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Pharmacist emergency department

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https://www.readbyqxmd.com/read/28338416/impact-of-a-complex-care-management-model-on-cost-and-utilization-among-adolescents-and-young-adults-with-special-care-and-health-needs
#1
Daniel D Maeng, Susan R Snyder, Thomas W Davis, Janet F Tomcavage
Adolescents and young adults with special care and health needs in the United States-many of whom have Medicaid coverage-at the transition phase between pediatric and adult care often experience critical care gaps. To address this challenge, a new model-referred to as Comprehensive Care Clinic (CCC)-has been developed and implemented by Geisinger Health System since 2012. CCC comprises a care team, consisting of a generalist physician, advanced practitioner, pharmacist, and a nurse case manager, that develops and closely follows a coordinated care plan...
March 24, 2017: Population Health Management
https://www.readbyqxmd.com/read/28293768/the-utility-of-a-medical-admissions-pharmacist-in-a-hospital-in-australia
#2
Sally B Marotti, Rachael May Theng Cheh, Anne Ponniah, Helen Phuong
Background Medication-related hospital admissions in Australia have previously been estimated to account for approximately 3% of all hospital admissions, with hospital entry points being a point of vulnerability. The timely medication review and reconciliation by a pharmacist at the early stage of an admission for patients admitted to the Acute Medical Unit (AMU) would be beneficial. Setting The Emergency Department (ED) and AMU in a 300 bed tertiary teaching hospital, in South Australia. Objective To investigate the impact of a Medical Admissions (MA) pharmacist on the proportion of AMU patients who receive a complete and accurate medication history by a pharmacist prior to admission and within 4 h of presentation...
March 15, 2017: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/28292506/the-development-and-feasibility-of-a-pharmacy-delivered-opioid-intervention-in-the-emergency-department
#3
Erin L Winstanley, Rebecca Mashni, Sydney Schnee, Nate Miller, Susan M Mashni
OBJECTIVES: To develop a brief intervention and to assess the feasibility of pharmacy-delivered education on opioid safety and overdose prevention in the emergency department. METHODS: A convenience sample of patients (n = 102) approached between May and June 2016 at a single community-based suburban emergency department located in the Midwest. RESULTS: The intervention included scripted counseling to be delivered in person and 2 educational brochures...
March 2017: Journal of the American Pharmacists Association: JAPhA
https://www.readbyqxmd.com/read/28192477/impact-of-early-in-hospital-medication-review-by-clinical-pharmacists-on-health-services-utilization
#4
Corinne M Hohl, Nilu Partovi, Isabella Ghement, Maeve E Wickham, Kimberlyn McGrail, Lisa N Reddekopp, Boris Sobolev
BACKGROUND: Adverse drug events are a leading cause of emergency department visits and unplanned admissions, and prolong hospital stays. Medication review interventions aim to identify adverse drug events and optimize medication use. Previous evaluations of in-hospital medication reviews have focused on interventions at discharge, with an unclear effect on health outcomes. We assessed the effect of early in-hospital pharmacist-led medication review on the health outcomes of high-risk patients...
2017: PloS One
https://www.readbyqxmd.com/read/28183322/impact-of-a-pharmacist-led-medication-review-on-hospital-readmission-in-a-pediatric-and-elderly-population-study-protocol-for-a-randomized-open-label-controlled-trial
#5
Pierre Renaudin, Karine Baumstarck, Aurélie Daumas, Marie-Anne Esteve, Stéphane Gayet, Pascal Auquier, Michel Tsimaratos, Patrick Villani, Stéphane Honore
BACKGROUND: Early hospital readmission of patients after discharge is a public health problem. One major cause of hospital readmission is dysfunctions in integrated pathways between community and hospital care that can cause adverse drug events. Furthermore, the French ENEIS 2 study showed that 1.3% of hospital stays originated from serious adverse drug events in 2009. Pharmacy-led medication reviews at hospital transitions are an effective means of decreasing medication discrepancies when conducted at admission or discharge...
