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emergency department pharmacist

Jamilah Alsaidan, Jane Portlock, Hisham Saad Aljadhey, Nada Atef Shebl, Bryony Dean Franklin
Background: Errors in medication use are a patient safety concern globally, with different regions reporting differing error rates, causes of errors and proposed solutions. The objectives of this review were to identify, summarise, review and evaluate published studies on medication errors, drug related problems and adverse drug events in the Gulf Cooperation Council (GCC) countries. Methods: A systematic review was carried out using six databases, searching for literature published between January 1990 and August 2016...
November 2018: Saudi Pharmaceutical Journal: SPJ: the Official Publication of the Saudi Pharmaceutical Society
Naren Gunja, Ian Dunlop, Milan Vaghasiya, Kevin Kuan, Simon Poon
BACKGROUND: Traditional implementations of electronic medication management (EMM) systems have involved two common formats - a 'big bang' approach on the day of go-live, or a phased ward-by-ward approach over months. OBJECTIVE: To describe the patient-centric roll-out, a novel implementation model in converting from paper to EMM. METHOD: This model iteratively converted a large tertiary teaching hospital to electronic from paper medication charts, commencing the roll-out in the emergency department (ED)...
October 18, 2018: Journal of Innovation in Health Informatics
Richard H Parrish
The problems related to pediatric pharmacotherapeutics and medication management are not unique to any particular country, as drug therapy problems are common causes of emergency department visits. Over the past 20 years, there were only sporadic scientific and commercial efforts to develop unique oral nonsterile dosage forms with a potential for mass production and standardization that would address the needs of pediatric patients under the age of four years with chronic diseases. This article raises awareness of the issues encountered in pharmacy pediatrics practice surrounding compounded nonsterile preparations...
September 2018: International Journal of Pharmaceutical Compounding
Ana María De Andrés-Lázaro, Òscar Miró Andreu
No abstract text is available yet for this article.
November 1, 2018: Farmacia Hospitalaria
Grégoire Cleirec, Maeva Fortias, Vanessa Bloch, Virgile Clergue-Duval, Frank Bellivier, Thomas Dusouchet, Céline Debaulieu, Florence Vorspan
BACKGROUND: On the brink of the opening of the first French drug consumption room in Paris, the general opinion of the local involved health care professionals and drug users was not known. The objective of this study was to determine their expectations and to search for influencing factors. METHOD: We carried out a quantitative cross-sectional study. A multiple choice questionnaire was proposed to the surrounding willing general practitioners (GPs) and pharmacists, to the emergency doctors of Lariboisière hospital, and to the professionals of the harm reduction facilities and their drug users (PWUD)...
October 25, 2018: Harm Reduction Journal
Lee Benjamin, Karen Frush, Kathy Shaw, Joan E Shook, Sally K Snow
Pediatric patients cared for in emergency departments (EDs) are at high risk of medication errors for a variety of reasons. A multidisciplinary panel was convened by the Emergency Medical Services for Children program and the American Academy of Pediatrics Committee on Pediatric Emergency Medicine to initiate a discussion on medication safety in the ED. Top opportunities identified to improve medication safety include using kilogram-only weight-based dosing, optimizing computerized physician order entry by using clinical decision support, developing a standard formulary for pediatric patients while limiting variability of medication concentrations, using pharmacist support within EDs, enhancing training of medical professionals, systematizing the dispensing and administration of medications within the ED, and addressing challenges for home medication administration before discharge...
March 2018: Pediatrics
M J Connolly, J B Broad, T Bish, X Zhang, D Bramley, N Kerse, K Bloomfield, M Boyd
INTRODUCTION: The complexity of care required by many older people living in long-term care (LTC) facilities poses challenges that can lead to potentially avoidable referrals to a hospital emergency department (ED). The Aged Residential Care Intervention Project (ARCHIP) ran an implementation study to evaluate a multidisciplinary team (MDT) intervention supporting LTC facility staff to decrease potentially avoidable ED presentations by residents. METHODS: ARCHIP (conducted in 21 facilities [1,296 beds] with previously noted high ED referral rates) comprised clinical coaching for LTC facility staff by a gerontology nurse specialist (GNS) and an MDT (facility senior nurse, resident's general practitioner, GNS, geriatrician, pharmacist) review of selected high-risk residents' care-plans...
