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https://www.readbyqxmd.com/read/28812473/implementation-of-a-pathway-for-the-treatment-of-fever-and-neutropenia-in-pediatric-patients-with-cancer
#1
Joy Vanderway, Catherine Vincent, Susan M Walsh, Jennifer Obrecht
Fever and neutropenia is an oncologic emergency. Time-to-antibiotics (TTA) refers to the amount of time from initial provider evaluation for fever and neutropenia to intravenous antibiotic administration. Research supports that rapid time-to-antibiotics (RTTA) is associated with improved patient outcomes. This quality improvement project evaluated the success of implementing an RTTA pathway in pediatric oncology patients with fever and neutropenia. The setting was an advanced practice nurse-managed pediatric ambulatory infusion center where patients with fever and neutropenia were often evaluated and treated...
September 2017: Journal of Pediatric Oncology Nursing: Official Journal of the Association of Pediatric Oncology Nurses
https://www.readbyqxmd.com/read/28777308/key-challenges-in-the-search-for-innovative-drug-treatments-for-special-populations-converging-needs-in-neonatology-pediatrics-and-medical-genetics
#2
Stuart MacLeod
The explosion of knowledge concerning the interplay of genetic and environmental factors determining pathophysiology and guiding therapeutic choice has altered the landscape in pediatric clinical pharmacology and pharmacy. The need for innovative research methods and design expertise for small clinical trials to be undertaken in sparse populations has been accentuated. At the same time, shortfalls in critical human resources represent a key challenge, especially in low- and middle-income countries where the need for new research and education directions is greatest...
August 4, 2017: Children
https://www.readbyqxmd.com/read/28765380/high-expenditure-pharmaceutical-use-among-children-in-medicaid
#3
Eyal Cohen, Matt Hall, Ruth Lopert, Brian Bruen, Lisa J Chamberlain, Naomi Bardach, Jennifer Gedney, Bonnie T Zima, Jay G Berry
BACKGROUND AND OBJECTIVES: Medication use may be a target for quality improvement, cost containment, and research. We aimed to identify medication classes associated with the highest expenditures among pediatric Medicaid enrollees and to characterize the demographic, clinical, and health service use of children prescribed these medications. METHODS: Retrospective, cross-sectional study of 3 271 081 Medicaid-enrolled children. Outpatient medication spending among high-expenditure medication classes, defined as the 10 most expensive among 261 mutually exclusive medication classes, was determined by using transaction prices paid to pharmacies by Medicaid agencies and managed care plans among prescriptions filled and dispensed in 2013...
August 1, 2017: Pediatrics
https://www.readbyqxmd.com/read/28755799/-professional-practice-evaluation-of-injectable-drug-preparation-and-administration-in-neonatology
#4
P Morin, B Guillois, L Gloanec, N Chatelier, G Saint-Lorant
AIM: Adverse drug events are a daily concern in neonatology departments. The aim of this study was to assess the professional practices of preparation and administration of injectable forms of medications in neonatology. MATERIALS AND METHODS: A professional practice evaluation with regard to the preparation and administration of various injectable forms of medications in different neonatology units within a given department was conducted by a pharmacy intern based on an assessment grid comprising ten criteria...
July 26, 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/28737480/healthcare-costs-for-allergic-rhinitis-patients-on-allergy-immunotherapy-a-retrospective-observational-study
#5
Felicia Allen-Ramey, Jianbin Mao, Cori Blauer-Peterson, Marvin Rock, Robert Nathan, Rachel Halpern
OBJECTIVE: Subcutaneous immunotherapy (SCIT) for allergic rhinitis (AR) has been shown to control symptoms for up to several years following treatment discontinuation, but the effect of SCIT on healthcare costs for commercially insured patients is unknown. The objective of this study was to compare healthcare costs and resource utilization for patients with AR who received SCIT compared with those who discontinued SCIT shortly after initiation. METHODS: This retrospective cohort study evaluated medical and pharmacy claims from the Optum Research Database from January 2009 through February 2014 for adults and pediatric patients with >7 (continuers) vs ≤7 (discontinuers) injection visits for SCIT within 60 days of initiation...
