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Hospital Pharmacy

Daniel Co, Leslie Roebuck, Jason VanLandingham
Background: Oritavancin is a lipoglycopeptide antibiotic indicated for the treatment of acute bacterial skin and soft tissue infections. The prolonged half-life of this agent allows for a course of therapy to be completed with a single dose. Oritavancin was added to our formulary as an option for treatment of acute bacterial skin and soft tissue infection to reduce admission and length of stay. Objective: The purpose of this study was to determine whether oritavancin is used appropriately at our hospital and to evaluate the impact to the institution...
July 2018: Hospital Pharmacy
Pooja H Patel, Kimberly W Dickerson
Background: Hospitalizations due to chronic diseases such as heart failure (HF) continue to increase worldwide. Fragmentation of care while transitioning from one care setting to another is an important factor contributing to hospitalizations. Fragmented discharge tools have been implemented; however, the impact of a comprehensive interdisciplinary discharge tool has not been previously studied. Objective: The goal of this study is to assess the impact of the implementation of Project Re-Engineered Discharge (RED) on the incidence of hospital readmissions, all-cause mortality, primary care physician follow-up rate, and cost savings for patients with HF...
July 2018: Hospital Pharmacy
Sheheryar Muhammad, Robert J Simonelli
Purpose: A case report of a patient who presented with an acute onset, fluctuating atrioventricular (AV) block and was diagnosed with Lyme carditis is presented. Summary: A 55-year-old man with progressively worsening generalized malaise, flu-like symptoms, dyspnea on exertion, and near syncope was admitted with bradycardia (heart rate was between 20 and 30 beats per minute upon admission). He endorsed having several tick bites after which he developed erythema migrans on his arm and abdomen. An electrocardiogram (ECG) revealed a second-degree AV block, fluctuating between Mobitz type I and Mobitz type II heart block, with a P-R interval of 300 ms...
July 2018: Hospital Pharmacy
Trevor N Christ, Jeryl J Villadolid, Anish Choksi, Monica Malec, Randall W Knoebel
Background: Pain is both common and undertreated in the hematology/oncology population despite national guidelines and a focus from The Joint Commission. Objective: Herein, we describe the features of a pain clinical decision support tool (PCDST) embedded into the electronic medical record (EMR) and report its impact on oncology inpatients at risk for uncontrolled pain. Methods: The PCDST was developed to identify patients with potentially uncontrolled pain, defined as a pain score ≥4. Clinical pharmacists were encouraged to use the tool to determine whether interventions were needed to better control pain...
July 2018: Hospital Pharmacy
Karen J Arthur, Deanna S Kania, Christina A White
Purpose: The purpose of this study was to utilize lean process improvement principles to enhance the health-system pharmacy administration learning experience within a postgraduate year 1 (PGY1) residency program. Summary: The Richard L. Roudebush VA Medical Center adopted the use of lean to improve customer service and workplace efficiency. The Residency Advisory Council, overseeing the 6 pharmacy residency programs, felt that training residents in a proven process improvement technique would benefit the service and assist in developing problem-solving skills...
July 2018: Hospital Pharmacy
Roland N Dickerson, Vanessa J Kumpf, Angela L Bingham, Allison B Blackmer, Todd W Canada, Lingtak-Neander Chan, Sarah V Cogle, Anne M Tucker
Purpose: The purpose of the article is to assist the pharmacist engaged in nutrition support therapy in staying current with pertinent literature. Methods: Several clinical pharmacists engaged in nutrition support therapy compiled a list of articles published in 2017 considered important to their clinical practice. The citation list was compiled into a spreadsheet where the author participants were asked to assess whether the article was considered important to nutrition support pharmacy practice. A culled list of publications was then identified whereby the majority (at least 5 out of 8 authors) considered the article to be of significance...
July 2018: Hospital Pharmacy
Scot Walker
Hereditary transthyretin amyloidosis is an inherited disorder that results in the gradual progressive deposit of abnormal protein called amyloid in the body's organs and tissues. There are currently no approved drugs to treat transthyretin amyloidosis, and patients may require liver transplantation for survival. There are a few drugs in development to treat hereditary transthyretin amyloidosis either by stabilizing the abnormal protein or by decreasing production of transthyretin. Both methods are being developed to slow progression of the disease...
July 2018: Hospital Pharmacy
Michael Gabay
Right-to-try legislation is intended to allow patients with life-threatening illnesses access to investigational medical treatments without formal Food and Drug Administration (FDA) involvement. Currently, right-to-try laws have been enacted in 40 states. Despite the increased passage of right-to-try legislation at the state level, individuals have detailed arguments both for and against these laws. Proponents state that right-to-try removes regulatory burdens and improves timely access to potentially lifesaving medications for terminally ill patients, reduces inequalities regarding access, and improves patient-provider communication and decision making...
July 2018: Hospital Pharmacy
Danial E Baker, Terri L Levien
Each month, subscribers to The Formulary Monograph Service receive 5 to 6 well-documented monographs on drugs that are newly released or are in late phase 3 trials. The monographs are targeted to Pharmacy & Therapeutics Committees. Subscribers also receive monthly 1-page summary monographs on agents that are useful for agendas and pharmacy/nursing in-services. A comprehensive target drug utilization evaluation/medication use evaluation (DUE/MUE) is also provided each month. With a subscription, the monographs are available online to subscribers...
