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A common source of error in pH measurements.

ABSTRACT: Glass-electrode assemblies in which the reference half-cell contains a porous ceramic type of liquid junction are likely to produce misleading pH measurements under normal service conditions. The error arises from substantial liquid-junction potentials, associated with the porous ceramic plug, which vary with the ionic composition of the solution under test. The error is not revealed by conventional two-point calibration procedures, since the majority of standard buffer solutions have a similar total ionic strength, but will nevertheless be present when the unknown solution differs in ionic strength from the standardizing buffers. The size of the error is proportional to the ratio between the salt concentration in the standard buffers and the concentration present in the unknown solution, and varies from one electrode specimen to another. The fault was present in 24 out of 30 electrodes in normal use selected at random from seven laboratories, and the mean error was 0.2pH unit per 10-fold salt-concentration difference between standard and test solutions. It is estimated that errors of this order must be widespread in the recent literature. Older pH determinations are likely to be more reliable, since the original reference electrode design with a free-flowing liquid junction is apparently free from the artefact.

SUBMITTER: Illingworth JA

PROVIDER: S-EPMC1162880 | biostudies-other | 1981 Apr

REPOSITORIES: biostudies-other

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Project description:Purpose/Objectives: Stereotactic radiosurgery (SRS) and stereotactic body radiation therapy (SBRT) may be considered "high risk" due to the high doses per fraction. We analyzed CyberKnife™ (CK) SRS and SBRT-related incidents that were prospectively reported to our in-house incident learning system (ILS) in order to identify severity, contributing factors, and common error pathways. Material and Methods: From 2012 to 2019, 221 reported incidents related to the 4,569 CK fractions delivered (5.8%) were prospectively analyzed by our multi-professional Quality and Safety Committee with regard to severity, contributing factors, as well as the location where the incident occurred (tripped), where it was discovered (caught), and the safety barriers that were traversed (crossed) on the CK process map. Based on the particular step in the process map that incidents tripped, we categorized incidents into general error pathways. Results: There were 205 severity grade 1-2 (did not reach patient or no clinical impact), 11 grade 3 (clinical impact unlikely), 5 grade 4 (altered the intended treatment), and 0 grade 5-6 (life-threatening or death) incidents, with human performance being the most common contributing factor (79% of incidents). Incidents most commonly tripped near the time when the practitioner requested CK simulation (e.g., pre-CK simulation fiducial marker placement) and most commonly caught during the physics pre-treatment checklist. The four general error pathways included pre-authorization, billing, and scheduling issues (n= 119); plan quality (n= 30); administration of IV contrast during simulation or pre-medications during treatment (n= 22); and image guidance (n= 12). Conclusion: Most CK incidents led to little or no patient harm and most were related to billing and scheduling issues. Suboptimal human performance appeared to be the most common contributing factor to CK incidents. Additional study is warranted to develop and share best practices to reduce incidents to further improve patient safety.

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A common source of error in pH measurements.

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