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Blake C, Dwenger A, Fox ER. Evaluation of pharmacy-supplied half and quarter tablets at an academic medical center. Am J Health Syst Pharm 2024; 81:S166-S170. [PMID: 38581352 DOI: 10.1093/ajhp/zxae100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Indexed: 04/08/2024] Open
Abstract
PURPOSE Manipulation of tablet medications to produce a customized dose is common practice, and splitting tablets may reduce the acquisition cost of the medication. However, cost savings may be diminished by the cost of the increased labor and repackaging materials needed when splitting tablets. Splitting tablets may also result in safety concerns if the final products are under (eg, reduced benefit) or over (eg, toxicity) the desired dosage. The purpose of this quality improvement project was to evaluate and recommend changes for all half- and quarter-tablet medications prepared and distributed from the inpatient pharmacy at University of Utah Health (U of U Health). SUMMARY The evaluation included all half- and quarter-tablet medications prepared by pharmacy technicians for administration to patients admitted to U of U Health hospitals. A final list of 173 half- and quarter-tablet dosages was evaluated for opportunities to decrease the total number. On the basis of the developed criteria, 93 half- and quarter-tablet dosages (54%) were recommended to be removed from routine stock in the inpatient pharmacy. Systems remain in place to create customized half and quarter tablets if required for patient care. CONCLUSION Reducing the number of medications for which half and quarter tablets are used may allow pharmacy technicians to prioritize other patient care tasks and potentially decrease waste.
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Affiliation(s)
- Caitlyn Blake
- Drug Information Service, University of Utah Health, Salt Lake City, UT, USA
| | - Andrew Dwenger
- Pharmacy Support Services, University of Utah Health, Salt Lake City, UT, USA
| | - Erin R Fox
- Pharmacy Department, University of Utah Health, Salt Lake City, UT, USA
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Babu D, Rowett D, Kalisch Ellett L, Marotti S, Wisdom A, Lim R, Harmon J. Exploration of 'micro' level factors that affect the involvement of clinical pharmacists in interprofessional ward rounds in hospitals: Through the lens of social cognitive theory. Res Social Adm Pharm 2024; 20:654-664. [PMID: 38627153 DOI: 10.1016/j.sapharm.2024.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Revised: 04/05/2024] [Accepted: 04/07/2024] [Indexed: 06/18/2024]
Abstract
BACKGROUND Macro and meso level factors that influence the participation by clinical pharmacists in ward rounds include pharmacy management culture, commitment to ward rounds and adequate time for ward rounds being included in workload models. The 'micro' level factors that affect the involvement of clinical pharmacists in ward rounds have not been widely explored. OBJECTIVE Explore 'micro' level factors to gain insight into clinical pharmacists' participation in interprofessional ward rounds in inpatient settings through the lens of social cognitive theory. METHOD A qualitative focused ethnographic study with five clinical pharmacists, four medical practitioners, one allied health professional and one nurse was conducted in three metropolitan hospitals in Southern Australia. Seven hours of semi-structured interview (n = 11) and 76-h of observations (n = 5) were conducted. A qualitative descriptive analysis was conducted (guided by Spradley) followed by reflexive thematic-analysis (according to Braun and Clarke's technique). RESULTS Three micro level factors influencing clinical pharmacist participation in ward rounds are: (1) Cognitive mindset of clinical pharmacists, (2) Behavioural conduct of clinical pharmacists, and (3) Social rules of the ward. Clinical pharmacists that did not participate in ward round reconciled their moral distress by transferring information without clinical judgement or interpretation of the patient scenario to medical practitioners. Clinical pharmacists that did participate in ward rounds demonstrated credibility by making relevant recommendations with a holistic lens. This enabled clinical pharmacists to be perceived as trustworthy by medical practitioners. Positive experiences of participating in ward rounds contributed to their cognitive upward spiral of thoughts and emotions, fostering continued participation. CONCLUSION Clinical pharmacists participate in ward rounds when they develop a positive mindset about ward round participation and perceive ward rounds as an enabler to the establishment of trusted professional relationships with medical practitioners. This trusted relationship creates an environment where the pharmacist develops confidence in making relevant recommendations.
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Affiliation(s)
- Dona Babu
- Quality Use of Medicines and Pharmacy Research Centre, UniSA Clinical and Health Sciences, University of South Australia, GPO Box 2471, Adelaide, SA, 5001, Australia; SA Pharmacy, SA Health, Adelaide, SA, 5000, Australia.
| | - Debra Rowett
- Quality Use of Medicines and Pharmacy Research Centre, UniSA Clinical and Health Sciences, University of South Australia, GPO Box 2471, Adelaide, SA, 5001, Australia; Drug and Therapeutics Information Service, Southern Adelaide Local Health Network, Adelaide, SA, 5000, Australia
| | - Lisa Kalisch Ellett
- Quality Use of Medicines and Pharmacy Research Centre, UniSA Clinical and Health Sciences, University of South Australia, GPO Box 2471, Adelaide, SA, 5001, Australia
| | - Sally Marotti
- Quality Use of Medicines and Pharmacy Research Centre, UniSA Clinical and Health Sciences, University of South Australia, GPO Box 2471, Adelaide, SA, 5001, Australia; SA Pharmacy, SA Health, Adelaide, SA, 5000, Australia
| | - Alice Wisdom
- SA Pharmacy, SA Health, Adelaide, SA, 5000, Australia
| | - Renly Lim
- Quality Use of Medicines and Pharmacy Research Centre, UniSA Clinical and Health Sciences, University of South Australia, GPO Box 2471, Adelaide, SA, 5001, Australia
| | - Joanne Harmon
- Rosemary Bryant AO Research Centre, Clinical and Health Sciences, University of South Australia, GPO Box 2471, Adelaide, SA, 5001, Australia
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Adhikari B, Ranabhat K, Khanal P, Poudel M, Marahatta SB, Khanal S, Paudyal V, Shrestha S. Procurement process and shortages of essential medicines in public health facilities: A qualitative study from Nepal. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0003128. [PMID: 38696399 PMCID: PMC11065305 DOI: 10.1371/journal.pgph.0003128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 03/25/2024] [Indexed: 05/04/2024]
Abstract
Ensuring access to essential medicines remains a formidable challenge in Nepal. The specific reasons for the shortage of essential medicines within Nepal have not been extensively investigated. This study addresses challenges associated with access to essential medicines, procurement process difficulties, and functionality of inventory management systems at different levels of public health facilities. Fifty-nine semi-structured in-depth interviews were conducted with health managers and service providers at provincial and local levels in six randomly selected districts of Bagmati province, Nepal. Interviews were audiotaped and transcribed verbatim, and the results were analyzed using the inductive approach and were later mapped within the four domains of "Procurement of essential medicines". The major barriers for the effective management of essential medicines included delays in the procurement process, primarily locally, leading to frequent stock-out of essential drugs, particularly at the health post level. Additionally, challenges arise from storage problems, mainly due to insufficient storage space and the need to manage additional comorbidities related to COVID-19. Other identified challenges encompass the absence of training on logistics management information systems, a lack of information technology resources in primary health facilities, inadequate qualified human resources to operate the IT system, and insufficient power backup. Moreover, unrealistic demand estimation from the service points, inadequate transportation costs, and manual inventory management systems further contributed to the complex landscape of challenges. This study identified procurement delays as the primary cause of essential medicine shortages in Bagmati Province, Nepal. We recommend implementing comprehensive procurement guidelines, collaborative training, and dedicated budgets to address this issue. Improving the procurement and inventory management process in low-resource settings requires a well-trained workforce, suitable storage spaces, and enhanced coordinated administrative tiers within health facilities at different levels to ensure the year-round availability of essential medicines in these settings.
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Affiliation(s)
- Basant Adhikari
- Ministry of Health, Bagmati Province, Hetauda, Nepal
- Nepal Public Health Association, Lalitpur, Nepal
- ASEAN Institute for Health Development, Mahidol University, Salaya, Thailand
| | - Kamal Ranabhat
- Ministry of Health and Population, Government of Nepal, Kathmandu, Nepal
- Central Department of Public Health, Institute of Medicine, Tribhuwan University, Kathmandu, Nepal
| | - Pratik Khanal
- Nepal Public Health Association, Lalitpur, Nepal
- Department of Global Public Health and Primary Care, Bergen Centre for Ethics and Priority Setting in Health, University of Bergen, Bergen, Norway
| | - Manju Poudel
- Oxford University Clinical Research Unit, Patan Academy of Health Science, Lalitpur, Nepal
| | - Sujan Babu Marahatta
- Nepal Open University, Lalitpur, Nepal
- Manmoohan Memorial Institute of Health Science, Kathmandu, Nepal
- Department of Public Health Sciences, University of California Davis, Davis, California, United States of America
- Bournemouth University, Poole, United Kingdom
| | - Saval Khanal
- Health Economics Consulting, Norwich Medical School, University of East Anglia, Norwich, United Kingdom
| | - Vibhu Paudyal
- School of Pharmacy, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King’s College, London, United Kingdom
| | - Sunil Shrestha
- School of Pharmacy, Monash University Malaysia, Selangor, Malaysia
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Ojha P, Anderson BJ, Draper EW, Flaker SM, Siska MH, Mara KC, Kennedy BD, Schreier DJ. Design and evaluation of an electronic prospective medication order review system for medication orders in the inpatient setting. JAMIA Open 2024; 7:ooae003. [PMID: 38283885 PMCID: PMC10822119 DOI: 10.1093/jamiaopen/ooae003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 08/21/2023] [Accepted: 01/05/2024] [Indexed: 01/30/2024] Open
Abstract
Objectives Since the 1970s, a plethora of tools have been introduced to support the medication use process. However, automation initiatives to assist pharmacists in prospectively reviewing medication orders are lacking. The review of many medications may be protocolized and implemented in an algorithmic fashion utilizing discrete data from the electronic health record (EHR). This research serves as a proof of concept to evaluate the capability and effectiveness of an electronic prospective medication order review (EPMOR) system compared to pharmacists' review. Materials and methods A subset of the most frequently verified medication orders were identified for inclusion. A team of clinical pharmacist experts developed best-practice EPMOR criteria. The established criteria were incorporated into conditional logic built within the EHR. Verification outcomes from the pharmacist (human) and EPMOR (automation) were compared. Results Overall, 13 404 medication orders were included. Of those orders, 13 133 passed pharmacist review, 7388 of which passed EPMOR. A total of 271 medication orders failed pharmacist review due to order modification or discontinuation, 105 of which passed EPMOR. Of the 105 orders, 19 were duplicate orders correctly caught by both EPMOR and pharmacists, but the opposite duplicate order was rejected, 51 orders failed due to scheduling changes. Discussion This simulation was capable of effectively discriminating and triaging orders. Protocolization and automation of the prospective medication order review process in the EHR appear possible using clinically driven algorithms. Conclusion Further research is necessary to refine such algorithms to maximize value, improve efficiency, and minimize safety risks in preparation for the implementation of fully automated systems.
