Hospital committees

The problems of the Laboratory of Neonatology are unique and distinct in many details from those of the general clinical chemistry laboratory. This requires a separate operation coordinated with the operation of the Pediatric Department of the hospital. It requires a highly sophisticated Chemist at the doctorate level as supervisor, trained in this area to insure that the results are meaningful and to supervise and accelerate the development of the techniques in this area. Developments in this direction are already taking place rapidly. The Committee on Pediatric Chemistry of the American Association of Clinical Chemists is now active in developing the list of normal values for the infant. 

Mangram AJ, Horan TC, Pearson ML, Silver LC, Jarvis WR Guideline for prevention of surgical site infection, 1999. Hospital Infection Control Practices Advisory Committee. Infect Control Hosp Epidemiol 1999 20 247-280. 

The Monowitz hospital had only three wards, with about three hundred beds. The bedsheets were dirty sources of infection. The SS urged Farben to install more and cleaner beds. But the technical committee turned down the request. "If they aren t strong enough to work, they don t belong on the factory grounds," said a foreman. 

The establishment of the Medicines Commission in May 1969 was followed by the establishment of a number of expert committees with specific advisory functions, appointed by Ministers after considering the recommendations of the Commission as proposed in section 4 of the Medicines Act. These expert committees, whose members are appointed by Ministers on the advice of the Medicines Commission, advise the LA and consist of independent experts such as hospital clinicians, general practitioners, pharmacists and clinical pharmacologists, and not the staff of the DHSS. 

Furthermore, Australia has a strong framework in place to support the ethical conduct of clinical trials, provided by the NHMRC, its principal committees and HRECs. In June 2003, there were 226 registered HRECs in Australia - 125 hospital (public and private), 53 imiversity, 23 government and 25 associated with professional and other bodies. 

The study must be approved by the local authorities, and blood samples must be obtained from patients after informed consent in accordance with the declaration of Helsinki (34). The present study was approved by the Ethical Review Committee of University College Hospital Galway. Extreme care should be taken when handling human blood sample. The presence in the sample of at least hepatitis B, hepatitis C, and human immunodeficiency virus should be tested. If this is not possible, treat the samples as if they would be infected. The personnel handling the human blood samples should be vaccinated at least for hepatitis B, and they must follow all the health and safety procedures of their institution. 

Smith, C.C., Bennett, P.M., Pearce, H.M., Harrison, P.I., Reynolds, D.J., Aronson, J.K. and Grahame-Smith, D.G. (1996) Adverse drug reactions in a hospital general medical unit meriting notification to the Committee on Safety of Medicines. British Journal of Clinical Pharmacology, 42, 423—429. 

A drugs and therapeutics committee (DTC), alternatively known as pharmacy and therapeutics committee, is aimed at ensuring safe and effective (rational) use of medicines in the facility or area under its jurisdiction. Hospital DTCs are common in industrialised countries and they are widely used to influence national decision-taking. Members of DTCs should represent the major specialties and the administration they should be independent and be without any conflict of interest. Critical to the success of DTCs are a sound scientific and clinical basis for decision taking, clear objectives a firm mandate, support by senior management, transparency in... 

III.b.1.4. Drugs and therapeutics committees in districts and hospitals. A drugs and therapeutics committee (DTC), also called a pharmacy and therapeutics committee, is a committee designated to ensure the safe and effective use of medicines in the facility or area under its jurisdiction. Such committees are well-established in industrial countries as a successful way of promoting more rational, cost-effective use of medicines in hospitals (Table 7). Governments may encourage hospitals to have DTCs by making it an accreditation requirement to various professional societies. DTC members should represent all the major specialities and the administration they should also be independent and declare any conflict of interest. A senior doctor... 

The IRB, also known as the ethics committee or human subjects committee, originally was established to protect people confined to hospitals, mental institutions, nursing homes, and prisons who may be used as subjects in clinical research. In the United States any institution conducting clinical studies supported by federal funds is required to have proposed studies reviewed and approved by an IRB. 

Institutional Review Boards. In university clinics and other hospitals engaged in research, ethics committees (also called Institutional Review Boards, IRBs) have been formed over the last three decades to monitor clinical research activities from scientific, legal, ethical and social viewpoints. All protocols relating to clinical trials must be submitted to these committees, which are generally made up of one or several doctors, a lawyer, a representative of the nursing staff and also community representatives such as priests. This composition forces clinical researchers to set out their intentions in such a way as to be clear enough for a lay person to understand and to assess whether the inconvenience and risks involved for the patient are in a reasonable relationship to the possible benefit of the planned trial. 

Independent Midpoint committees are groups of experts who. based on blinded and standardized reports, decide whether specific event(s) reported for a patient meet the criteria of a defined primary Midpoint. Examples of endpoints are imminent need of hospitalization, suicide attempt, etc. (see Box 5.7). 

The clinical part of the study was conducted with participation of 116 adolescent patients aged from 10 to 18 years hospitalized by the Department of Pediatrics for examination and treatment of chronic dyspeptic complaints. The control group comprised 38 age matched healthy volunteers. The Regional Research Ethics Committee of Ukraine approved the study. 

Six healthy male volunteers aged 21-30 years and weighing 65-85 kg were informed about the possible risks and side effects of the study and their written consent was obtained. Routine clinical tests showed all subjects to have values within the normal ranges. The Ethical Committee of the Helsinki Deaconess Institute Hospital approved the experimental protocol. 

In the hospital setting, drugs are prescribed on a particular page of the patient s hospital chart called the physician s order sheet (POS) or chart order. The contents of that prescription are specified in the medical staff rules by the hospital s Pharmacy and Therapeutics Committee. The patient s name is typed or written on the form therefore, the orders consist of the name and strength of the medication, the dose, the route and frequency of administration, the date, other pertinent information, and the signature of the prescriber. If the duration of therapy or the number of doses is not specified (which is often the case), the medication is continued until the prescriber discontinues the order or until it is terminated as a matter of policy routine, eg, a stop-order policy. 

Acknowledgments. This work was financially supported by the Polish Committee of Scientific Research, grant no. 3 T09A 038 Oil. We are grateful to Professors K. Dusek of Prague and R.F.T. Stepto of Manchester who kindly read the manuscript and added many remarks that improved the original text. One of the authors (H.G.) is indebted to Professor Witold Brostow of the Center for Materials Characterization, University of North Texas, Denton for hospitality and A.C. Ramamurthy of the Ford Motor Co. for providing facilities that helped this paper to be written. 

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