Patients complaints

The nurse reports patient complaints of difficulty hearing or tinnitus (ringing in the ears) to the primary health care provider before the next dose is due. In addition, the nurse monitorsthe fluid intake and output and bringsany decrease in the urinary output to the attention of the primary health care provider. 

The nurse must also closely observe die patient for odier adverse drug reactions, such as anorexia, nausea, vomiting, and diarrhea. Some adverse drug reactions are also signs of digitalis toxicity, which can be serious. The nurse should carefully consider any patient complaint or comment, record it on die patient s chart, and bring it to die attention of the primary care provider. 

Assess the patient complaint to yield a detailed description of headache precipitating factors presence or absence of prodromal symptoms location, intensity, and duration of pain changes in sensory acuity and neurologic alterations. 

If extravasation occurs, the infusion should be stopped immediately, with aspiration of fluid from the site, needle, and tubing as much as possible. The affected limb or area should be elevated (if possible). The site should be documented photographically as well as the time, date, site, patient complaints, and estimated volume of extravasated drug.36 Both hot and cold packs have been used to manage extravasations, but use of the proper therapy for certain agents is critical. For example, warm compresses have been shown to worsen doxorubicin extravasations, whereas cold packs may exacerbate vinca alkaloid... 

Simple Patient complaint of queasiness or discomfort Complex Weight loss fever abdominal pain Laboratory tests Simple None... 

Ipratropium bromide has a slower onset of action than short-acting /J2-agonists (15 to 20 minutes vs. 5 minutes for albuterol). For this reason, it may be less suitable for as-needed use, but it is often prescribed in this manner. Ipratropium has a more prolonged bronchodilator effect than short-acting /l2-agonists. Its peak effect occurs in 1.5 to 2 hours and its duration is 4 to 6 hours. The recommended dose via MDI is two puffs four times a day with upward titration often to 24 puffs/day. It is also available as a solution for nebulization. The most frequent patient complaints are dry mouth, nausea, and, occasionally, metallic taste. Because it is poorly absorbed systemically, anticholinergic side effects are uncommon (e.g., blurred vision, urinary retention, nausea, and tachycardia). 

Affective disturbances, resulting in feelings of dysphoria, anger, and decreased tolerance for patients complaints... 

Treatment will call upon dopamine agonists, opioid medications, a benzodiazepine (clonazepam) that increases total sleep time, and drugs most commonly used as antiepileptic medication, such as gabapentin or equivalent. Dopamine agonists are the most effective and reduce the sleep deprivation and the patients complaints. But not all patients respond to dopamine agonists and methadone has been prescribed in the most refractory cases (21). 

Results of clinical investigations involving human subjects, including investigator and enrollment information, protocol information, study population, study period, safety and effectiveness data, adverse reactions and complications, patient discontinuations, patient complaints, device failures and -replacements, data tabulations, subject report forms for deaths and discontinuations, statistical analyses, contraindications, and precautions for use of the device. Studies conducted under an IDE should be identified. 

The device is generally comfortable and well accepted by many patients, but its use does have certain disadvantages. Some patients have problems with discomfort (foreign body sensation) or expulsion of the Lacrisert.The insert can be wetted with saline before insertion to improve comfort, but this can make even more difficult the insert s placement into the lower cul-de-sac, which requires a moderate amount of dexterity. Supplementation with artificial tears after insertion may improve comfort. The most common patient complaint is blurred vision associated with the intense release of polymer during the first 4 to 6 hours after instillation, from a thickened tear film.Adding such fluid as drops of NaCl 0.9% or artificial tear solution can reduce the tear film viscosity and minimize the visual complaints. As the insert dissolves it releases debris that can blur vision and cause irritation. Most patients with mild signs and symptoms of dry eye do not experience improvement with use of the insert, as compared with the use of conventional tear solutions. Because some tear secretion is necessary to dissolve the Lacrisert, KCS patients with low basal tear secretion may not benefit from or tolerate its use. 

Lactobacillus preparations replace colonic microflora. This supposedly restores normal intestinal function and suppresses the growth of pathogenic microorganisms. However, a dairy product diet containing 200 to 400 g of lactose or dextrin is equally effective in producing recolonization of normal flora. The dosage varies depending on the brand used and lactobacillus preparations should be administered with milk, juice, water, or cereal. Intestinal flatus is the primary patient complaint experienced with this modality. 

Before a treat-or-refer recommendation can be made, the pharmacist or other health professional must make a reasoned assessment of the problem and make a presumptive diagnosis (or at least rule out some of the many skin disorders). Several factors affect this decision, including patient age and hormonal status, patient complaint and history, and lesion assessment. 

The most common patient complaints with topical tacrolimus therapy are transient itching and burning at the site of application. Although no data support the practice, many clinicians recommend pretreatment with topical corticosteroids to prevent or reduce tacrolimus-induced burning and erythema. Systemic adverse effects of tacrolimus, while well documented with oral therapy, have not been observed in patients using the topical ointment for AD. Patients who receive long-term systemic immunosuppressants are prone to devel-... 

All failed batches should be fully investigated with the supplier, to assess the route of manufacture, with the intention of preventing further deliveries of defective materials. This also applies when problems are identified during production use, or during a patient complaints investigation. 

Each entity must have a way to deal with patient complaints. There must be a process to receive complaints. The pharmacy must have a contact person. The pharmacy must document the complaint and the resolution. The complaints can be anon5mous and pharmacy employees can make complaints. 

Patient complaints include loss of appetite, vomiting, abdominal pain, obstipation, G1 bleeding or a palpable mass in the right lower quadrant. 

Hickson, G. B., and others. Patient Complaints and Malpractice Risk. Joarn<2/ of the American Medical Association, 2002, 257(22), 2951-2957. 

Dermal cutaneous vascular response is also altered by barrier disruption after exposure to SLS for three consecutive days, the skin exhibits an increased cutaneous blood flow after exposure to tap water (Ramsing and Agner 1997), which probably explains frequent patient complaints that water aggravates their dry skin or hand dermatitis. 

If a product is prepared for a single patient in a community pharmacy by the pharmacist himself, the quality risks are considered to be low. The academic education, the ethical requirements, his legal position and the supervision by Pharmaceutical Inspection, are all intended to guarantee an adequate product for the individual patient. Eventually the patient himself can complain to the pharmacists who made the product about the quality thereof insofar the patient has enough insight in that. Section 25.6 as well as Sect. 35.6.13 deal with processing patient complaints. 

Deviations may be noticed within the organisation without leading to a defective product or service. In a less strictly organised situation such as a pharmacy, deviations may be expected to be less noticed. In contrast patient s complaints wUl, in pharmacies, come through quite quickly. Patients are the end users and in fact test each element of the batch, but a patient complaint about a slightly deviating content is quite unlikely. 

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