February 9, 2017: Trials
https://www.readbyqxmd.com/read/28151991/clinical-impact-of-pharmacogenetic-profiling-with-a-clinical-decision-support-tool-in-polypharmacy-home-health-patients-a-prospective-pilot-randomized-controlled-trial
#6
Lindsay S Elliott, John C Henderson, Moni B Neradilek, Nicolas A Moyer, Kristine C Ashcraft, Ranjit K Thirumaran
BACKGROUND: In polypharmacy patients under home health management, pharmacogenetic testing coupled with guidance from a clinical decision support tool (CDST) on reducing drug, gene, and cumulative interaction risk may provide valuable insights in prescription drug treatment, reducing re-hospitalization and emergency department (ED) visits. We assessed the clinical impact of pharmacogenetic profiling integrating binary and cumulative drug and gene interaction warnings on home health polypharmacy patients...
2017: PloS One
https://www.readbyqxmd.com/read/28148459/exploring-factors-associated-with-asthma-related-emergency-department-visits-among-adults-a-path-analysis-approach
#7
Maithili Deshpande, Kevin A Look
BACKGROUND: Asthma is an expensive chronic lung disease that affects 7% of U.S. adults and results in as many as 1.8 million emergency department (ED) visits each year. Pharmacists play an important role in managing asthma, including assessing control and monitoring disease progression, educating the patient about the disease and associated treatments, and ensuring safe and cost-effective medication use. However, comprehensive studies that account for the complex relationships between factors impacting asthma-related ED visits are lacking in the adult asthma population...
January 23, 2017: Research in Social & Administrative Pharmacy: RSAP
https://www.readbyqxmd.com/read/28115860/improving-outpatient-primary-medication-adherence-with-physician-guided-automated-dispensing
#8
Jacob G Moroshek
BACKGROUND: Physician dispensing, different from pharmacist dispensing, is a way for practitioners to supply their patients with medications, at the point of care. The InstyMeds dispenser and logistics system can automate much of the dispensing, insurance adjudication, inventory management, and regulatory reporting that is required of physician dispensing. OBJECTIVE: To understand the percentage of patients that exhibit primary adherence to medication in the outpatient setting when choosing InstyMeds...
2017: ClinicoEconomics and Outcomes Research: CEOR
https://www.readbyqxmd.com/read/28090164/a-comparison-of-medication-histories-obtained-by-a-pharmacy-technician-versus-nurses-in-the-emergency-department
#9
Marija Markovic, A Scott Mathis, Hoytin Lee Ghin, Michelle Gardiner, Germin Fahim
PURPOSE: To compare the medication history error rate of the emergency department (ED) pharmacy technician with that of nursing staff and to describe the workflow environment. METHODS: Fifty medication histories performed by an ED nurse followed by the pharmacy technician were evaluated for discrepancies (RN-PT group). A separate 50 medication histories performed by the pharmacy technician and observed with necessary intervention by the ED pharmacist were evaluated for discrepancies (PT-RPh group)...
January 2017: P & T: a Peer-reviewed Journal for Formulary Management
https://www.readbyqxmd.com/read/28076735/reducing-medication-errors-in-hospital-discharge-summaries-a-randomised-controlled-trial
#10
Erica Y Tong, Cristina P Roman, Biswadev Mitra, Gary S Yip, Harry Gibbs, Harvey H Newnham, De Villiers Smit, Kirsten Galbraith, Michael J Dooley
OBJECTIVES: To evaluate whether pharmacists completing the medication management plan in the medical discharge summary reduced the rate of medication errors in these summaries. DESIGN: Unblinded, cluster randomised, controlled investigation of medication management plans for patients discharged after an inpatient stay in a general medical unit. SETTING: The Alfred Hospital, an adult major referral hospital in metropolitan Melbourne, with an annual emergency department attendance of about 60000 patients...
