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Pharmacist critical care

Trang H Au, Courtney C Cavalieri, David D Stenehjem
Clinical pharmacists are important contributors to the care of patients with cancer; it is therefore critical for oncology clinical pharmacists to stay current with new anticancer therapies. This review summarizes the epidemiology and pathogenesis of non-small cell lung cancer, including the most common genetic alterations, as well as the mechanism of action, clinical development, pharmacodynamics and pharmacokinetics of the anaplastic lymphoma kinase inhibitor ceritinib for the treatment of patients with anaplastic lymphoma kinase-positive non-small cell lung cancer...
October 13, 2016: Journal of Oncology Pharmacy Practice
Andrea L Murphy, Ruth Martin-Misener, Stan P Kutcher, Claire L O'Reilly, Timothy F Chen, David M Gardner
BACKGROUND: The role of community pharmacists is changing globally with pharmacists engaging in more clinically-oriented roles, including in mental health care. Pharmacists' interventions have been shown to improve mental health related outcomes but various barriers can limit pharmacists in their care of patients. We aimed to explore the experiences of people with lived experience of mental illness and addictions in community pharmacies to generate findings to inform practice improvements...
October 12, 2016: BMC Health Services Research
L Cortejoso, R A Dietz, G Hofmann, M Gosch, A Sattler
BACKGROUND: Inappropriate pharmacotherapy among older adults remains a critical issue in our health care systems. Besides polypharmacy and multiple comorbidities, the age-related pharmacokinetic and pharmacodynamic changes may increase the risk of adverse drug reactions and medication errors. OBJECTIVE: The main target of this study was to describe the characteristics of pharmaceutical interventions in two geriatric wards (orthogeriatric ward and geriatric day unit) of a general teaching hospital and to evaluate the clinical significance of the detected medication errors...
2016: Clinical Interventions in Aging
Nicola Rudall, Catherine McKenzie, June Landa, Richard S Bourne, Ian Bates, Rob Shulman
PURPOSE: Clinical pharmacist (CP) interventions from the PROTECTED-UK cohort, a multi-site critical care interventions study, were further analysed to assess effects of: time on critical care, number of interventions, CP expertise and days of week, on impact of intervention and ultimately contribution to patient care. METHODS: Intervention data were collected from 21 adult critical care units over 14 days. Interventions could be error, optimisation or consults, and were blind-coded to ensure consistency, prior to bivariate analysis...
October 4, 2016: International Journal of Pharmacy Practice
Alyssa Chappell, Katelyn Dervay
Purpose: To describe an innovative strategy for incorporating leadership training and development across multiple postgraduate year 2 (PGY2) pharmacy residency programs at a single institution. Background: Tampa General Hospital has 7 pharmacy residency positions: 4 postgraduate year 1 (PGY1) residents and a single resident for each of the 3 PGY2 programs (critical care, emergency medicine, and solid organ transplant). Administrative topics are incorporated across the PGY1 and PGY2 residency programs, with each PGY2 program having additional administrative topics specific to their specialty area...
September 2016: Hospital Pharmacy
Catherine Korte, Jennifer L Garber, Jillian L Descourouez, Katelyn R Richards, Karen Hardinger
PURPOSE: This article reviews organ donor pathophysiology as it relates to medication use with the goal of maximizing the successful procurement and transplantation of donor organs. SUMMARY: The number of patients requiring organ transplantation continues to grow, yet organ donation rates remain flat, making it critical to appropriately manage each organ donor in order to ensure viability of all transplantable organs. The care given to one organ donor is tantamount to the care of several transplant recipients...