November 2018: Maturitas
C Grézard, J Rivard, P Robinson, G Leboucher, B Charpiat
INTRODUCTION: Potassium is used to treat or prevent hypokalemia and exhibits all the characteristics of an intravenous to oral therapy conversion program. Despite this, the intravenous route for potassium replacement seems frequently unjustified. OBJECTIVES: To determine the impact of a conversion program on the use of intravenous and oral galenic forms in a university tertiary care hospital. METHODS: Two promotion campaigns were conducted in 2006 and 2009...
October 6, 2018: Annales Pharmaceutiques Françaises
Lorena Medina Ruiz
AIM: The aim of this study was to examine an emergency department's (ED) multidisciplinary teams' (MDTs) attitudes towards an advanced nurse practitioner (ANP) service. The ED in question is not the author's place of work. METHOD: A Likert-type questionnaire was used to gain a total attitude score (TAS), which was analysed in relation to participants' gender, age, professional background, level of education and years of experience in the ED, as well as previous and current contact with emergency nurse practitioners and/or ANPs...
October 2, 2018: Emergency Nurse: the Journal of the RCN Accident and Emergency Nursing Association
Raoul Daoust, Jean Paquet, Alexis Cournoyer, Éric Piette, Judy Morris, Sophie Gosselin, Marcel Émond, Gilles Lavigne, Jacques Lee, Jean-Marc Chauny
OBJECTIVES: Prescription opioid diversion is a significant contributor to the opioid misuse epidemic. We examined the quantity of opioids consumed by emergency department (ED) discharged patients after treatment for an acute pain condition (musculoskeletal, fracture, renal colic, abdominal pain and other), and the percentage of unused opioids available for potential misuse. DESIGN: Prospective cohort study. SETTING: Tertiary care trauma centre academic hospital...
September 17, 2018: BMJ Open
Steven Chan, Lynn Babcock, Gary Geis, Mary Frey, Venita Robinson, Benjamin Kerrey
INTRODUCTION: Multicenter clinical trials of high-acuity, low-frequency emergencies are expensive and resource intensive. Current standards for trial preparation have significant limitations. Our objective is to describe our use of in situ simulation (ISS) to identify and mitigate threats to enrollment, protocol adherence, and patient safety in preparation for a multicenter clinical trial of antiepileptics for status epilepticus in the emergency department. METHODS: This is a descriptive study of ISS conducted in the emergency department at a free-standing, academic pediatric institution...
September 13, 2018: Simulation in Healthcare: Journal of the Society for Simulation in Healthcare
Angela N Migowa, William M Macharia, Pauline Samia, John Tole, Alfred K Keter
Background: Medication-related errors account for one out of every 131 outpatient deaths, and one out of 854 inpatient deaths. The risk is threefold greater in the pediatric population. In sub-Saharan Africa, research on medication-related errors has been obscured by other health priorities and poor recognition of harm attributable to such errors.Our primary objective was to assess the effect of introduction of a voice recognition system (VRS) on the prevalence of medication errors. The secondary objective was to describe characteristics of observed medication errors and determine acceptability of VRS by clinical service providers...
September 2018: Therapeutic Advances in Drug Safety
Victoria C Liu, Insaf Mohammad, Bibban B Deol, Ann Balarezo, Lili Deng, Candice L Garwood
OBJECTIVES: This study aimed to evaluate hospital utilization and characterize interventions of pharmacist-led telephonic post-discharge medication reconciliation. METHOD: A retrospective analysis was conducted, including 833 index events in 586 geriatric patients receiving the intervention. Medicare claims were used to capture 30-day hospital utilization (admission to the emergency department, observation unit, or inpatient hospitalization) following discharge from any of these locations...
August 30, 2018: Journal of Aging and Health
Alemayehu B Mekonnen, Andrew J McLachlan, Jo-Anne E Brien, Desalew Mekonnen, Zenahbezu Abay
Background The role of pharmacists in medication reconciliation (MedRec) is highly acknowledged in many developed nations. However, the impact of this strategy has not been well researched in low-and-middle-income countries, including Ethiopia. Objective The aim of this study was to investigate the impact of pharmacist-led MedRec intervention on the incidence of unintentional medication discrepancies in Ethiopia. Setting Emergency department in a tertiary care teaching hospital in Ethiopia. Method A single centre, prospective, pre-post study was conducted on adults (aged 18 years or over) that had been hospitalized for at least 24 h and were taking at least 2 home medications on admission...
