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emergency department pharmacist

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...
August 28, 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)...
August 6, 2018: 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
Junpei Komagamine, Kenichi Sugawara, Miho Kaminaga, Shinpei Tatsumi
INTRODUCTION: Given that polypharmacy and potentially inappropriate prescribing are common in elderly orthopaedic patients, pharmacist interventions to improve medication practices among this population are important. However, past studies have reported mixed results regarding the effectiveness of pharmacist-led interventions in inpatient elderly care. Furthermore, few randomised controlled trials have evaluated patient-relevant outcomes as a primary endpoint. Therefore, we will evaluate whether a pharmacist-led intervention could reduce readmission of hospitalised elderly orthopaedic patients with polypharmacy or potentially inappropriate prescribing...
July 30, 2018: BMJ Open
Christine D Jones, Amanda Anthony, Matthew D Klein, Courtney Shakowski, Holly K Smith, Amy Go, Katharine Perica, Hemali Patel, Jonathan Pell, Read Pierce
OBJECTIVES: To evaluate the feasibility and effect of a pharmacist-led transitions-of-care (TOC) pilot targeted to patients at high risk of readmission on process measures, hospital readmissions, and emergency department (ED) visits. SETTING: Academic medical center in Colorado. PRACTICE DESCRIPTION: Pharmacists enrolled patients identified as high risk for readmission in a TOC pilot from July 2014 to July 2015. The pilot included medication reconciliation, medication counseling, case management or social work evaluation, a postdischarge telephone call, and an expedited primary care follow-up appointment...
September 2018: Journal of the American Pharmacists Association: JAPhA
Emily R Locke, Rachel M Thomas, Deborah M Woo, Ethan H K Nguyen, Bryson K Tamanaha, Valerie G Press, Gayle E Reiber, Peter J Kaboli, Vincent S Fan
BACKGROUND: Proper inhaler technique is important for effective drug delivery and symptom control in chronic obstructive pulmonary disease (COPD) and asthma, yet not all patients receive inhaler instructions. INTRODUCTION: Using a retrospective chart review of participants in a video telehealth inhaler training program, the study compared inhaler technique within and between monthly telehealth visits and reports associated with patient satisfaction. MATERIALS AND METHODS: Seventy-four (N = 74) rural patients prescribed ≥1 inhaler participated in three to four pharmacist telehealth inhaler training sessions using teach-to-goal (TTG) methodology...
July 17, 2018: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
Teresa George Abraham, Charnicia Huggins, Gilda Diaz-Fuentes, John Roglieri
OBJECTIVE: Asthma is one of the major causes of hospital readmissions in the South Bronx. The goal of this study was to assess the impact of asthma education provided by registered pharmacists with asthma educator certification (AE-C), on medication adherence and hospitalizations/Emergency Department (ED) visits. METHODS: This was a retrospective chart review of patients seen in the pulmonary clinic from October 2014 to August 2015 for asthma education by AE-C pharmacists...
July 17, 2018: Journal of Asthma: Official Journal of the Association for the Care of Asthma
Danielle McDonald, Rupal Mansukhani, Suzannah Kokotajlo, Frank Diaz, Christine Robinson
OBJECTIVE: This study was conducted to evaluate the impact of education on optimizing medication histories in a single-center pediatric emergency department. METHODS: This was a prospective, 2-phase study of 200 patients ages 21 years and younger who presented to the pediatric emergency department in January and February 2017. In phase I of the study, 100 patients were interviewed by both a nurse and a pharmacist. Between phases I and II, the pharmacist educated each nurse and disseminated standardized education materials...
May 2018: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
Christina Herbert, Holly Winkler
Introduction: The demand for mental health (MH) services has increased as more veterans seek MH care. At the South Texas Veterans Health Care System, Primary Care Mental Health Integration (PCMHI) was developed to manage patients with uncomplicated MH conditions, including depression, anxiety, or posttraumatic stress disorder (PTSD), within an interdisciplinary primary care (PC) team that includes clinical pharmacy specialists (CPSs). Pharmacists have improved outcomes and access to care for many chronic medical conditions, but limited data demonstrate the impact of MH pharmacists within PC...
May 2018: The mental health clinician
Julia Boyle, Cassandra Clement, Abril Atherton, Christopher Stock
Introduction: Opioid-related overdoses have risen despite extensive media coverage and apparent awareness of this public health crisis. Emergency department visits related to opioid use nearly tripled from 2004 to 2011. Patients with mental illness are more likely to be prescribed opioids and have higher rates of overdose. This retrospective chart review sought to determine if opioid represcribing occurred after patients were treated for a nonfatal opioid overdose (NFO) at a Veterans Affairs hospital...
November 2017: The mental health clinician
Sarah M Westberg, Angela Yarbrough, Eric D Weinhandl, Terrence J Adam, Amanda R Brummel, Shannon L Reidt, Brian T Sick, Wendy L St Peter
BACKGROUND: Improved understanding of how drug therapy problems (DTPs) contribute to rehospitalization is needed. OBJECTIVE: The primary objectives were to assess the association of DTP likelihood of harm (LoH) severity score, as measured by comprehensive medication management (CMM) pharmacist after hospital discharge, with 30-day risk of hospital readmission, observation visit, or emergency department visit, and to determine whether resolution of DTPs reduces 30-day risk...
June 1, 2018: Annals of Pharmacotherapy
Lawson Kloesel, Maria Carvalho, Fabiana Banov
There is a high incidence of household knife-related injuries requiring emergency department treatment in the U.S. The Pitch Ointment, a named formula developed by a compounding pharmacist, was used separately by two patients who suffered a knife injury in a finger and a foot. This formula combines Pinene (L-Alpha) 0.5% and Canada Balsam 5% in PracaSil-Plus, special ingredients with applications in scar and wound healing. The patients' level of satisfaction with the Pitch Ointment was very high since all 4 treatment satisfaction domains by the Treatment Satisfaction Questionnaire for Medication (effectiveness, side effects, convenience, global satisfaction) were rated over 85...
May 2018: International Journal of Pharmaceutical Compounding
Kirk Moberg
Substance misuse is a critical and costly public health problem in the United States. Data as of 2016 show 11,517 cases of opioid analgesic misuse, with the majority (6924 cases) related to hydrocodone misuse. Substance misuse impacts our society significantly with high costs related to healthcare, crime, and lost productivity. Opioid analgesic pain relievers are one of the most prescribed classes of medications and are among the most common drugs related to misuse. Increases in emergency department visits of over 200% have been associated with a dramatic surge in written prescriptions for opioid pain relievers...
May 2018: American Journal of Managed Care
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