September 23, 2016: American Journal of Health-system Pharmacy: AJHP
Cameron L Jordan, Terry L Noah, Marianna M Henry
This review seeks to re-introduce cystic fibrosis (CF) clinicians to the pharmacology of drug-drug interactions among medications commonly used in CF and provide a framework for understanding these interactions among medications outside the scope of this discussion. We here focus on drugs impacted by the cytochrome P-450 (CYP450) enzyme system and on interactions involving antimicrobials, psychotropic medications, and cystic fibrosis transmembrane conductance regulator (CFTR) modulators. Particular attention is needed when prescribing rifampin, azole antifungals and the CFTR modulators, ivacaftor, and lumacaftor/ivacaftor, in combination with other medications...
October 2016: Pediatric Pulmonology
Thomas De Rijdt, Isabel Spriet, Ludo Willems, Marianne Blanckaert, Martin Hiele, Alexander Wilmer, Steven Simoens
BACKGROUND: The inappropriate startup of long-term acid suppressive therapy (AST) can have clinical and pharmacoeconomic impacts on ambulatory care. OBJECTIVE: To assess the proportion of patients with appropriate initiation of long-term AST in non-critically ill patients. To describe possible risk factors for nonappropriate AST. To calculate the potential savings when eliminating the nonappropriate startup of AST. METHOD: This observational, retrospective study evaluated the appropriateness of startup of long-term AST in medical records using a broad variety of international criteria and guidelines and using a validated screening instrument...
September 20, 2016: Annals of Pharmacotherapy
Marina Sáez Belló, Ana Moya Gil, M Ángeles López Montenegro Soria, Pablo Sánchez Sancho, Pau Frias Ruiz, Mónica Climente Martí
OBJECTIVES: To assess the inclusion of the Therapeutic Drug Monitoring Report (TDMR) in the Electronic Clinical Record (ECR). METHOD: An observational ambispective cohort study with a duration of 149 days: PRE (retrospective, 49 days) with the TDMR printed in paper, and POST (prospective, 100 days) with the TDMR included in the ECR. EXCLUSION CRITERIA: Patients not hospitalized, applications for Therapeutic Drug Monitoring by Critical Care and Neonatal Units, as well as monitoring with an objective other than dose adjustment...
September 2016: Farmacia Hospitalaria
Tyler Sledge, Nick Lonardo, Heidi Simons, Wayne Shipley
BACKGROUND: Critical care pharmacists are established and valuable members of the critical care team, however there is rarely written evidence of their daily involvement in the patient's electronic medical record (EMR). Documentation in the EMR has the advantage of ensuring a seamless pass-off and provides an opportunity to capture the pharmacist's cognitive and clinical impact in a way that traditional systems of tracking "interventions" fail to do. We investigated implementation of pharmacist progress notes in a surgical intensive care unit (ICU) and their utility in measuring pharmacist activity...
July 2016: Hospital Pharmacy
Seth R Bauer, Sandra L Kane-Gill
No abstract text is available yet for this article.
July 2016: Hospital Pharmacy
Wei Liu, Marie Gerdtz, Elizabeth Manias
AIMS AND OBJECTIVES: This paper examines the communication strategies that nurses, doctors, pharmacists and patients use when managing medications. BACKGROUND: Patient-centred medication management is best accomplished through interdisciplinary practice. Effective communication about managing medications between clinicians and patients has a direct influence on patient outcomes. There is a lack of research that adopts a multidisciplinary approach and involves critical in-depth analysis of medication interactions among nurses, doctors, pharmacists and patients...
October 2016: Journal of Clinical Nursing
Diane Murray, Cathy Sedgeworth, Moira Kinnear, Lesley Diack
AIM: To gather opinions from doctors and pharmacists to improve the design of the PICU MR form generated by the electronic prescribing and clinical notes system to support transfer of care from PICU to downstream wards that use paper systems. METHOD: A purposive sample of 10 forms covering a comprehensive range of medication information common to PICU patients was selected from practice between March 2014 and May 2014. Pharmacists (n=7) and doctors (n=9) who received these forms on downstream wards were invited to participate in semi-structured one-to-one interviews (n=20) with the PICU pharmacist within 48 hrs of receipt to explore their views about the form...