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Affiliation(s)
- Pooja Ojha
- Department of Pharmacy Services, Mayo Clinic, Rochester, MN 55905, United States
| | - Benjamin J Anderson
- Department of Pharmacy Services, Mayo Clinic, Rochester, MN 55905, United States
| | - Evan W Draper
- Department of Pharmacy Services, Mayo Clinic, Rochester, MN 55905, United States
| | - Susan M Flaker
- Department of Pharmacy Services, Mayo Clinic, Rochester, MN 55905, United States
| | - Mark H Siska
- Department of Pharmacy Services, Mayo Clinic, Rochester, MN 55905, United States
| | - Kristin C Mara
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN 55905, United States
| | - Brian D Kennedy
- Department of Pharmacy Services, Mayo Clinic, Rochester, MN 55905, United States
| | - Diana J Schreier
- Department of Pharmacy Services, Mayo Clinic, Rochester, MN 55905, United States
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Griebe K, Jiang C, MacDonald NC. Assessing the pharmacy workforce's preparedness for a workplace violence event. Am J Health Syst Pharm 2023; 80:1840-1846. [PMID: 37698265 DOI: 10.1093/ajhp/zxad225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Indexed: 09/13/2023] Open
Abstract
PURPOSE The purpose of this article is to describe the planning, implementation, and findings of a "person with a weapon" exercise for an inpatient pharmacy department. SUMMARY There has been an increased focus on workplace violence in healthcare within the last few years. The health-system pharmacy workforce should take an active role in planning for workplace violence events by completing a risk assessment analysis and performing tabletop and functional exercises. This study provides an example of how health-system pharmacists collaborated with an emergency management team, security, and communications to carry out a person with a weapon exercise in an inpatient hospital pharmacy. Areas for improvement were identified for pharmacy, communications, and security during education sessions and the tabletop and functional exercises, demonstrating the importance of a multidisciplinary approach when planning for a person with a weapon event. As a result of this exercise, there was increased awareness of the "run, hide, fight" tactic, an increase in workplace violence education and staff awareness, and an enhancement of security measures, including technology improvements. CONCLUSION This workplace violence exercise provides an example of how the pharmacy workforce can engage in emergency preparedness planning and risk mitigation for a workplace violence event. Other health systems can use the action plan, findings, and improvements to raise awareness and train about workplace violence events and support the safety of the pharmacy workforce.
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Affiliation(s)
- Kristin Griebe
- Department of Pharmacy Services, Henry Ford Hospital, Detroit, MI, USA
| | - Christine Jiang
- Department of Pharmacy Services, Henry Ford Health, Detroit, MI, USA
| | - Nancy C MacDonald
- Department of Pharmacy Services, Henry Ford Hospital, Detroit, MI, USA
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Tran VD, Vo TML, Nguyen Di K, Vo QLD, Dewey RS, Pham TT, Tran BK, Pham DT. Job satisfaction of hospital pharmacists in a representative province in Mekong Delta, Vietnam. PLoS One 2023; 18:e0291201. [PMID: 37708111 PMCID: PMC10501634 DOI: 10.1371/journal.pone.0291201] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 08/23/2023] [Indexed: 09/16/2023] Open
Abstract
BACKGROUND Job satisfaction is an important factor affecting job performance and turnover of healthcare workers, especially hospital pharmacists. Nevertheless, limited studies have reported this issue in the context of Vietnam. OBJECTIVES To help maintain the quality and size of the limited hospital pharmacy workforce in Vietnam, especially in the Mekong Delta area, this study investigated the job satisfaction of hospital pharmacists, and the associated factors, in Vinh Long province, a representative province in the central Mekong Delta. METHODS A cross-sectional survey was conducted, recruiting hospital pharmacists working in all 17 province/district-affiliated healthcare facilities across Vinh Long province, Vietnam, between August and September 2022. RESULTS Among the 235 survey participants (representing a response rate of 97.1%), 189 pharmacists (80.4%) reported that they were satisfied with their job. Working conditions, leadership styles, and benefits were factors found to significantly influence job satisfaction. Pharmacists who had worked in the field for 3-5 years (OR = 3.752, 95% CI = 1.036-13.595), more than 5 years (OR = 6.361, 95% CI = 2.264-17.875), did not have additional duties besides their primary responsibilities (OR = 2.046, 95% CI = 1.005-4.163), and worked in a private healthcare facility (OR = 12.021, 95% CI = 1.470-98.316), were significantly more likely to be satisfied with their job. CONCLUSIONS Most hospital pharmacists were satisfied with their current job. To further improve job satisfaction in this population, further improvements to working conditions are necessary.
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Affiliation(s)
- Van De Tran
- Department of Health Organization and Management, Can Tho University of Medicine and Pharmacy, Can Tho, Vietnam
| | - Thi My Loan Vo
- Faculty of Pharmacy, Can Tho University of Medicine and Pharmacy, Can Tho, Vietnam
- Tam Binh District Health Center, Vinh Long, Vietnam
| | - Khanh Nguyen Di
- Department of Medical Testing, Faculty of Health Sciences, Dong Nai Technology University, Dong Nai, Vietnam
| | - Quang Loc Duyen Vo
- Department of Chemistry, College of Natural Sciences, Can Tho University, Can Tho, Vietnam
| | - Rebecca Susan Dewey
- Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, University of Nottingham, Nottingham, United Kingdom
| | - Trung Tin Pham
- Department of Health Organization and Management, Can Tho University of Medicine and Pharmacy, Can Tho, Vietnam
| | - Ba Kien Tran
- Department of Pharmaceutical Administration, Hai Duong Central College of Pharmacy, Hai Duong, Vietnam
| | - Duy Toan Pham
- Department of Medical Testing, Faculty of Health Sciences, Dong Nai Technology University, Dong Nai, Vietnam
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7
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Chamoun N, Ramia E, Sacre H, Haddad M, Haddad C, Hajj A, Namnoum J, Zeenny RM, Iskandar K, Akel M, Salameh P. Validation of the specialized competency framework for pharmacists in hospital settings (SCF-PHS): a cross-sectional study. J Pharm Policy Pract 2023; 16:86. [PMID: 37430355 DOI: 10.1186/s40545-023-00592-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Accepted: 06/26/2023] [Indexed: 07/12/2023] Open
Abstract
OBJECTIVES This study aimed to validate the content of the specialized competency frameworks for pharmacists working in hospital settings (hospital and clinical pharmacists) and pilot the frameworks for practice assessment. METHODS This online cross-sectional study was carried out between March and October 2022 among a sample of 96 Lebanese pharmacists working in hospital settings. The frameworks were distributed to full-time hospital and clinical pharmacists, who filled them out according to their role in the hospital. RESULTS Overall, the competencies were distributed over five domains for hospital pharmacists (fundamental skills, safe and rational use of medicines, patient-centered care, professional skills, and preparedness for emergencies), while for clinical pharmacists, competencies were distributed over seven domains (quality improvement, clinical knowledge and skills, soft skills, ability to conduct clinical research, ability to provide effective education, use information technology to make decisions and reduce errors, and emergency preparedness). Moreover, Cronbach alpha values were appropriate, indicating sufficient to high internal consistency. Pharmacists were highly confident in most competencies, with some exceptions related to research in emergency settings (data evaluation, research, and reporting). CONCLUSIONS This study could validate competency frameworks for clinical and hospital pharmacists, with the competencies and their respective behaviors showing an adequate construct analysis. It also identified the domains that require further development, i.e., soft skills and research in emergency settings. Both these domains are timely and needed to overcome the current practice challenges in Lebanon.
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Affiliation(s)
- Nibal Chamoun
- Department of Pharmacy Practice, Lebanese American University School of Pharmacy, Byblos, Lebanon
| | - Elsy Ramia
- Department of Pharmacy Practice, Lebanese American University School of Pharmacy, Byblos, Lebanon
| | - Hala Sacre
- INSPECT-LB (Institut National de Santé Publique, d'Épidémiologie Clinique et de Toxicologie-Liban), Beirut, Lebanon
- Drug Information Center, Order of Pharmacists of Lebanon, Beirut, Lebanon
| | - Mansour Haddad
- Faculty of Pharmacy, Yarmouk University, Irbid, 21163, Jordan
| | - Chadia Haddad
- INSPECT-LB (Institut National de Santé Publique, d'Épidémiologie Clinique et de Toxicologie-Liban), Beirut, Lebanon.
- School of Medicine, Lebanese American University, Byblos, Lebanon.
- Research Department, Psychiatric Hospital of the Cross, P.O. Box 60096, Jal Eddib, Lebanon.
- School of Health Sciences, Modern University for Business and Science, Beirut, Lebanon.
| | - Aline Hajj
- INSPECT-LB (Institut National de Santé Publique, d'Épidémiologie Clinique et de Toxicologie-Liban), Beirut, Lebanon
- Laboratoire de Pharmacologie, Pharmacie Clinique et Contrôle de Qualité des Médicament (LPCQM), Faculty of Pharmacy, Saint Joseph University of Beirut, Beirut, Lebanon
- Faculté de Pharmacie, Université Laval, Quebec, Canada
- Oncology Division, CHU de Québec Université Laval Research Center, Quebec, Canada
| | - Joya Namnoum
- Methodology and Statistics in Biomedical Research Unit, Faculty of Medicine, Paris-Saclay University, Kremlin-Bicêtre, Paris, France
| | - Rony M Zeenny
- INSPECT-LB (Institut National de Santé Publique, d'Épidémiologie Clinique et de Toxicologie-Liban), Beirut, Lebanon
- Department of Pharmacy, American University of Beirut Medical Center, Beirut, Lebanon
| | - Katia Iskandar
- INSPECT-LB (Institut National de Santé Publique, d'Épidémiologie Clinique et de Toxicologie-Liban), Beirut, Lebanon
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
- Faculty of Pharmacy, Lebanese University, Hadat, Lebanon
| | - Marwan Akel
- INSPECT-LB (Institut National de Santé Publique, d'Épidémiologie Clinique et de Toxicologie-Liban), Beirut, Lebanon
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
- School of Education, Lebanese International University, Beirut, Lebanon
| | - Pascale Salameh
- INSPECT-LB (Institut National de Santé Publique, d'Épidémiologie Clinique et de Toxicologie-Liban), Beirut, Lebanon
- School of Medicine, Lebanese American University, Byblos, Lebanon
- Faculty of Pharmacy, Lebanese University, Hadat, Lebanon
- Department of Primary Care and Population Health, University of Nicosia Medical School, 2417, Nicosia, Cyprus
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Binda DD, Gonzalez M, Rosales V, Black W, Ortega R. When Veterinary Drugs Reach Human Hospitals: A Problem-Based Learning Discussion. A A Pract 2023; 17:e01705. [PMID: 37463288 DOI: 10.1213/xaa.0000000000001705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/20/2023]
Abstract
The delivery of drugs from the manufacturer to the hospital is a complex process. Despite numerous safeguards, lapses may occur, creating the potential for patient harm. Recently, an urban tertiary care medical center received a shipment of isoflurane bottles labeled for veterinary use. This error was not identified until the veterinary isoflurane reached the operating room automated medication dispensing system. No patients received the anesthetic. This report describes how such an error occurred, explains the differences between veterinary and human medications, and emphasizes the importance of vigilance in the drug supply chain to prevent patient harm.
