Propofol sedation is used more frequently in pediatric procedures because of its ability to provide varying sedation levels. The authors evaluated all outpatient pediatric procedures using propofol sedation over a 6-year period. All sedation was provided by pediatric intensivists at a single institution. In all, 4716 procedures were recorded during the study period; 15% of procedures were associated with minor complications, whereas only 0.1% of procedures were associated with major complications. Significantly more major complications associated with propofol occurred during bronchoscopy (P = .001). Propofol administered by a pediatric intensivist is a safe sedation technique in the pediatric outpatient setting.

Our study highlighted the continuing need for advance directive resident curricula. Medical school curricula alone do not appear to be sufficient for residents' needs in this area.

Introduction:Medications are critical to the management of patient conditions, and they can have significant effects on the success or failure of medical interventions. Patient perceptions of drug warnings play an important role in medication compliance and ultimately disease management. Several factors may affect patients' understanding of drug warnings and drug labeling, including health literacy and interactions with physicians and pharmacists. Purpose: The purpose of this article is to provide a review of the literature related to patient perceptions of drug warnings and drug labeling. Descriptive articles and studies regarding patient perceptions and knowledge of adverse drug reaction warnings were reviewed. Methods: The following databases were utilized to search the literature related to patient perceptions of drug warnings: PubMed, Academic Search Premiere, CINAHL, Medline, Psych Info, Business Source Complete, Alternative Healthwatch, Health Source (both Nursing/Academic and Consumer additions), JSTOR, and Master File Premiere. For the purpose of this review, any peer-reviewed article was eligible. Exclusionary criteria included: articles published in languages other than English, articles/studies on patient perceptions of vaccines and chemotherapy, and articles related to perceptions of medications administered in the inpatient setting. Forty-six articles were included in the review. Results: Health literacy has been shown to have a major impact on patients' ability to understand potential adverse reactions and instructions on correct dosing of medications. Direct communication with physicians and pharmacists is one of the most important and effective variables in promoting understanding of drug warnings. Appropriateness of written medical information that is informative and timely can improve patients' perceptions of drug warnings and hopefully disease management. Conclusion: As patients increasingly assume more personal responsibility as informed consumers of health care, it is even more important to address patient perceptions of drug warnings considering how this fits in the context of their overall care.

No abstract

The patient panel conference experience was a powerful mechanism for enhancing competency education. The conferences were an effective means of presenting real-life examples of systems issues in the context of a hospital system.