July 24, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28689305/assessment-of-drug-related-problems-in-pediatric-ward-of-zewditu-memorial-referral-hospital-addis-ababa-ethiopia
#6
Mequanent Kassa Birarra, Tigist Bacha Heye, Workineh Shibeshi
Background Although medications play a vital role in the cure, palliation, and inhibition of disease, they also expose patients to drug-related problems (DRPs). DRPs are common in hospitalized patients. Specifically, pediatrics population are easily affected by DRPs, as dynamic and kinetic behaviors of drugs in this population are usually different than  in adults. Objectives To assess the prevalence of DRPs and associated factors in a pediatric setting in Ethiopia. Setting Pediatric ward of Zewditu Memorial Referral Hospital, Addis Abbeba, Ethiopia...
July 8, 2017: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/28669553/expert-consensus-guidelines-for-stocking-of-antidotes-in-hospitals-that-provide-emergency-care
#7
Richard C Dart, Lewis R Goldfrank, Brian L Erstad, David T Huang, Knox H Todd, Jeffrey Weitz, Vikhyat S Bebarta, E Martin Caravati, Fred M Henretig, Theodore R Delbridge, William Banner, Sandra M Schneider, Victoria E Anderson
We provide recommendations for stocking of antidotes used in emergency departments (EDs). An expert panel representing diverse perspectives (clinical pharmacology, medical toxicology, critical care medicine, hematology/oncology, hospital pharmacy, emergency medicine, emergency medical services, pediatric emergency medicine, pediatric critical care medicine, poison centers, hospital administration, and public health) was formed to create recommendations for antidote stocking. Using a standardized summary of the medical literature, the primary reviewer for each antidote proposed guidelines for antidote stocking to the full panel...
June 29, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28638300/characteristics-of-pediatric-clinical-interventions-documented-by-a-school-of-pharmacy
#8
Lea S Eiland
OBJECTIVES: Documentation of interventions by pharmacists has become a standard of practice in clinical practice sites. Pharmacists' interventions in pediatric practice settings for short periods of time have been reported in the literature. A single study has described faculty and student interventions in the pediatric setting. The objective of this study was to characterize 4 years of interventions by faculty and students of a school of pharmacy that occurred at various pediatric practice sites throughout a state...
May 2017: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/28612089/the-intensive-care-delirium-research-agenda-a-multinational-interprofessional-perspective
#9
REVIEW
Pratik P Pandharipande, E Wesley Ely, Rakesh C Arora, Michele C Balas, Malaz A Boustani, Gabriel Heras La Calle, Colm Cunningham, John W Devlin, Julius Elefante, Jin H Han, Alasdair M MacLullich, José R Maldonado, Alessandro Morandi, Dale M Needham, Valerie J Page, Louise Rose, Jorge I F Salluh, Tarek Sharshar, Yahya Shehabi, Yoanna Skrobik, Arjen J C Slooter, Heidi A B Smith
Delirium, a prevalent organ dysfunction in critically ill patients, is independently associated with increased morbidity. This last decade has witnessed an exponential growth in delirium research in hospitalized patients, including those critically ill, and this research has highlighted that delirium needs to be better understood mechanistically to help foster research that will ultimately lead to its prevention and treatment. In this invited, evidence-based paper, a multinational and interprofessional group of clinicians and researchers from within the fields of critical care medicine, psychiatry, pediatrics, anesthesiology, geriatrics, surgery, neurology, nursing, pharmacy, and the neurosciences sought to address five questions: (1) What is the current standard of care in managing ICU delirium? (2) What have been the major recent advances in delirium research and care? (3) What are the common delirium beliefs that have been challenged by recent trials? (4) What are the remaining areas of uncertainty in delirium research? (5) What are some of the top study areas/trials to be done in the next 10 years? Herein, we briefly review the epidemiology of delirium, the current best practices for management of critically ill patients at risk for delirium or experiencing delirium, identify recent advances in our understanding of delirium as well as gaps in knowledge, and discuss research opportunities and barriers to implementation, with the goal of promoting an integrated research agenda...
June 13, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28608652/impact-of-pharmacy-services-on-cystic-fibrosis-medication-adherence
#10
Jeffery T Zobell, Elizabeth Schwab, Dave S Collingridge, Cody Ball, Robert Nohavec, Fadi Asfour
OBJECTIVES: The purpose of this study is to characterize the impact of pharmacy services on medication adherence and hospitalizations for pediatric cystic fibrosis (CF) patients. METHODS: A retrospective health insurance claims analysis and patient medical charts review from January 1, 2014 to December 31, 2016 of patients from the Pediatric Intermountain CF Center was performed. Adherence to dornase alfa and hospital admissions for pulmonary exacerbations pre and post the implementation of an integrated pharmacy team were reviewed...