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Affiliation(s)
- Dhanesh D Binda
- From the Department of Anesthesiology, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts
| | - Mauricio Gonzalez
- From the Department of Anesthesiology, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts
| | - Victoria Rosales
- From the Department of Anesthesiology, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts
| | - William Black
- Department of Pharmacy Services, Boston Medical Center, Boston, Massachusetts
| | - Rafael Ortega
- From the Department of Anesthesiology, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts
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Bochniarz M, Inglot-Brzęk E, Lewandowska A, Podgórska J. Directions of Changes in the Profession of Hospital Pharmacist in Poland. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14522. [PMID: 36361404 PMCID: PMC9658758 DOI: 10.3390/ijerph192114522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 10/30/2022] [Accepted: 11/04/2022] [Indexed: 06/16/2023]
Abstract
The Act on the Pharmacist Profession, adopted on 10 December 2020, is a breakthrough for the entire community of pharmacists in Poland. Due to the scope of the changes introduced in the Act, the question is whether pharmacists in Poland are suitably prepared for pharmaceutical care and clinical pharmacy services. The main aim of the study is to assess the readiness of hospital pharmacists to introduce changes in the way the profession functions. The result of the study is the presentation of the concept of a new model of pharmacist functioning in healthcare entities and the indication of actions necessary to carry out such a change. The questionnaire was addressed to all hospital pharmacists in Poland. Two hundred and seventy-seven hospital pharmacists were included in the research. The analysis of the data revealed that almost all (96.1%) respondents indicated the need to introduce changes to the model of functioning of pharmacists in medical entities. Two-thirds of pharmacists declared readiness to start work to introduce changes. Hospital pharmacists recognize the importance of clinical pharmacy in their current practice; however, the biggest barrier is the lack of financing, an insufficient number of staff, a lack of knowledge and skills, and a lack of tools to use the service.
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Affiliation(s)
- Marcin Bochniarz
- Specialist Hospital, Subcarpathian Oncology Centre, 36-200 Brzozów, Poland
| | | | - Anna Lewandowska
- Department of Management, University of Information Technology and Management, 35-225 Rzeszów, Poland
| | - Joanna Podgórska
- Department of Economics and Finance, University of Information Technology and Management, 35-225 Rzeszów, Poland
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Hospital pharmacy management in a tertiary care charitable hospital: Compliance study with quality standards. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2022. [DOI: 10.1016/j.cegh.2022.101154] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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11
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A Comparative Analysis of Public Hospital Pharmacy Systems in Norway and Pakistan: A Pilot Implementation of the American Society of Health-System Pharmacists’ (ASHP) Guidelines. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19137885. [PMID: 35805553 PMCID: PMC9265955 DOI: 10.3390/ijerph19137885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 06/17/2022] [Accepted: 06/22/2022] [Indexed: 12/04/2022]
Abstract
The objective of the study was to analyze and compare public hospital pharmacy practices in Pakistan and Norway. In addition, the study intended to identify the challenges to improving the public hospital pharmacy system and to propose recommendations that could help reform the practice to enhance patient safety and compliance. A cross-sectional study was conducted to understand public hospital pharmacies’ organizational structure and determine their practices in Norway and Pakistan. The results of the research showed differences in 11 main areas of the pharmacy systems of the sampled hospitals. When compared to Norway, the study found that the public hospital pharmacy system in Pakistan could be improved in nine main areas. The results show that hospital pharmacies in Pakistan could benefit from the experience of similar international structures in relation to universal standards and practices.
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Malik P, Rangel M, VonBriesen T. Why the Utilization of Ready-to-Administer Syringes During High-Stress Situations Is More Important Than Ever. JOURNAL OF INFUSION NURSING 2022; 45:27-36. [PMID: 34839309 PMCID: PMC8700297 DOI: 10.1097/nan.0000000000000451] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The COVID-19 pandemic has led to a high-stress environment causing a significant impact on frontline workers, including pharmacists and nurses. In addition to the increased workload, scarcity of resources, and emotional challenges, the frontline health care workers are required to wear additional personal protective equipment that can further limit their range of movement and decrease efficiency. The potential for errors can increase in these types of high-stress situations. One way to reduce the risk of errors is to use manufacturer-prepared, ready-to-administer (RTA) prefilled syringes, when appropriate. The use of RTA prefilled syringes is supported by literature evidence, recommendations, and guidelines from various professional organizations and societies.
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Affiliation(s)
- Pashmina Malik
- Fresenius Kabi, Lake Zurich, Illinois
- Pashmina Malik, PharmD, MPH, is the director of medical affairs at Fresenius Kabi and is responsible for leading the Simplist ready-to-administer products portfolio and generic pharmaceutical infusion products. Dr Malik is an accomplished clinical leader who has worked in large global pharmaceutical companies and has experience working with pharmaceutical products in multiple therapeutic areas, including critical care, anesthesia and analgesia, pain management, oncology, parenteral nutrition, and infectious disease. She has also worked as a home infusion clinical pharmacist before she moved to the pharmaceutical industry. Dr Malik earned her doctor of pharmacy from Midwestern University Chicago College of Pharmacy, her master of public health from University of Illinois Chicago, and Executive Leadership Scholar Program from Kellogg School of Management at Northwestern University
- Melissa Rangel, PharmD, RPh, is a senior medical affairs associate with Fresenius Kabi serving as an operational lead for creating and managing the dissemination of medical information. Prior to joining Fresenius Kabi, Dr Rangel worked as a clinical pharmacist in hospital and retail settings. Dr Rangel earned her doctor of pharmacy from Drake University College of Pharmacy and Health Sciences
- Tracy VonBriesen, MS, RN, is the director of human factors at Fresenius Kabi, focusing on new product development of combination drug-device products. Ms VonBriesen has led teams that provide clinical and human factors support during development activities required for product life cycle management of serialized and nonserialized infusion devices and combination products. Ms VonBriesen is a registered nurse with 20 years of experience and holds a master's degree in patient safety leadership from the University of Illinois School of Medicine. Prior to her corporate nursing career, Ms VonBriesen's clinical background encompassed a variety of hospital-based assignments including neonatal intensive care and liver transplants
| | - Melissa Rangel
- Fresenius Kabi, Lake Zurich, Illinois
- Pashmina Malik, PharmD, MPH, is the director of medical affairs at Fresenius Kabi and is responsible for leading the Simplist ready-to-administer products portfolio and generic pharmaceutical infusion products. Dr Malik is an accomplished clinical leader who has worked in large global pharmaceutical companies and has experience working with pharmaceutical products in multiple therapeutic areas, including critical care, anesthesia and analgesia, pain management, oncology, parenteral nutrition, and infectious disease. She has also worked as a home infusion clinical pharmacist before she moved to the pharmaceutical industry. Dr Malik earned her doctor of pharmacy from Midwestern University Chicago College of Pharmacy, her master of public health from University of Illinois Chicago, and Executive Leadership Scholar Program from Kellogg School of Management at Northwestern University
- Melissa Rangel, PharmD, RPh, is a senior medical affairs associate with Fresenius Kabi serving as an operational lead for creating and managing the dissemination of medical information. Prior to joining Fresenius Kabi, Dr Rangel worked as a clinical pharmacist in hospital and retail settings. Dr Rangel earned her doctor of pharmacy from Drake University College of Pharmacy and Health Sciences
- Tracy VonBriesen, MS, RN, is the director of human factors at Fresenius Kabi, focusing on new product development of combination drug-device products. Ms VonBriesen has led teams that provide clinical and human factors support during development activities required for product life cycle management of serialized and nonserialized infusion devices and combination products. Ms VonBriesen is a registered nurse with 20 years of experience and holds a master's degree in patient safety leadership from the University of Illinois School of Medicine. Prior to her corporate nursing career, Ms VonBriesen's clinical background encompassed a variety of hospital-based assignments including neonatal intensive care and liver transplants
| | - Tracy VonBriesen
- Fresenius Kabi, Lake Zurich, Illinois
- Pashmina Malik, PharmD, MPH, is the director of medical affairs at Fresenius Kabi and is responsible for leading the Simplist ready-to-administer products portfolio and generic pharmaceutical infusion products. Dr Malik is an accomplished clinical leader who has worked in large global pharmaceutical companies and has experience working with pharmaceutical products in multiple therapeutic areas, including critical care, anesthesia and analgesia, pain management, oncology, parenteral nutrition, and infectious disease. She has also worked as a home infusion clinical pharmacist before she moved to the pharmaceutical industry. Dr Malik earned her doctor of pharmacy from Midwestern University Chicago College of Pharmacy, her master of public health from University of Illinois Chicago, and Executive Leadership Scholar Program from Kellogg School of Management at Northwestern University
- Melissa Rangel, PharmD, RPh, is a senior medical affairs associate with Fresenius Kabi serving as an operational lead for creating and managing the dissemination of medical information. Prior to joining Fresenius Kabi, Dr Rangel worked as a clinical pharmacist in hospital and retail settings. Dr Rangel earned her doctor of pharmacy from Drake University College of Pharmacy and Health Sciences
- Tracy VonBriesen, MS, RN, is the director of human factors at Fresenius Kabi, focusing on new product development of combination drug-device products. Ms VonBriesen has led teams that provide clinical and human factors support during development activities required for product life cycle management of serialized and nonserialized infusion devices and combination products. Ms VonBriesen is a registered nurse with 20 years of experience and holds a master's degree in patient safety leadership from the University of Illinois School of Medicine. Prior to her corporate nursing career, Ms VonBriesen's clinical background encompassed a variety of hospital-based assignments including neonatal intensive care and liver transplants
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13
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Rocha BG, Silva AMS, Pereira ML, Baldoni AO, Ayres LR, Penm J, Moles R, Sanches C. Perception of pharmacists regarding human resources, training, and development of a national hospital pharmacy: a preliminary report on Basel Statements. BRAZ J PHARM SCI 2022. [DOI: 10.1590/s2175-97902022e19877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Affiliation(s)
| | | | | | | | | | - Jonathan Penm
- International Pharmaceutical Federation, Netherlands; University of Sydney, Australia; Prince of Wales Hospital, Australia
| | - Rebekah Moles
- International Pharmaceutical Federation, Netherlands; University of Sydney, Australia
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14
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Weingarten MM, Cokley JA, Moffett B, DiCarlo S, Misra SN. Trends and Costs Associated With the Diagnosis and Treatment of Infantile Spasms: A 10-Year Multicenter Retrospective Review. J Pediatr Pharmacol Ther 2021; 27:29-37. [PMID: 35002556 PMCID: PMC8717615 DOI: 10.5863/1551-6776-27.1.29] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 06/05/2021] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Early treatment of infantile spasms (IS) may be imperative for improvement of neurodevelopmental outcomes. Existing studies have led to inconclusive recommendations with variation in treatment. Our objective was to determine the national average cost, initial diagnostic workup, treatments, and hospital length of stay for patients with IS. METHODS This retrospective cohort study was designed to review data of patients < 2 years from 43 non-profit institutions. Data obtained included patient demographics, length of stay, admission cost, and treatments used from 2004 to 2014. Cost data were collected and adjusted to 2014 dollars, the year data were analyzed. RESULTS A total of 6183 patients met study criteria (n = 3382, 55% male). Three-quarters of patients (n = 4684, 76%) had an electroencephalogram, 56.4% had brain imaging (n = 3487), and 17% (n = 1050) underwent a lumbar puncture. Medication for IS was initiated during inpatient hospital stay in two-thirds of all patients (n = 4139, 67%). Most patients were initiated on corticotropin (n = 2066, 33%) or topiramate (n = 1804, 29%). Average length of stay was 5.8 days with an average adjusted cost of $18,348. Over time there was an 86.6% increase in cost from an average $12,534.54 (2004) to $23,391.20 (2014), a significant change (p < 0.01). This correlated with an increase in average length of stay. CONCLUSIONS Variability exists in diagnostic workup and pharmacotherapy initiated for IS, which may lead to differences in the cost of hospital stay. Further studies may help determine contributing factors to increased cost and improve health care utilization for IS patients.