January 16, 2017: Medical Journal of Australia
https://www.readbyqxmd.com/read/28068783/clinical-pharmacist-management-of-bacteremia-in-a-community-hospital-emergency-department
#11
C Dustin Waters, Bryce J Bitton, Annie Torosyan, Kevin P Myers
BACKGROUND: Bacteremia is a serious condition that leads to high morbidity and mortality. Data describing pharmacist involvement in the management of bacteremia in the emergency department are lacking. OBJECTIVE: To determine if pharmacist involvement in the management of bacteremia in the emergency department (ED) led to an increase in appropriate treatment of bacteremia as well as improvements in patient outcomes. METHODS: The primary outcome of this retrospective cohort study was the rate of appropriate treatment of bacteremia...
January 1, 2017: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/28039294/process-mapping-evaluation-of-medication-reconciliation-in-academic-teaching-hospitals-a-critical-step-in-quality-improvement
#12
Anne Holbrook, James M Bowen, Harsit Patel, Chris O'Brien, John J You, Roshan Tahavori, Jeff Doleweerd, Tim Berezny, Dan Perri, Carmine Nieuwstraten, Sue Troyan, Ameen Patel
BACKGROUND: Medication reconciliation (MedRec) has been a mandated or recommended activity in Canada, the USA and the UK for nearly 10 years. Accreditation bodies in North America will soon require MedRec for every admission, transfer and discharge of every patient. Studies of MedRec have revealed unintentional discrepancies in prescriptions but no clear evidence that clinically important outcomes are improved, leading to widely variable practices. Our objective was to apply process mapping methodology to MedRec to clarify current processes and resource usage, identify potential efficiencies and gaps in care, and make recommendations for improvement in the light of current literature evidence of effectiveness...
December 30, 2016: BMJ Open
https://www.readbyqxmd.com/read/28035037/evaluation-of-a-care-transition-program-with-pharmacist-provided-home-based-medication-review-for-elderly-singaporeans-at-high-risk-of-readmissions
#13
McVin Hua Heng Cheen, Chong Ping Goon, Wan Chee Ong, Paik Shia Lim, Choon Nam Wan, Mei Yan Leong, Giat Yeng Khee
OBJECTIVE: This study aimed to determine whether pharmacist-provided home-based medication review (HBMR) can reduce readmissions in the elderly. DESIGN: Retrospective cohort study. SETTING: Patient's home. PARTICIPANTS: Records of patients referred to a care transition program from March 2011 through March 2015 were reviewed. Patients aged 60 years and older taking more than 5 medications and had at least 2 unplanned admissions within 3 months preceding the first home visit were included...
December 29, 2016: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/28010959/urine-culture-guided-antibiotic-interventions-a-pharmacist-driven-antimicrobial-stewardship-effort-in-the-emergency-department
#14
Xi Zhang, Nicole Rowan, Bethann Mangel Pflugeisen, Sanjin Alajbegovic
BACKGROUND: Antibiotics are overprescribed for abnormal urine tests including asymptomatic bacteriuria (AB), contributing to rising antimicrobial resistance rates. Pharmacists reviewed urine cultures daily from emergency department (ED) encounters to assess antibiotic appropriateness. We studied antibiotic prescribing practices and assessed compliance to national guidelines, correlations with urine analysis (UA) components, and opportunities for antimicrobial stewardship in the ED. METHODS: This quality improvement project (QIP) was a prospective cohort study at a community hospital ED, with data collected from finalized urine cultures resulting October 30, 2014 through January 5, 2015...
December 16, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27988200/dissecting-costs-of-ct-study-application-of-tdabc-time-driven-activity-based-costing-in-a-tertiary-academic-center
#15
Yoshimi Anzai, Marta E Heilbrun, Derek Haas, Luca Boi, Kirk Moshre, Satoshi Minoshima, Robert Kaplan, Vivian S Lee
RATIONALE AND OBJECTIVES: The lack of understanding of the real costs (not charge) of delivering healthcare services poses tremendous challenges in the containment of healthcare costs. In this study, we applied an established cost accounting method, the time-driven activity-based costing (TDABC), to assess the costs of performing an abdomen and pelvis computed tomography (AP CT) in an academic radiology department and identified opportunities for improved efficiency in the delivery of this service...