June 13, 2017: Pediatric Pulmonology
https://www.readbyqxmd.com/read/28597354/pharmacologic-considerations-for-pediatric-sedation-and-anesthesia-outside-the-operating-room-a-review-for-anesthesia-and-non-anesthesia-providers
#11
REVIEW
Narjeet Khurmi, Perene Patel, Molly Kraus, Terrence Trentman
Understanding the pharmacologic options for pediatric sedation outside the operating room will allow practitioners to formulate an ideal anesthetic plan, allaying anxiety and achieving optimal immobilization while ensuring rapid and efficient recovery. The authors identified relevant medical literature by searching PubMed, MEDLINE, Embase, Scopus, Web of Science, and Google Scholar databases for English language publications covering a period from 1984 to 2017. Search terms included pediatric anesthesia, pediatric sedation, non-operating room sedation, sedation safety, and pharmacology...
June 8, 2017: Paediatric Drugs
https://www.readbyqxmd.com/read/28595685/implementing-psychopharmacology-rounds-in-a-nursing-facility-to-improve-antipsychotic-usage
#12
Evan Sasson, Marian James, Berhane Wubshet, Darko Todorov, Henry Cohen
OBJECTIVES: Evaluate whether implementing of pharmacy-led psychopharmacology rounds in a nursing facility will improve the rate of antipsychotic use. DESIGN: Single-center, prospective; medication use evaluation (MUE). SETTING: Rutland Nursing Home, Brooklyn, New York. PARTICIPANTS: Nursing facility residents, excluding the pediatric unit. INTERVENTIONS: Weekly interdisciplinary psychopharmacology rounds that include: clinical pharmacists, nurse managers, medical director, social workers, and administration...
June 1, 2017: Consultant Pharmacist: the Journal of the American Society of Consultant Pharmacists
https://www.readbyqxmd.com/read/28562517/intravenous-iron-sucrose-for-children-with-iron-deficiency-anemia
#13
Kristiyana Kaneva, Erika Chow, Cathy G Rosenfield, Michael J Kelly
Iron deficiency anemia (IDA) is the most common nutritional deficiency in children. Most children with IDA are treated with oral iron preparations. However, intravenous (IV) iron is an alternative for children with severe IDA who have difficulty in adhering to or absorbing oral iron. We sought to describe the safety and effectiveness of IV iron sucrose for treatment of IDA in children. Pharmacy records of children who received IV iron sucrose at a children's hospital between 2004 and 2014 were reviewed. Laboratory markers of anemia and iron studies were obtained and preinfusion and postinfusion values were compared...
July 2017: Journal of Pediatric Hematology/oncology
https://www.readbyqxmd.com/read/28526021/current-status-challenges-and-the-way-forward-for-clinical-pharmacy-service-in-ethiopian-public-hospitals
#14
Arebu Issa Bilal, Zelalem Tilahun, Gebremedhin Beedemariam Gebretekle, Belete Ayalneh, Bisrat Hailemeskel, Ephrem Engidawork
BACKGROUND: Clinical pharmacy service has evolved steadily over the past few decades and is now contributing to the 'patient care journey' at all stages. It is improving the safety and effectiveness of medicines and has made a significant contribution to the avoidance of medication errors. In Ethiopia, clinical pharmacy service is in its initial phase, being started in July 2013. This study therefore aimed at assessing the status, challenges and way forward of clinical pharmacy service in the country...
May 19, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28506399/encouraging-pharmacist-intervention-and-standardization-of-labeling-and-dispensing-of-oral-liquid-medications
#15
Lauren A Endriukaitis, Leslie A Briars, Adam J Bursua
OBJECTIVES: To initiate a call to action for community pharmacists and key-pharmacy stakeholders in the standardization of oral-liquid dosage forms. DATA SOURCES: Not applicable. SUMMARY: Unintentional overdose of medication due to administration error results in thousands of pediatric hospitalizations yearly. A lack of prescription and dosage device standardization pertaining to oral-liquid medications continue to be a public health hazard...