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Affiliation(s)
| | - Jon A. Cokley
- Baylor College of Medicine, Texas Children's Hospital, Houston, TX (JAC, BM, SD)
| | - Brady Moffett
- Baylor College of Medicine, Texas Children's Hospital, Houston, TX (JAC, BM, SD)
| | - Shannon DiCarlo
- Baylor College of Medicine, Texas Children's Hospital, Houston, TX (JAC, BM, SD)
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15
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ASHP Standard for Certification as a Center of Excellence in Medication-Use Safety and Pharmacy Practice. Am J Health Syst Pharm 2021; 79:564-599. [PMID: 34729588 DOI: 10.1093/ajhp/zxab368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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16
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Development and validation of tool to assess the perception, expectation & satisfaction about the patient care services provided by the community pharmacist. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2021. [DOI: 10.1016/j.cegh.2021.100873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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17
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Khanina A, Cairns KA, Kong DCM, Thursky KA, Slavin MA, Roberts JA. The impact of pharmacist‐led antifungal stewardship interventions in the hospital setting: a systematic review. JOURNAL OF PHARMACY PRACTICE AND RESEARCH 2021. [DOI: 10.1002/jppr.1721] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Affiliation(s)
- Anna Khanina
- Peter MacCallum Cancer Centre The National Centre for Infections in Cancer Melbourne Australia
- Sir Peter MacCallum Department of Oncology The University of Melbourne Melbourne Australia
| | | | - David C. M. Kong
- The National Centre for Antimicrobial Stewardship The Peter Doherty Institute for Infection and Immunity Melbourne Australia
- Centre for Medicine Use and Safety Monash Institute of Pharmaceutical SciencesMonash University Parkville Australia
- Ballarat Health Services Parkville Australia
| | - Karin A. Thursky
- Peter MacCallum Cancer Centre The National Centre for Infections in Cancer Melbourne Australia
- Sir Peter MacCallum Department of Oncology The University of Melbourne Melbourne Australia
- The National Centre for Antimicrobial Stewardship The Peter Doherty Institute for Infection and Immunity Melbourne Australia
- Department of Medicine University of Melbourne Parkville Australia
- Department of Infectious Diseases Peter MacCallum Cancer Centre Melbourne Australia
| | - Monica A. Slavin
- Peter MacCallum Cancer Centre The National Centre for Infections in Cancer Melbourne Australia
- Sir Peter MacCallum Department of Oncology The University of Melbourne Melbourne Australia
- Department of Medicine University of Melbourne Parkville Australia
- Department of Infectious Diseases Peter MacCallum Cancer Centre Melbourne Australia
| | - Jason A. Roberts
- Faculty of Medicine The University of Queensland University of Queensland Centre for Clinical Research Brisbane Australia
- Departments of Pharmacy and Intensive Care Medicine Royal Brisbane and Women’s Hospital Brisbane Australia
- Division of Anaesthesiology Critical Care Emergency and Pain Medicine Nîmes University Hospital University of Montpellier Nîmes France
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18
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Griebe K, Jiang C, To L, Peters M, MacDonald NC. Pharmacy emergency preparedness training as a PGY2 longitudinal rotation. Am J Health Syst Pharm 2021; 78:669-673. [PMID: 33594437 PMCID: PMC7929405 DOI: 10.1093/ajhp/zxab044] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Kristin Griebe
- Department of Pharmacy Services Henry Ford Hospital Detroit, MI, USA
| | - Christine Jiang
- Department of Pharmacy Services Henry Ford Hospital Detroit, MI, USA
| | - Long To
- Department of Pharmacy Services Henry Ford Hospital Detroit, MI, USA
| | - Michael Peters
- Department of Pharmacy Services Henry Ford Hospital Detroit, MI, USA
| | - Nancy C MacDonald
- Department of Pharmacy Services Henry Ford Hospital Detroit, MI, USA
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19
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Booth JP, Kennerly-Shah JM, Hartman AD. Description of the role of pharmacist independent double checks during cognitive order verification of outpatient parenteral anti-cancer therapy. J Oncol Pharm Pract 2021; 28:381-386. [PMID: 33611975 DOI: 10.1177/1078155221994319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
INTRODUCTION To describe pharmacist interventions as a result of an independent double check during cognitive order verification of outpatient parenteral anti-cancer therapy. METHODS A single-center, retrospective analysis of all individual orders for outpatient, parenteral anti-cancer agents within a hematology/oncology infusion center during a 30 day period was conducted. The primary endpoint was error identification rates during first and second verification. Secondary endpoints included the type, frequency, and severity of errors identified during second verification using a modified National Coordinating Council for Medication Error Reporting and Prevention Index. RESULTS A total of 1970 anti-cancer parenteral orders were screened, from which 1645 received an independent double check and were included. The number of errors identified during first and second verification were 30 (1.8%) and 10 (0.6%) respectively; second verification resulted in a 33.3% increase in corrected errors. The 10 errors identified during second verification included: four rate transcriptions to optimize pump interoperability, three rate and/or volume modifications, two dosage adjustments, and one treatment deferral due to toxicity. The severity was classified as Category A for four (40%), Category C for three (30%), and Category D for three (30%) errors. This correlated to a low capacity for harm for seven (70%) and a serious capacity for three (30%) errors. CONCLUSIONS Second verification of outpatient, parenteral anti-cancer medication orders resulted in a 33.3% increase in corrected errors. Three errors detected during second verification were determined to have a serious capacity for harm, supporting the value of independent double checks during pharmacist cognitive order verification.
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Affiliation(s)
- Jennifer P Booth
- Department of Pharmacy, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Julie M Kennerly-Shah
- The Arthur G. James Cancer Hospital and Richard Solove Research Institute, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Amber D Hartman
- The Arthur G. James Cancer Hospital and Richard Solove Research Institute, The Ohio State University Wexner Medical Center, Columbus, OH, USA
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20
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Risk of Patient Harm Related to Unnecessary Dilution of Ready-to-Administer Prefilled Syringes: A Literature Review. JOURNAL OF INFUSION NURSING 2021; 43:146-154. [PMID: 32287169 DOI: 10.1097/nan.0000000000000366] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Unnecessary dilution of ready-to-administer (RTA) syringes could increase the risk of patient harm attributed to errors related to incorrect dose, improper labeling, and the potential for microbial contamination. Although published guidelines endorse the use of commercially available RTA syringes, recent surveys indicate that best practices are not always implemented. The purpose of this article is to review the existing literature and to assess the incidence and nature of errors related to the unnecessary dilution of RTA intravenous (IV) push medications in the inpatient clinical setting. The PubMed database was searched to identify studies of errors related to the use of RTA syringes for IV push medications within the last 10 years. An additional search was conducted using other search engines to identify relevant articles in the grey literature. This literature review concludes that unnecessary dilution of IV push medication in RTA syringes is an unsafe practice that occurs routinely. This practice increases the risk of patient harm through errors related to incorrect dose, improper labeling of syringes, and the potential for microbial contamination of the product. Greater awareness of the risks associated with unnecessary dilution of RTA syringes is still needed to eliminate this unsafe IV push medication administration practice and to thereby further improve outcomes.