February 2017: Academic Radiology
https://www.readbyqxmd.com/read/27920036/clinical-relevance-of-pharmacist-intervention-in-an-emergency-department
#16
Maria Antonia Pérez-Moreno, Juan Manuel Rodríguez-Camacho, Beatriz Calderón-Hernanz, Bernardino Comas-Díaz, Jordi Tarradas-Torras
OBJECTIVES: To evaluate the clinical relevance of pharmacist intervention on patient care in emergencies, to determine the severity of detected errors. Second, to analyse the most frequent types of interventions and type of drugs involved and to evaluate the clinical pharmacist's activity. METHODS: A 6-month observational prospective study of pharmacist intervention in the Emergency Department (ED) at a 400-bed hospital in Spain was performed to record interventions carried out by the clinical pharmacists...
December 5, 2016: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/27919875/the-layered-learning-practice-model-lessons-learned-from-implementation
#17
Nicole R Pinelli, Stephen F Eckel, Maihan B Vu, Morris Weinberger, Mary T Roth
PURPOSE: Pharmacists' views about the implementation, benefits, and attributes of a layered learning practice model (LLPM) were examined. METHODS: Eligible and willing attending pharmacists at the same institution that had implemented an LLPM completed an individual, 90-minute, face-to-face interview using a structured interview guide developed by the interdisciplinary study team. Interviews were digitally recorded and transcribed verbatim without personal identifiers...
December 15, 2016: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/27915457/combined-use-of-the-rationalization-of-home-medication-by-an-adjusted-stopp-in-older-patients-rasp-list-and-a-pharmacist-led-medication-review-in-very-old-inpatients-impact-on-quality-of-prescribing-and-clinical-outcome
#18
Lorenz Van der Linden, Liesbeth Decoutere, Karolien Walgraeve, Koen Milisen, Johan Flamaing, Isabel Spriet, Jos Tournoy
BACKGROUND: Polypharmacy and potentially inappropriate drugs have been associated with negative outcomes in older adults which might be reduced by pharmacist interventions. OBJECTIVES: Our objective was to evaluate the effect of a pharmacist intervention, consisting of the application of the Rationalization of home medication by an Adjusted STOPP in older Patients (RASP) list and a pharmacist-led medication review on polypharmacy, the quality of prescribing, and clinical outcome in geriatric inpatients...
December 3, 2016: Drugs & Aging
https://www.readbyqxmd.com/read/27884844/medication-reconciliation-as-a-medication-safety-initiative-in-ethiopia-a-study-protocol
#19
Alemayehu B Mekonnen, Andrew J McLachlan, Jo-Anne E Brien, Desalew Mekonnen, Zenahebezu Abay
INTRODUCTION: Medication related adverse events are common, particularly during transitions of care, and have a significant impact on patient outcomes and healthcare costs. Medication reconciliation (MedRec) is an important initiative to achieve the Quality Use of Medicines, and has been adopted as a standard practice in many developed countries. However, the impact of this strategy is rarely described in Ethiopia. The aims of this study are to explore patient safety culture, and to develop, implement and evaluate a theory informed MedRec intervention, with the aim of minimising the incidence of medication errors during hospital admission...
November 24, 2016: BMJ Open
https://www.readbyqxmd.com/read/27873322/non-medical-prescribing-versus-medical-prescribing-for-acute-and-chronic-disease-management-in-primary-and-secondary-care
#20
REVIEW
Greg Weeks, Johnson George, Katie Maclure, Derek Stewart
BACKGROUND: A range of health workforce strategies are needed to address health service demands in low-, middle- and high-income countries. Non-medical prescribing involves nurses, pharmacists, allied health professionals, and physician assistants substituting for doctors in a prescribing role, and this is one approach to improve access to medicines. OBJECTIVES: To assess clinical, patient-reported, and resource use outcomes of non-medical prescribing for managing acute and chronic health conditions in primary and secondary care settings compared with medical prescribing (usual care)...
November 22, 2016: Cochrane Database of Systematic Reviews
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