July 2018: Hospital Pharmacy
BrookeAnne Magrum, Robert J Weber
Background: The Director's Forum series is designed to guide pharmacy leaders in establishing patient-centered services in hospitals and health-systems. This article focuses on leadership strategies for managing organizational change within a pharmacy department. Objective: The goals of this article are to describe the foundations of pharmacy organizational structure changes and strategies to efficiently and effectively manage the associated change. Methods: This article will aim to (1) describe the organizational structure change process, (2) list known rules to follow when redesigning an organizational structure, (3) briefly describe the organizational change at the Ohio State Wexner Medical Center, and (4) describe leadership strategies to overcome potential challenges of organizational changes...
July 2018: Hospital Pharmacy
(no author information available yet)
No abstract text is available yet for this article.
July 2018: Hospital Pharmacy
Michael R Cohen, Judy L Smetzer
No abstract text is available yet for this article.
July 2018: Hospital Pharmacy
Debra A Goff
No abstract text is available yet for this article.
July 2018: Hospital Pharmacy
Logan C Joiner, Clay Tynes, John Arnold, Rachel R Miller, Greg Gorman
Purpose: The purpose of this study was to determine the physical compatibility of micafungin with commonly used concentrations of sodium bicarbonate hydration fluids administered via a Y-site connected to a central venous catheter (Y-site/CVC). Methods: Micafungin sodium (evaluated concentration of 1.5 mg/mL) was combined in a 3:1 (vehicle:drug) ratio with the following commonly used hydration vehicles: 40 mEq/L sodium bicarbonate in 5% dextrose in water with ¼ normal saline (40SB-D5W-1/4NS), 75 mEq/L sodium bicarbonate in D5W (75SB-D5W), and 154 mEq/L sodium bicarbonate in D5W (154SB-D5W)...
April 2018: Hospital Pharmacy
David M Hill, Sean Lloyd, William L Hickerson
Background: Glycemic control in burn patients is critical for reducing infection and mortality. Objective: This study was conducted to assess the incidence and outcomes of hypoglycemia during continuous insulin infusions (CII). Methods: This institutional review board-approved study was a retrospective, single burn center, electronic chart review. Patients admitted between January 1, 2013, and October 31, 2014, who received a CII were included. Patients with incomplete data or who received <24 hours of CII were excluded...
April 2018: Hospital Pharmacy
Anne Krasniak, William Darko, Christopher D Miller, Robert Seabury, Luke A Probst
Purpose: The role of health-system pharmacists continues to expand, and this area of pharmacy practice increasingly requires augmented baseline training. It is unclear how Post Graduate Year 1 (PGY-1) pharmacy residencies may be changing to meet these needs.The objectives of our survey were to describe PGY-1 pharmacy residency program design among academic medical centers, characterize program changes enacted over 5-year period, and describe career paths among PGY-1 pharmacy residency graduates. Methods: A 32-item questionnaire was developed independently, which was reviewed and validated by 4 residency program directors...
April 2018: Hospital Pharmacy
Varsha Varakantham, Ashok Kumar Kurakula Sailoo, Dinesh Kumar Bharatraj
Background: The monitoring of hypertension treatment can provide insight into the rational drug use pattern. The objective of this study was to examine the antihypertensive medication use among South Indian adults with hypertension in compliance with the hypertension treatment guidelines (Seventh Joint National Committee [JNC 7] and JNC 8). Methods and Results: A total of 550 hypertensive people aged >25 years were included in this retrospective cross-sectional study. The order of drugs prescribed in the year 2012 was beta blockers (BB) > calcium channel blockers (CCB) > CCB + BB > angiotensin receptor blockers (ARB) > angiotensin-converting enzyme inhibitors (ACEI) > thiazide diuretics, whereas in the year 2014, the order has changed drastically, namely, ACEI > CCB > ARB > BB > thiazide diuretics ( P < ...
April 2018: Hospital Pharmacy
Cheyenne Newsome, Keenan Ryan, Ludmila Bakhireva, Preeyaporn Sarangarm
Background: Pharmacy residents' knowledge of biostatistics is a self-identified deficit. Objective: To describe statistical training practices across postgraduate year 1 (PGY1) pharmacy residency programs and correlate training practices with residency program directors' (RPDs) confidence in their residents' statistical abilities. Methods: A 13-item survey was sent to PGY1 RPDs and included questions regarding respondents' institution, program characteristics, type and amount of statistical training offered and desired, as well as performance of statistics, resident project publication rates, and RPDs' confidence in residents' statistical abilities...
April 2018: Hospital Pharmacy
Nicholas P Gazda, Emily Griffin, Kasey Hamrick, Jordan Baskett, Meghan M Mellon, Stephen F Eckel, Robert P Granko
Purpose: The purpose of this article is to share experiences after the development of a health-system pharmacy administration residency with a MS degree and express the need for additional programs in nonacademic medical center health-system settings. Summary: Experiences with the development and implementation of a health-system pharmacy administration residency at a large community teaching hospital are described. Resident candidates benefit from collaborations with other health-systems through master's degree programs and visibility to leaders at your health-system...
April 2018: Hospital Pharmacy
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