pharmacists recorded all recommendations , which were then analyzed by type and acceptance . RESULTS The rate of preventable ordering ADEs decreased by 66 % from 10.4 per 1000 patient-days ( 95 % confidence interval [ CI ] , 7 - 14 ) before the intervention to 3.5 ( 95 % CI , 1 - 5 ; P<.001 ) after the intervention . In the control unit , the rate was essentially unchanged during the same time periods : 10.9 ( 95 % CI , 6 - 16 ) and 12.4 ( 95 % CI , 8 - 17 ) per 1000 patient-days . The pharmacist made 366 recommendations related to drug ordering , of which 362 ( 99 % ) were accepted by physicians . CONCLUSIONS The presence of a pharmacist on rounds as a full member of the patient care team in a medical ICU was associated with a substantially lower rate of ADEs caused by prescribing errors . Nearly all the changes were readily accepted by physicians Abstract Background : Medication-related adverse events ( MRAEs ) form a large proportion of all adverse events in hospitalized patients and are associated with considerable preventable harm . Detailed information on harm related to drugs administered during hospitalization is scarce . Knowledge of the nature and preventability of MRAEs is needed to prioritize and improve medication-related patient safety . Objective : To provide information on the nature , consequences and preventability of MRAEs occurring during hospitalization in the Netherl and s. Study Design : Analysis of MRAEs identified in a retrospective chart review of patients hospitalized during 2004 . Methods : The records of 7889 patients admitted to 21 hospitals in 2004 were review ed by trained nurses and physicians using a three-stage process . For each hospital , patient records of 200 discharged and 200 deceased patients were r and omly selected and review ed . For each patient record , characteristics of the patient and the admission were collected . After identification of an MRAE the physician review ers determined the type , severity , preventability , drug category and excess length of stay associated with the MRAE . Data on additional interventions or procedures related to MRAEs were obtained by linking our data to the national hospital registration data base . The excess length of stay and the additional medical procedures were 
    Output:
    
Conclusions ADEs are a relevant problem in surgical patients and nonsurgical patients , with a high proportion of preventable ADEs .
The occurrence of ADEs appears to be higher in nonsurgical patients than in surgical patients .