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21
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Huang Y, Yao D, Xi X, Wang Y, Yao W. Current status of pharmacy services in primary healthcare institutions in Jiangsu Province, China. Aust J Prim Health 2020; 26:424-430. [PMID: 32900425 DOI: 10.1071/py20038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Accepted: 06/17/2020] [Indexed: 11/23/2022]
Abstract
China is attempting to establish a pharmacy services network in primary healthcare (PHC) institutions. This study investigated the current status of pharmacy services in China. Following a conceptual framework derived from the structure-process-outcome model, a questionnaire was sent to a sample of 700 administrators, 2000 GPs, 2000 pharmacy service providers, 2000 patients with chronic diseases and 2000 patients receiving antibiotic transfusion treatment, selected using a multistage sampling strategy, from PHC institutions in Jiangsu Province, China, in July and August 2016. The installation of pharmaceutical facilities and devices, staffing by pharmaceutical professionals, patterns of pharmacy service provision and the outcomes of these services were assessed using descriptive statistics. There were 8346 respondents from 665 institutions (response rate 95.9%). Pharmaceutical department (63.0%), dispensary (50.2%) and pharmacy intravenous admixture services (54.1%) were not established in many PHC institutions. Dispensing (22.9%), pharmacotherapy consultation for patients (19.3%), drug management (17.4%) and prescription checking (16.5%) were the most important tasks for pharmacy service providers. Patients reported lower satisfaction with the dissemination of information regarding medication use (mean (±s.d.) 8.85±1.00%), the treatment of adverse drug reactions (5.65±0.50%), medical insurance reimbursement (15.25±2.45%) and the convenience of buying drugs (6.35±0.65%). Several issues regarding the facilities and devices related to pharmacy services, the quality and responsibilities of pharmacy service providers and the outcomes of pharmacy services may hamper the development of a pharmacy service system in PHC in China.
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Affiliation(s)
- Yuankai Huang
- National Development Research Center of Licensed Pharmacist, China Pharmaceutical University, Longmian Avenue 639, Jiangning District, Nanjing 211198, China
| | - Dongning Yao
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, N22-2057, Taipa, Macau, China, 999078
| | - Xiaoyu Xi
- National Development Research Center of Licensed Pharmacist, China Pharmaceutical University, Longmian Avenue 639, Jiangning District, Nanjing 211198, China
| | - Yitao Wang
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, N22-2057, Taipa, Macau, China, 999078; and Corresponding authors. ;
| | - Wenbing Yao
- National Development Research Center of Licensed Pharmacist, China Pharmaceutical University, Longmian Avenue 639, Jiangning District, Nanjing 211198, China; and Corresponding authors. ;
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22
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Guo X, Yao D, Liu J, Huang Y, Wang Y, Yao W. The current status of pharmaceutical care provision in tertiary hospitals: results of a cross-sectional survey in China. BMC Health Serv Res 2020; 20:518. [PMID: 32513167 PMCID: PMC7282101 DOI: 10.1186/s12913-020-05371-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Accepted: 05/26/2020] [Indexed: 11/19/2022] Open
Abstract
Background Pharmaceutical care is attached with increasing importance around the world due to its clinical and economical effects. Tertiary hospitals are equipped with the richest healthcare resources and pioneer in the implementation of pharmaceutical care. Understanding current status of pharmaceutical care provision in tertiary hospitals not only helps to improve the practice in tertiary hospitals but also guide the development of pharmaceutical care in secondary and primary health institutions. Method Data of a cross-sectional survey were used. The cross-sectional survey was conducted from July 2015 to June 2016, involving 520 hospital directors, 740 clinical pharmacists, 1298 physicians, 778 dispensing pharmacists and 3096 patients from 292 hospitals of 23 provinces, 4 municipalities in mainland China. The survey aimed to comprehensively investigate the current status of pharmaceutical care and health care professional’s understanding of clinical pharmacist system in tertiary hospitals. This study reports results pertaining to current status of pharmaceutical care, including pharmacy department practice rules, guidelines and records, application of rational drug use software, staffing and working arrangement of clinical pharmacists and physicians, patients’ satisfaction toward pharmaceutical care. Results A majority of the tertiary hospitals established clinical pharmacist system (84.2%), clinical pharmacist management rules (89%), clinical pharmacists’ working ethics (89%) and applied clinical rational drug use software (93.8%). However, a number of hospitals did not establish a performance evaluation system (37%) and payment rules for pharmaceutical care (81.9%). Most of the clinical pharmacists met the educational background set by the government. Averagely there were 8.3 clinical pharmacists per hospital and 90.7% of the tertiary hospitals had at least five full-time clinical pharmacists. Pharmaceutical care services provided include checking prescriptions, making treatment plans and joining clinical rounds and etc. Both physicians and patients were generally satisfied with pharmaceutical care services provided. Conclusion China has made progress in pharmaceutical care provision, but problems such as lack of rules for pharmaceutical care payment and a performance evaluation system, a monotonous variety of pharmaceutical care activities remain unsolved. Policy makers and hospitals directors are suggested to pay more attention to these problems.
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Affiliation(s)
- Xiaobo Guo
- National Development Research Center of Licensed Pharmacist, China Pharmaceutical University, Nanjing, China
| | - Dongning Yao
- Institute of Chinese Medical Sciences, University of Macau, Macao SAR, Macao, China
| | - Jie Liu
- National Development Research Center of Licensed Pharmacist, China Pharmaceutical University, Nanjing, China
| | - Yuankai Huang
- National Development Research Center of Licensed Pharmacist, China Pharmaceutical University, Nanjing, China
| | - Yitao Wang
- Institute of Chinese Medical Sciences, University of Macau, Macao SAR, Macao, China
| | - Wenbing Yao
- National Development Research Center of Licensed Pharmacist, China Pharmaceutical University, Nanjing, China.
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Ayele Y, Hawulte B, Feto T, Basker GV, Bacha YD. Assessment of patient satisfaction with pharmacy service and associated factors in public hospitals, Eastern Ethiopia. SAGE Open Med 2020; 8:2050312120922659. [PMID: 32435492 PMCID: PMC7223202 DOI: 10.1177/2050312120922659] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Accepted: 04/06/2020] [Indexed: 11/17/2022] Open
Abstract
Background: A comprehensive understanding of the extent of patient satisfaction and its determinants are crucial in improving the quality of service. Hence, this research was designed to measure patient satisfaction with pharmacy service. Methods: A cross-sectional study was conducted among 422 patients to assess satisfaction with pharmacy service in public hospitals located in Eastern Ethiopia from September to January 2018. Data were collected through an exit interview using structured questionnaires. Then, it was entered into EpiData version 3.1 and exported to STATA version 14.2 for analysis. Associations between dependent and independent variables were assessed by multiple logistic regression using an adjusted odds ratio at a 95% confidence interval and the p values of less than 0.05. Results: A total of 407 samples were included in the final analysis. The mean overall satisfaction of clients measured out of five was 2.29 (standard deviation ± 0.56). The proportion of overall satisfaction was 46.19%. Patients within the age range of 26–35 years and 36–50 years were found to have 50% (adjusted odds ratio = 0.5, 95% confidence interval: 0.3, 0.9) and 60% (adjusted odds ratio = 0.4, 95% confidence interval: 0.2, 0.8) decreased likelihood of satisfaction compared with patients within the range of 18–25 years, respectively. Likewise, patients who attended only secondary education compared to their counterpart (a certificate and above) were less likely to be satisfied (adjusted odds ratio = 0.4, 95% confidence interval: 0.2, 0.8). In contrast, rural dwellers and patients who collected all their medications from the respective hospital were found to be more satisfied compared with their equivalent (adjusted odds ratio = 3, 95% confidence interval: 1.8, 5.2) and (adjusted odds ratio = 2.2, 95% confidence interval: 1.4, 3.5), respectively. Conclusion: Patient satisfaction with pharmacy service was found to be very low considering the current health-care system movement toward delivering quality service. Hence, health-care providers and administrators should give due attention to contributing factors in order to improve the quality of service and ultimately increase patient satisfaction.
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Affiliation(s)
- Yohanes Ayele
- Department of Clinical Pharmacy, School of Pharmacy, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Behailu Hawulte
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Tilaye Feto
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - G Vijai Basker
- Department of Clinical Pharmacy, School of Pharmacy, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Yadeta Dessie Bacha
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
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Job satisfaction among pharmacy professionals working in public hospitals and its associated factors, eastern Ethiopia. J Pharm Policy Pract 2020; 13:11. [PMID: 32426143 PMCID: PMC7216524 DOI: 10.1186/s40545-020-00209-3] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Accepted: 04/08/2020] [Indexed: 11/16/2022] Open
Abstract
Background Poor job satisfaction has been associated with less productivity and high staff turnover. Various factors are thought to contribute for job dissatisfaction among pharmacy professionals and very limited studies have been conducted in eastern part of Ethiopia. Therefore, the current study was aimed to assess the level of job satisfaction among pharmacy professionals and its predictors. Methods A cross-sectional study was conducted among 232 pharmacy professionals to assess level of job satisfaction in public hospitals located in the eastern Ethiopia. The data were collected using self- administered semi-structured questionnaires. Data were entered into Epi-Data version 3.1 and exported to STATA version 14.2 for analysis. Associations between the dependent and independent variables were assessed by multivariate analysis using an Adjusted Odds Ratio (AOR) at a 95% confidence interval (CI) and p-value less than 0.05 was considered as significant. Results A total 220 questionnaires were found complete and included in the analysis. The mean age of participants was 27.6(SD + 4.1). More than half of the respondents (55.4%) had a bachelor degree and the majority (86.4%) were working less than 40 h per week, mostly in dispensing units (75.4%). About one third of the participants (32.7, 95% CI; 26.8–39.2) were found to be satisfied with their job. Age category of 20 to 25 years in reference to age greater than 30 years (AOR = 3.5, 95% CI; 1.1–9.7), holding a bachelor degree in reference to having diploma (AOR = 4.2, 95% CI; 1.8–10.00), working for more than 40 h per week (AOR = 6.2, 95% CI, 2.4–16), and working in dispensing units (AOR = 2.4, 95% CI; 1.1–5.5) were found to have strong association with job dissatisfaction. Conclusion In this study, the job satisfaction levels of pharmacy professionals were found to be very low. The age category of 20 to 25, holding a bachelor degree, working for more than 40 h per week, and working in dispensing unit were found to be strong predictors of job dissatisfaction. Hence, pharmacy directors and hospital administrators should work to reduce unnecessary workload on the staffs and create good working climate.