October 2018: International Journal of Clinical Pharmacy
Patrick Redmond, Tamasine C Grimes, Ronan McDonnell, Fiona Boland, Carmel Hughes, Tom Fahey
BACKGROUND: Transitional care provides for the continuity of care as patients move between different stages and settings of care. Medication discrepancies arising at care transitions have been reported as prevalent and are linked with adverse drug events (ADEs) (e.g. rehospitalisation).Medication reconciliation is a process to prevent medication errors at transitions. Reconciliation involves building a complete list of a person's medications, checking them for accuracy, reconciling and documenting any changes...
August 23, 2018: Cochrane Database of Systematic Reviews
Hussain T Bakhsh, Stephen J Perona
INTRODUCTION: We aimed to evaluate the effect of a pharmacist-led educational intervention on administration of ondansetron in patients receiving IV opioid analgesia in the emergency department. METHODS: This study is a retrospective chart review undertaken in a single-community emergency department. During October and November 2015, emergency medicine pharmacists completed an educational initiative targeting medical and nursing staff designed to reduce prophylactic administration of ondansetron...
August 17, 2018: Journal of Emergency Nursing: JEN: Official Publication of the Emergency Department Nurses Association
Lotta Schepel, Lasse Lehtonen, Marja Airaksinen, Raimo Ojala, Jouni Ahonen, Outi Lapatto-Reiniluoto
BACKGROUND: 10-30% of hospital stays by older patients are drug-related. The admission phase is important for identifying drug-related problems, but taking an incorrect medication history often leads to medication errors. OBJECTIVES: To enhance medication history recording and identify drug-related problems (DRPs) of older patients admitted to emergency departments (EDs). METHODS: DRPs were identified by pharmacists-led medication reconciliation and review procedures in two EDs in Finland; Helsinki University Hospital (HUS), and Kuopio University Hospital (KUH)...
2019: International Journal of Risk & Safety in Medicine
Niteesh K Choudhry, Thomas Isaac, Julie C Lauffenburger, Chandrasekar Gopalakrishnan, Marianne Lee, Amy Vachon, Tanya L Iliadis, Whitney Hollands, Sandra Elman, Jacqueline M Kraft, Samrah Naseem, Scott Doheny, Jessica Lee, Julie Barberio, Lajja Patel, Nazleen F Khan, Joshua J Gagne, Cynthia A Jackevicius, Michael A Fischer, Daniel H Solomon, Thomas D Sequist
Importance: Approximately half of patients with chronic conditions are nonadherent to prescribed medications, and interventions have been only modestly effective. Objective: To evaluate the effect of a remotely delivered multicomponent behaviorally tailored intervention on adherence to medications for hyperlipidemia, hypertension, and diabetes. Design, Setting, and Participants: Two-arm pragmatic cluster randomized controlled trial at a multispecialty group practice including participants 18 to 85 years old with suboptimal hyperlipidemia, hypertension, or diabetes disease control, and who were nonadherent to prescribed medications for these conditions...
September 1, 2018: JAMA Internal Medicine
Lindsay Dryden, Norman F Dewhurst
OBJECTIVE: To evaluate the clinical and cost implications generated by a newly integrated ED pharmacist in a Canadian urban, university-affiliated tertiary care hospital. METHODS: A pharmacist documented all interventions that took place over a 5-week period. Interventions were assessed by a review panel for clinical significance and probability of harm had the intervention not occurred. Direct medication cost and cost avoidance as a result of interventions were calculated...
August 6, 2018: International Journal of Pharmacy Practice
J Lalande, B Vrignaud, D Navas, K Levieux, B Herbreteau, A Guillou, C Gras-Le Guen, E Launay
We present a prospective, observational study evaluating the incidence of medication errors (ME) in a university hospital pediatric emergency department and describe their characteristics and determinants. A systematic analysis of the handwritten prescriptions was conducted by a clinician and pharmacist. Of 11,573 consecutively studied prescriptions in children under 15 years of age, the ME incidence was 0.9% (n=102). The incidence of errors found was statistically significantly higher in children older than 5 years (OR=2...
August 2018: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
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