May 2017: Journal of the American Pharmacists Association: JAPhA
https://www.readbyqxmd.com/read/28497209/pharmacists-perspectives-of-the-current-status-of-pediatric-asthma-management-in-the-u-s-community-pharmacy-setting
#16
Amanda Elaro, Sinthia Bosnic-Anticevich, Kathleen Kraus, Karen B Farris, Smita Shah, Carol Armour, Minal R Patel
Objective To explore community pharmacists' continuing education, counseling and communication practices, attitudes and barriers in relation to pediatric asthma management. Setting Community pharmacies in Michigan, United States. Methods Between July and September 2015 a convenience sample of community pharmacists was recruited from southeastern Michigan and asked to complete a structured, self-reported questionnaire. The questionnaire elucidated information on 4 general domains relating to pharmacists' pediatric asthma management including: (1) guidelines and continuing education (CE); (2) counseling and medicines; (3) communication and self-management practices; (4) attitudes and barriers to practice...
August 2017: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/28470786/practice-variation-and-effects-of-e-mail-only-performance-feedback-on-resource-use-in-the-emergency-department
#17
Melissa M Tavarez, Brandon Ayers, Jong H Jeong, Carmen M Coombs, Ann Thompson, Robert W Hickey
OBJECTIVES: Higher resource utilization in the management of pediatric patients with undifferentiated vomiting and/or diarrhea does not correlate consistently with improved outcomes or quality of care. Performance feedback has been shown to change physician practice behavior and may be a mechanism to minimize practice variation. We aimed to evaluate the effects of e-mail-only, provider-level performance feedback on the ordering and admission practice variation of pediatric emergency physicians for patients presenting with undifferentiated vomiting and/or diarrhea...
May 4, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28460699/case-study-of-high-dose-ketamine-for-treatment-of-complex-regional-pain-syndrome-in-the-pediatric-intensive-care-unit
#18
REVIEW
Tracy Ann Pasek, Kelli Crowley, Catherine Campese, Rachel Lauer, Charles Yang
Complex regional pain syndrome (CRPS) is a life-altering and debilitating chronic pain condition. The authors are presenting a case study of a female who received high-dose ketamine for the management of her CRPS. The innovative treatment lies not only within the pharmacologic management of her pain, but also in the fact that she was the first patient to be admitted to our pediatric intensive care unit solely for pain control. The primary component of the pharmacotherapy treatment strategy plan was escalating-dose ketamine infusion via patient-controlled-analgesia approved by the pharmacy and therapeutics committee guided therapy for this patient...
June 2017: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/28459929/behavioral-approach-to-appropriate-antimicrobial-prescribing-in-hospitals-the-dutch-unique-method-for-antimicrobial-stewardship-dumas-participatory-intervention-study
#19
Jonne J Sikkens, Michiel A van Agtmael, Edgar J G Peters, Kamilla D Lettinga, Martijn van der Kuip, Christina M J E Vandenbroucke-Grauls, Cordula Wagner, Mark H H Kramer
Importance: Inappropriate antimicrobial prescribing leads to antimicrobial resistance and suboptimal clinical outcomes. Changing antimicrobial prescribing is a complex behavioral process that is not often taken into account in antimicrobial stewardship programs. Objective: To examine whether an antimicrobial stewardship approach grounded in behavioral theory and focusing on preserving prescriber autonomy and participation is effective in improving appropriateness of antimicrobial prescribing in hospitals...
August 1, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28419343/utilizing-a-modified-care-coordination-measurement-tool-to-capture-value-for-a-pediatric-outpatient-parenteral-and-prolonged-oral-antibiotic-therapy-program
#20
Louise E Vaz, Cindi L Farnstrom, Kimberly K Felder, Judith Guzman-Cottrill, Hannah Rosenberg, Richard C Antonelli
Background.: Outpatient parenteral or prolonged oral antibiotic therapy (OPAT) programs reduce inpatient healthcare costs by shifting care to outpatient settings. Care coordination (CC) is a necessary component to successfully transition patients. Our objective was to assess outcomes of provider time spent on nonreimbursable CC activities in a pediatric OPAT program. Methods.: We used a qualitative feasibility pilot design and modified the Care Coordination Measurement Tool...
April 17, 2017: Journal of the Pediatric Infectious Diseases Society
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