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25
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Chamoun N, Usta U, Karaoui LR, Salameh P, Hallit S, Shuhaiber P, Henaine AM, Akiki Y, Zeenny RM, Iskandar K. Current Trends in Hospital Pharmacy Practice in Lebanon. Hosp Pharm 2020; 55:112-118. [PMID: 32214445 PMCID: PMC7081488 DOI: 10.1177/0018578718823733] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objectives: For decades, the role of hospital pharmacists has been instrumental in elevating pharmacy practice worldwide. Recently, the Hospital Pharmacy Section of the International Pharmaceutical Federation (FIP), the European Association of Hospital Pharmacists (EAHP), and the American Society of Health-System Pharmacists (ASHP) updated their statements about the future role and responsibilities of the pharmacy executive in hospitals and health systems. A series of surveys were conducted around the globe to better understand the current state of hospital pharmacy practice. The purpose of these surveys was to identify challenges in hospital pharmacy practice and to develop improvement strategies. The objective of this national survey is to evaluate hospital pharmacy practice in Lebanon. Methods: A cross-sectional observational study was performed among pharmacists working in hospital settings in Lebanon, from January through June 2016. Based on a literature review, a questionnaire to elicit Lebanese hospital pharmacists' practice was developed. Results: The results showed a nonsignificant difference between university teaching and nonuniversity teaching hospitals in the processes of drug procurement, preparation, dispensing, and drug administration. However, statistically significant differences were observed between university teaching and nonuniversity teaching hospitals with respect to having clinical pharmacists (P < .001) and highly qualified personnel (P < .005). Pharmacy services in teaching hospitals seemed to be more advanced cooperating with affiliated medical schools. Furthermore, teaching hospitals were more likely to have pharmacists providing information about the safety of the medications used (P = .029). Although not statistically significant, there was a higher trend toward having a designated champion for medication safety (P = .052). Conclusion: The results of our survey showed that teaching hospitals were more compliant with the International Statements of Hospital Pharmacy Practice compared with nonteaching hospitals. There is room for improvement especially if the application of the accreditation standards for safe hospital pharmacy practice becomes mandatory for all hospitals, which is expected to standardize pharmacy practice and secure both medication and patient safety.
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Affiliation(s)
- Nibal Chamoun
- School of Pharmacy, Lebanese American University, Byblos, Lebanon
| | - Ulfat Usta
- Pharmacy Department, American University of Beirut Medical Center, Beirut, Lebanon
| | - Lamis R. Karaoui
- School of Pharmacy, Lebanese American University, Byblos, Lebanon
| | - Pascale Salameh
- Faculty of Pharmacy, Lebanese University, Beirut, Lebanon
- Faculty of Medicine, Lebanese University, Beirut, Lebanon
- INSPECT-LB: Institut National de Sante Publique, Epidemiologie Clinique et Toxicologie, Beirut, Lebanon
| | - Souheil Hallit
- INSPECT-LB: Institut National de Sante Publique, Epidemiologie Clinique et Toxicologie, Beirut, Lebanon
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon
| | | | - Anna-Maria Henaine
- Faculty of Pharmacy, Lebanese University, Beirut, Lebanon
- Faculty of Business, Balamand University, Koura, Lebanon
| | - Youssef Akiki
- Faculty of Pharmacy, Lebanese University, Beirut, Lebanon
- Faculty of Business, Balamand University, Koura, Lebanon
| | - Rony M. Zeenny
- Pharmacy Department, American University of Beirut Medical Center, Beirut, Lebanon
| | - Katia Iskandar
- INSPECT-LB: Institut National de Sante Publique, Epidemiologie Clinique et Toxicologie, Beirut, Lebanon
- INSERM, Equipe 5, EQUITY, Toulouse, France
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ASHP Practice Advancement Initiative 2030: New recommendations for advancing pharmacy practice in health systems. Am J Health Syst Pharm 2019; 77:113-121. [DOI: 10.1093/ajhp/zxz271] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Abstract
Purpose
The process of updating the recommendations of the ASHP Practice Advancement Initiative (PAI) is described, and the new recommendations targeted toward the year 2030 are presented.
Summary
The process for updating ASHP recommendations for pharmacy-practice change included online surveys of pharmacists, pharmacy technicians, and other stakeholders; extensive discussions by an advisory panel, a strategic planning group, and participants in a town hall session at a national conference; an online public comment period; and final approval by the ASHP Board of Directors.
Conclusion
The guidance offered by the 59 updated PAI recommendations, which take into account environment trends that are likely to affect the pharmacy enterprise, will help health-system pharmacists in their ongoing pursuit of optimal, safe, and effective use of medicines.
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Pitchayajittipong C, Sriboon S, Kulmee S, Prachuabaree L, Srisawai K, Wattanawong W, Sripa S, Anderson C, Supapaan T. An Overview of Pharmaceutical Production in Thai Hospitals. Hosp Pharm 2019; 56:265-275. [PMID: 34381260 DOI: 10.1177/0018578719890090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Purpose: The purpose of this research was to provide an overview of pharmaceutical production in Thai hospitals. Methods: A cross-sectional survey was developed to study pharmaceutical production in the 1347 Thai hospitals. A representative sample was chosen using multistep selection arriving at a final total of 750 hospitals. Five experts in hospital pharmacy production were recruited to evaluate the content validity. The questionnaire consisted of 2 parts: (1) general details of the hospitals and (2) the type of pharmaceutical products. The latter classification were further divided into 6 types: (1) nonsterile products, (2) extemporaneous preparations, (3) total parenteral nutrition, (4) intravenous admixtures, (5) cytotoxic preparations, and (6) herbal medicine products. All data were analyzed via descriptive statistics. Results: From the 750 questionnaires sent out, 395 hospitals (52.67%) responded to the questionnaires. Regarding the 395 respondent sample group, approximately 60% of the hospitals were involved in pharmaceutical production. The top 3 pharmaceutical products were as follows: (1) cytotoxic preparations (315 items); (2) liquid nonsterile preparations (60 items), and (3) liquid extemporaneous preparations (52 items). The most frequently mentioned reasons for the production of each dosage form were as follows: (1) no commercially available product in appropriate dosage form or strength needed and (2) product was prepared following the hospital's policy. The support needs in hospital pharmacy production were revealed as follows: (1) master formula, (2) quality assurance and quality control processes, (3) equipment, (4) standard references, (5) buildings, (6) personnel, (7) budget, (8) raw material suppliers, and (9) the coordination between the faculties of pharmaceutical sciences and hospitals. Conclusions: Approximately 60% of the respondents had pharmaceutical production in their hospitals. The greatest need for support was for a master formula to inform hospital-based pharmaceutical production. These findings provide essential information, especially for stakeholders, to understand the professional challenges and likely pharmaceutically related health service changes in the future.
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Lanier C, Moss J, Tunney R, Baird R, Kelly K. Clinical Pharmacy Practice Patterns Among North Carolina Rural Hospitals. J Pharm Pract 2019; 34:279-286. [PMID: 31422734 DOI: 10.1177/0897190019866325] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Rural hospitals are isolated without adequate funding needed to provide for clinical services offered at larger health systems. The purpose of this study is to determine the clinical pharmacy services available and desired by rural hospitals in North Carolina. METHODS This prospective, cross-sectional, survey was distributed to a cohort of rural pharmacy directors and managers at rural hospitals across North Carolina. Data collected pertained to characteristics of the hospital and pharmacy, pharmacy director, clinical services, and responder impressions on their ability to maintain or enhance clinical services. Responses were summarized utilizing descriptive statistics and free-responses were coded for similar themes. RESULTS Seventeen respondents (32.6%) completed the survey. Clinical activities varied, as did characteristics of the hospitals and staff. Improved patient care is the primary reason why hospital pharmacies expand their clinical participation (46.7%). Pharmacy directors believed growth of clinical activities was a long-term goal while reporting regulations, staff, and finances as barriers to growth. CONCLUSION Clinical pharmacy services vary in NC rural hospitals. Directors exhibit a willingness to expand clinical responsibilities. Rural hospital pharmacy directors desire pharmacists to be active clinically in patient care, but face barriers in reaching that goal.
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Affiliation(s)
- Cameron Lanier
- 233484Campbell University College of Pharmacy & Health Sciences, Buies Creek, NC, USA
- 385561Harnett Health System, Dunn, NC, USA
| | - Jason Moss
- 233484Campbell University College of Pharmacy & Health Sciences, Buies Creek, NC, USA
- 385561Harnett Health System, Dunn, NC, USA
| | - Robert Tunney
- 233484Campbell University College of Pharmacy & Health Sciences, Buies Creek, NC, USA
- Vidant Health, Greenville, SC, USA
| | | | - Kim Kelly
- 233484Campbell University College of Pharmacy & Health Sciences, Buies Creek, NC, USA
- 385561Harnett Health System, Dunn, NC, USA
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Fanikos J, Burger M, Canada T, Ebright P, Fleming J, Harder KA, Pham JC, Sawyer MD, Stevenson JG. An assessment of currently available i.v. push medication delivery systems. Am J Health Syst Pharm 2019; 74:e230-e235. [PMID: 28438828 DOI: 10.2146/ajhp150830] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Affiliation(s)
| | | | - Todd Canada
- MD Anderson Cancer Center, Houston, TX, and University of Texas at Austin College of Pharmacy, Austin, TX
| | | | - Joshua Fleming
- Leesburg Regional Medical Center, Central Florida Health, Leesburg, FL
| | - Kathleen A Harder
- Center for Design in Health, University of Minnesota, Minneapolis, MN
| | - Julius Cuong Pham
- Department of Anesthesia and Critical Care Medicine, Armstrong Institute for Patient Safety and Quality, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Melinda D Sawyer
- Armstrong Institute for Patient Safety and Quality, Johns Hopkins University School of Medicine, Baltimore, MD
| | - James G Stevenson
- Department of Clinical Pharmacy, University of Michigan College of Pharmacy, Ann Arbor, MI, and Visante, St. Paul, MN.