September 2016: Archives of Disease in Childhood
Lucy Wheeler, Janet James, Sarah Byrne, Julian Forton
AIM: To audit oxygen prescribing in a children's hospital following the introduction of a new paediatric medication chart, which incorporates an oxygen prescription section. METHOD: In June 2015 a 1-day snapshot audit was carried out across all wards in the children's hospital. All patients receiving oxygen on that day were included:▸ The audit was repeated in July 2015.▸ The standards for the audit were set at 100% in accordance with our local guidelines...
September 2016: Archives of Disease in Childhood
Emily Siu, Kalaimaran Sadasivam, Nanna Christiansen
INTRODUCTION: Prescription errors, including continuous infusion prescriptions are one major source of concern in the paediatric population. Evidence suggests that use of an electronic or web-based calculator could minimise these errors. In our paediatric critical care unit (PCCU) we have created an electronic continuous infusion prescription chart to target errors in this area and conducted an audit to assess its effect on error reduction. AIM: To create an electronic continuous infusion prescription chart and audit its effect on prescription errors...
September 2016: Archives of Disease in Childhood
John Bell, Gerald Dziekan, Charles Pollack, Varocha Mahachai
: In order for the global healthcare system to remain sustainable, healthcare spending needs to be reduced, and self-treating certain conditions under the guidance of a pharmacist provides a means of accomplishing this goal. This article was developed to describe global healthcare trends affecting self-care with a specific focus on the role of the pharmacist in facilitating over-the-counter (OTC) medication management. Potential healthcare-related economic benefits associated with the self-care model are outlined...
October 2016: Advances in Therapy
Neha Patel, James E Siegler, Nathaniel Stromberg, Neil Ravitz, C William Hanson
BACKGROUND: In hospitals, effective and efficient communication among care providers is critical to the provision of high-quality patient care. Yet, major problems impede communications including the frequent use of interruptive and one-way communication paradigms. This is especially frustrating for frontline providers given the dynamic nature of hospital care teams in an environment that is in constant flux. METHODS: We conducted a pre-post evaluation of a commercially available secured messaging mobile application on 4 hospital units at a single institution for over one year...
2016: Applied Clinical Informatics
Caitlin K Frail, Oscar W Garza, Alison L Haas
OBJECTIVE: To describe an innovative community pharmacy-based pilot program using technology to support transitions of care for patients living in rural areas. SETTING: This service occurred through a partnership between 1 independent community pharmacy organization with 5 locations in Ohio and Indiana and one 92-bed general medical and surgical county hospital during May 2014 to May 2015. PRACTICE DESCRIPTION AND INNOVATION: Community pharmacists worked with patients immediately following discharge to reconcile their medications and make recommendations to optimize therapy...
September 2016: Journal of the American Pharmacists Association: JAPhA
Janice Oh, Joshua R Bia, Muhamad Ubaid-Ullah, Jeffrey M Testani, Francis Perry Wilson
BACKGROUND: Clinical decision support systems, including electronic alerts, ideally provide immediate and relevant patient-specific information to improve clinical decision-making. Despite the growing capabilities of such alerts in conjunction with an expanding electronic medical record, there is a paucity of information regarding their perceived usefulness. We surveyed healthcare providers' opinions concerning the practicality and efficacy of a specific text-based automated electronic alert for acute kidney injury (AKI) in a single hospital during a randomized trial of AKI alerts...
August 2016: Clinical Kidney Journal
Dai Yumino
As heart failure progresses to the end stage, it becomes more difficult to maintain the same level of quality of life using the established therapy for the heart failure patients. We believe that an innovative home medical care for heart failure therapy that focuses on the individual's quality of daily living and early intervention is necessary. The roles of home medical care include: early discharge to home as opposed to long hospitalization; the prevention of re-hospitalization; the provision of good care; treatment of any exacerbations; and options available at the end of the patient's life at home...
2016: Yakugaku Zasshi: Journal of the Pharmaceutical Society of Japan
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