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Bickham P, Golembiewski J, Meyer T, Murray CG, Wagner D. ASHP guidelines on perioperative pharmacy services. Am J Health Syst Pharm 2019; 76:903-820. [DOI: 10.1093/ajhp/zxz073] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Peggy Bickham
- University of Illinois Hospital and Health Sciences System, Hospital Pharmacy Services, Chicago, IL
| | - Julie Golembiewski
- University of Illinois at Chicago College of Pharmacy, Department of Pharmacy Practice, UI Health, Hospital Pharmacy and Anesthesiology, Chicago, IL
| | - Tricia Meyer
- Baylor Scott & White Medical Center–Temple, Texas A&M College of Medicine, Temple, TX
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31
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Watson K, Leon N, Reed BN, Levit MB, Devabhakthuni S. Physical examination training for pharmacy residents in adult patient care programs: A survey of program directors. JOURNAL OF THE AMERICAN COLLEGE OF CLINICAL PHARMACY 2019. [DOI: 10.1002/jac5.1121] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Kristin Watson
- Department of Pharmacy Practice and Science; ATRIUM Cardiology Collaborative, University of Maryland School of Pharmacy; Baltimore Maryland
| | - Nicholas Leon
- Department of Pharmacy Practice, College of Pharmacy; Thomas Jefferson University; Philadelphia Pennsylvania
| | - Brent N. Reed
- Department of Pharmacy Practice and Science; ATRIUM Cardiology Collaborative, University of Maryland School of Pharmacy; Baltimore Maryland
| | | | - Sandeep Devabhakthuni
- Department of Pharmacy Practice and Science; ATRIUM Cardiology Collaborative, University of Maryland School of Pharmacy; Baltimore Maryland
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Perlman A, Horwitz E, Hirsh-Raccah B, Aldouby-Bier G, Fisher Negev T, Hochberg-Klein S, Kalish Y, Muszkat M. Clinical pharmacist led hospital-wide direct oral anticoagulant stewardship program. Isr J Health Policy Res 2019; 8:19. [PMID: 30709417 PMCID: PMC6357500 DOI: 10.1186/s13584-019-0285-9] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Accepted: 11/05/2018] [Indexed: 12/20/2022] Open
Abstract
Introduction In the past decade, direct-acting oral anticoagulants (DOAC) have been introduced to medical practice for several indications, with a wide range of dosing regimens. As both over- and under-dosing might lead to life-threatening events, development of methods promoting safe and effective utilization of these agents is imperative. The Hadassah Clinical Pharmacy team initiated a hospital-wide program, for monitoring and promoting safe and effective prescription of DOAC during hospitalization. This study describes the types of drug related problems addressed and the program’s performance in terms of consultation rates and physician acceptance. Methods Electronic medical records throughout the hospital were screened for DOAC orders. All DOAC orders were assessed by a clinical pharmacist for potentially-inappropriate prescribing. When potentially-inappropriate prescribing or a drug-related problem was identified, the clinical pharmacist provided consultation on management options. In specific cases, additional guidance was provided by coagulation and pharmacology specialists. Data on patient characteristics, clinical pharmacist consultations, and physician response was retrospectively retrieved for the first six months of 2017. Characteristics of patients with and without consultations were compared, consultations were categorized by the recommended management of the drug related problem, and physician acceptance rates were evaluated by category. Results During the evaluated period, 585 patients with DOAC orders were identified. Patients were evenly distributed by gender, and age averaged 78 years. Most patients received apixaban (75%) followed by rivaroxaban (14%) and dabigatran (11%), and most (63%) received “reduced dose” regimens. Clinical pharmacists provided 258 consultations for 210 patients, regarding anticoagulation management, such that more than one in three patients on DOAC had potentially inappropriate prescribing or drug related problems. Consultations included alerts regarding potentially inappropriate DOAC doses and recommendations to increase (29%) or decrease (5%) the dose, potentially inappropriate concomitant antiplatelet agents (20%), need for DOAC level monitoring (23%), and alerts regarding other drug related problems (23%). More than 70% of recommendations were accepted by the attending physician. Conclusion Due to the complexity of DOAC management, potentially-inappropriate prescribing and drug related problems are common. Multidisciplinary collaborative projects including review and consultation by clinical pharmacists are an effective method of improving management of patients on DOAC. Trial registration Retrospectively registered at clinicaltrials.gov, NCT03527615.
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Affiliation(s)
- Amichai Perlman
- Department of Pharmacy, Hadassah Hebrew University Medical Center, Jerusalem, Israel.,Department of Medicine, Hadassah Hebrew University Medical Center, Mt Scopus, Jerusalem, Israel.,Department of Cardiology, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - Ehud Horwitz
- Department of Pharmacy, Hadassah Hebrew University Medical Center, Jerusalem, Israel.,Department of Medicine, Hadassah Hebrew University Medical Center, Mt Scopus, Jerusalem, Israel
| | - Bruria Hirsh-Raccah
- Department of Pharmacy, Hadassah Hebrew University Medical Center, Jerusalem, Israel.,Department of Cardiology, Hadassah Hebrew University Medical Center, Jerusalem, Israel.,Department of Oncology, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - Gefen Aldouby-Bier
- Department of Pharmacy, Hadassah Hebrew University Medical Center, Jerusalem, Israel.,Department of Orthopedics, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - Tamar Fisher Negev
- Department of Pharmacy, Hadassah Hebrew University Medical Center, Jerusalem, Israel.,Department of Hematology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Sarit Hochberg-Klein
- Department of Pharmacy, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - Yosef Kalish
- Department of Hematology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Mordechai Muszkat
- Department of Medicine, Hadassah Hebrew University Medical Center, Mt Scopus, Jerusalem, Israel.
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Smith ZR, Rangarajan K, Barrow J, Carter D, Coons JC, Dzierba AL, Falvey J, Fester KA, Guido MR, Hao D, Ou NN, Pogue KT, MacDonald NC. Development of best practice recommendations for the safe use of pulmonary hypertension pharmacotherapies using a modified Delphi method. Am J Health Syst Pharm 2019; 76:153-165. [DOI: 10.1093/ajhp/zxy020] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Zachary R Smith
- Department of Pharmacy, Henry Ford Hospital, Detroit, Michigan
| | | | - Jennifer Barrow
- Department of Pharmacy, University of North Carolina Medical Center, Chapel Hill, NC
| | - Danielle Carter
- Department of Pharmacy Services, Brigham & Women’s Hospital, Boston, MA
| | - James C Coons
- Department of Pharmacy, UPMC Presbyterian Hospital, Pittsburgh, PA, and University of Pittsburgh School of Pharmacy, Pittsburgh, PA
| | - Amy L Dzierba
- Department of Pharmacy, New York-Presbyterian Hospital, New York, NY
| | - Jennifer Falvey
- Department of Pharmacy, University of Rochester Medical Center, Rochester, NY
| | - Keith A Fester
- Department of Pharmacy, Barnes-Jewish Hospital, St. Louis, MO
| | - Maria R Guido
- Department of Pharmacy, University of Cincinnati Medical Center, Cincinnati, OH
| | - Diana Hao
- Department of Pharmacy Services, UC Davis Medical Center, Sacramento, CA
| | - Narith N Ou
- Department of Pharmacy, Mayo Clinic, Rochester, MN
| | - Kristen T Pogue
- Department of Pharmacy, University of Michigan Hospitals and Health Centers, Ann Arbor, MI
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The Impact of Phone Interruptions on the Quality of Simulated Medication Order Validation Using Eye Tracking: A Pilot Study. Simul Healthc 2019; 14:90-95. [PMID: 30601467 DOI: 10.1097/sih.0000000000000350] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Order validation is an important component of pharmacy services, where pharmacists review orders with a focus on error prevention. Interruptions are frequent and may contribute to a reduction in error detection, thus potential medication errors. However, studying such errors in practice is difficult. Simulation has potential to study these events. METHODS This was a pilot, simulation study. The primary objective was to determine the rate of medication error detection and the effect of interruptions on error detection during simulated validation. Secondary objectives included determining time to complete each prescription page. The scenario consisted of validating three handwritten medication order pages containing 12 orders and 17 errors, interrupted by three phone calls timed during one order for each page. Participants were categorized in groups: seniors and juniors (including residents). Simulation sessions were videotaped and eye tracking was used to assist in analysis. RESULTS Eight senior and five junior pharmacists were included in the analysis. There was a significant association between interruption and error detection (odds ratio = 0.149, 95% confidence interval = 0.042-0.525, P = 0.005). This association did not vary significantly between groups (P = 0.832). Juniors took more time to validate the first page (10 minutes 56 seconds vs. 6 minutes 42 seconds) but detected more errors (95% vs. 69%). However, all major errors were detected by all participants. CONCLUSIONS We observed an association between phone interruptions and a decrease in error detection during simulated validation. Simulation provides an opportunity to study order validation by pharmacists and may be a valuable teaching tool for pharmacists and pharmacy residents learning order validation.
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Hawkins-Taylor C, Taylor MB, Carlson AM. Pharmacy Practice in the South Dakota Correctional System: Discovery of an Unconventional Experiential Practice Site. Innov Pharm 2018; 9:10.24926/iip.v9i4.994. [PMID: 34007728 PMCID: PMC7640774 DOI: 10.24926/iip.v9i4.994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Pharmacists must be prepared to care for populations where health disparities are greatest and their services can best impact public health needs. Such preparation requires that students have access to practice experiences in underserved environments where pharmacy practice, cultural competence and knowledge of population health are experienced simultaneously. The correctional facility is such a place. The American Society of Health-System Pharmacists recommends that students receive preceptorship opportunities within the correctional system. The occasional collaboration or experiential opportunity, like Kingston's early model, has occurred between health professional schools and correctional facilities. However, to date, the correctional facility-experiential site remains an untapped opportunity, at least in a complete, coordinated, pharmaceutical care, patient management framework. Consequently, a short research study asked: To what extent is there potential for correctional facilities to serve as experiential practice sites for pharmacy students? The research objective was to identify pharmaceutical practices within South Dakota correctional system and compare those practices to the guidelines established by the Association of American College of Pharmacy's as optimal for student training. To understand medical and pharmaceutical practices in SDPS, three South Dakota Adult prison facilities were included in the exploratory study. Data was collected through a mixed methods approach designed to obtain perspectives about the SDPS health care system from individuals representing the numerous job levels and roles that exist within the health care continuum. Interviews and a web-based surveys were used to collect data. A review of a 36-page transcript along with 498 freeform survey comments revealed that while exact themes from the Exemplary Practice Framework may not have been evident, related words or synonyms for patient-centered care, informatics, public health, medication therapy management, and quality improvement appeared with great frequency.
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36
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Eiland LS, Benner K, Gumpper KF, Heigham MK, Meyers R, Pham K, Potts AL. ASHP–PPAG Guidelines for Providing Pediatric Pharmacy Services in Hospitals and Health Systems. Am J Health Syst Pharm 2018; 75:1151-1165. [DOI: 10.2146/ajhp170827] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Affiliation(s)
- Lea S. Eiland
- Auburn University Harrison School of Pharmacy, Auburn, AL
| | - Kim Benner
- Samford University McWhorter School of Pharmacy, Birmingham, AL
| | | | | | - Rachel Meyers
- Ernest Mario School of Pharmacy, Rutgers, The State University of New Jersey, Saint Barnabas Medical Center, Piscataway, NJ
| | | | - Amy L. Potts
- Vanderbilt Children’s Hospital Pharmacy, Nashville, TN
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Mailman JF, Semchuk W. Pharmacists' Roles in Critical Care: Environmental Scan of Current Practices in Canadian Intensive Care Units. Can J Hosp Pharm 2018; 71:215-216. [PMID: 29955196 PMCID: PMC6019081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Affiliation(s)
- Jonathan F Mailman
- Clinical Pharmacist Specialist, Saskatchewan Health Authority - Regina, Clinical Lecturer, College of Medicine, University of Saskatchewan, Regina, Saskatchewan
| | - William Semchuk
- Manager, Clinical Pharmacy Services, Director, Hospital Pharmacy Residency Program, Saskatchewan Health Authority - Regina, Regina, Saskatchewan
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Eiland LS, Benner K, Gumpper KF, Heigham MK, Meyers R, Pham K, Potts AL. ASHP-PPAG Guidelines for Providing Pediatric Pharmacy Services in Hospitals and Health Systems. J Pediatr Pharmacol Ther 2018; 23:177-191. [PMID: 29970974 PMCID: PMC6027974 DOI: 10.5863/1551-6776-23.3.177] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/19/2018] [Indexed: 11/11/2022]
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A Review of Best Practices for Intravenous Push Medication Administration. JOURNAL OF INFUSION NURSING 2018; 40:354-358. [PMID: 29112582 DOI: 10.1097/nan.0000000000000247] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
In 2015, the Institute for Safe Medication Practices (ISMP) released safe practice guidelines for adult intravenous (IV) push medications. ISMP's most recent set of guidelines has added to a growing list of recommendations from professional groups on the safe use of IV medications. These recommendations and guidelines vary with regard to their audience, scope, and terminology. In some ways, these variations may contribute to confusion and delayed adoption of the standards. This report attempts to provide clarity about the rationale and background regarding the need for practice improvement, discussion of various guidelines, and practice mitigation strategies to improve patient safety.
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40
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Zainal INA, Karim NAA, Soh YC, Suleiman AK, Khan TM, Hameed MA, Ming LC, Lean QY. Key Elements of Pharmacoinformatics for the Degrees of Bachelor and Master of Pharmacy. Ther Innov Regul Sci 2017; 51:419-425. [DOI: 10.1177/2168479017701977] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Koehler T, Brown A. Documenting the evolution of the relationship between the pharmacy support workforce and pharmacists to support patient care. Res Social Adm Pharm 2017; 13:280-285. [PMID: 28190480 PMCID: PMC5317196 DOI: 10.1016/j.sapharm.2016.10.012] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Accepted: 10/17/2016] [Indexed: 11/03/2022]
Abstract
Since 2009 there has been a focus on the relationship between pharmacy technicians, pharmacy support workforce cadres and pharmacists in the literature. 2009-2011 saw a framework of role evolution develop, with publications from 2012 to 2015 documenting further maturity in the development of practice models for improved patient care and optimal use of personnel. The dominant narrative in the published academic literature has been made by certain high- income countries (mainly Canada, Denmark, United Kingdom and the United States of America). In these countries there are significant numbers of pharmacists available and there has been an increasing interest to utilize pharmacy support workforce cadres to allow the extension of clinical roles of pharmacists in these contexts. This is not a systematic presentation of all the literature available but rather a commentary overview supported by key papers. Key points from this literature include: (To allow the reader to clearly understand the country of origin of the themes presented, care has been taken to note the country of origin of the papers used in this commentary).
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Affiliation(s)
| | - Andrew Brown
- A.N.Brown Health Systems Strengthening Consultancy Pty Ltd, 121/54 Printers Way, Kingston, ACT, Australia.
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Michel O, Beney J, Turini P, Desmedt M, Roulet L. [Patient's own medications in a Swiss regional hospital: where are we and where should we go?]. ANNALES PHARMACEUTIQUES FRANÇAISES 2017; 75:294-301. [PMID: 28168967 DOI: 10.1016/j.pharma.2016.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2016] [Revised: 11/30/2016] [Accepted: 12/01/2016] [Indexed: 10/20/2022]
Abstract
OBJECTIVE The use of patient's own medications (POMs) during inpatient admissions may represent a risk if not adequately supervised. The objective of this work was: (i) to assess the management of POMs in our hospital, and (ii) to identify actions to assure this practice. METHODS A questionnaire survey was conducted among caregivers of the medical, surgery and geriatric units of a Swiss regional hospital. Six criteria for appropriate management of POMs were identified from the literature and internal consensus. Based on this survey and data from literature, the investigators identified relevant actions to be implemented for optimizing the management of POMs. RESULTS Out of the 21 included units, 3 already set an inner written POMs policy, and 3 managed POM in accordance with selected criteria. The main issues were that POMs were mainly stored in the patient's room, and that quality criteria were not systematically checked before POMs' administration. POMs were mainly used to ensure continuity of treatment. Two thirds of the units systematically returned POMs to the patients upon discharge, but rarely sorted them out before recovery. Ten actions were identified to secure the management of POMs. CONCLUSION These results confirm that POMs are commonly used and indicate a potential for improvement in the management of POMs in our hospital. An institutional guideline is now planned to support the implementation of the identified actions.
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Affiliation(s)
- O Michel
- Service de pharmacie, institut central des hôpitaux (ICH), hôpital du Valais, avenue du Grand-Champsec 86, 1951 Sion, Suisse
| | - J Beney
- Service de pharmacie, institut central des hôpitaux (ICH), hôpital du Valais, avenue du Grand-Champsec 86, 1951 Sion, Suisse
| | - P Turini
- Service qualité des soins et sécurité des patients, hôpital du Valais, Suisse
| | - M Desmedt
- Direction des soins infirmiers, hôpital du Valais, Suisse
| | - L Roulet
- Service de pharmacie, institut central des hôpitaux (ICH), hôpital du Valais, avenue du Grand-Champsec 86, 1951 Sion, Suisse.
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Bott QD. ASHP Guidelines on Pharmacy Services in Correctional Facilities. Am J Health Syst Pharm 2016; 73:1784-1790. [PMID: 27769974 DOI: 10.2146/ajhp160143] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Affiliation(s)
- Quinn D. Bott
- U.S. Public Health Service, United States Penitentiary/FPC Leavenworth, Leavenworth, KS
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Hospital pharmacy service in developing nations: The case of Nepal. Res Social Adm Pharm 2016; 12:1038-1039. [PMID: 27311381 DOI: 10.1016/j.sapharm.2016.05.046] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2016] [Accepted: 05/16/2016] [Indexed: 11/20/2022]
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Mozaffar M, Shahidi S, Badri S. Ganciclovir use evaluation in kidney transplantation departments. J Res Pharm Pract 2016; 5:212-4. [PMID: 27512714 PMCID: PMC4966242 DOI: 10.4103/2279-042x.185742] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Objective: In this study, we evaluated certain aspects of the usage and administration of one lifesaving, high-cost medication, i.e., Ganciclovir for the prevention and treatment of cytomegalovirus (CMV) infection in transplant patients. Methods: This study was performed from 2013 to 2015 by conducting a medication use evaluation (MUE) program in the kidney transplantation departments of two tertiary care hospitals in Isfahan, Iran. The MUE criteria for the drug were developed by applying drug information references. In every category of data, the number (percent) of cases, in which drug therapy was in accordance with the predetermined criteria, was calculated. Findings: During the study period, 67 cases were observed. The only documented drug interaction was the minor interaction of Ganciclovir with mycophenolate mofetil in 77% of the patients. In all patients, intravenous (IV) infusion was the route of administration, mainly in the peripheral veins. Four patients showed adverse drug reaction, which leads to Ganciclovir discontinuation. Ganciclovir was administered despite contraindication in 34.3% of the patients. Conclusion: In this study, we faced a relatively unacceptable situation, in which Ganciclovir is handled somehow inappropriately. It seems necessary to develop an updated local guideline to approximate the administering pattern of such costly medications to standard protocols.
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Affiliation(s)
- Maryam Mozaffar
- Isfahan Pharmacy Students' Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Shahrzad Shahidi
- Isfahan Kidney Diseases Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Shirinsadat Badri
- Isfahan Kidney Diseases Research Center, Isfahan University of Medical Sciences, Isfahan, Iran; Department of Clinical Pharmacy and Pharmacy Practice, Isfahan University of Medical Sciences, Isfahan, Iran
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NCPDP recommendations for dose accumulation monitoring in the inpatient setting: Acetaminophen case model, version 1.0. Am J Health Syst Pharm 2016; 73:1144-65. [PMID: 27267535 PMCID: PMC6477888 DOI: 10.2146/ajhp160215] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
PURPOSE Best practices and guidance are provided for improved electronic detection and alerting of inadvertent supratherapeutic cumulative doses of acetaminophen and other medications with narrow therapeutic ranges in inpatient settings. SUMMARY Despite the use of medication safety technologies, overdosage and associated sentinel events continue to be serious problems in many inpatient settings. The tools needed to monitor and employ dose alerts, accumulators, and warning systems are available to reduce inadvertent overdose. Required are staff training and the implementation of processes that provide guidance and documentation of the drug reconciliation process from admittance to discharge for safe patient passage through the various transitions of care. Recommendations to achieve optimal patient safety outcomes include the adoption and integration of available technologies with full functionality configured to meet the institution's policies and processes, initial training and retraining of all staff who use these systems, continuing education of the patient care staff on the dosing safety requirements, and assigning a prominent role to the clinical pharmacist in the entire drug-use and reconciliation process. CONCLUSION The key factors contributing to inadvertent overdosage in inpatient settings include a lack of recognition of recommended maximum daily dosages; failure to optimally communicate medication information at transitions of care; failure to optimally implement medication safety technologies, particularly dose accumulator calculation features and associated alerts; and alert fatigue and override.
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Rector KB, Veverka A, Evans SK. Improving pharmacist documentation of clinical interventions through focused education. Am J Health Syst Pharm 2014; 71:1303-10. [DOI: 10.2146/ajhp130670] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Affiliation(s)
- Katherine B. Rector
- Internal Medicine, Department of Pharmacy; and Internal Medicine, Department of Pharmacy, Carolinas Medical Center, Charlotte, NC
| | - Angie Veverka
- Internal Medicine, Department of Pharmacy; and Internal Medicine, Department of Pharmacy, Carolinas Medical Center, Charlotte, NC
| | - Stacie Krick Evans
- VHA Performance Services, Charlotte; at the time of writing she was Clinical Manager, Department of Pharmacy, Carolinas Medical Center
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