Hospital Pharmacy最新文献

{"title":"Implementation and Evaluation of Standardized Drug Expiration Processes Across Non-automated Areas","authors":"Nathan J. Oblizajek, Marc A. Phillips, David A. Cecere, Mary J. Braham","doi":"10.1177/00185787231218947","DOIUrl":"https://doi.org/10.1177/00185787231218947","url":null,"abstract":"Objective: The study aimed to enhance medication management efficiency by introducing a systematic approach to redistributing medications to high-utilization zones, thereby mitigating the volume and expenses associated with non-returnable expired medications. Methods: This quality improvement initiative encompassed 2 key phases. Initially, a standardized workflow for managing expiring medications was implemented across 2 satellite pharmacy areas. Subsequently, the impact of these interventions was assessed by comparing pre-implementation and post-implementation data on the quantity and monetary value of expired medications. Baseline data were derived from expired medication records spanning January 1, 2022, to December 31, 2022. The new workflow was established in December 2022, and post-implementation data were collected from January 1, 2023, to March 31, 2023. The process rollout involved devising workflow protocols, creating supportive documentation, and delivering training to pharmacy personnel. Data collection encompassed medication identifiers, stock locations, date medications were received, expiration dates, along with wholesale acquisition cost for each item. Descriptive statistical methods were employed for analysis. Results: Comparative analysis of pre-implementation and post-implementation data revealed substantial reductions in the annual estimated quantity of expired medications (284 fewer items, representing a 13.6% decrease) and corresponding wholesale acquisition costs ($5075 USD reduction, translating to a 19.7% decrease) within the satellite areas during the study period. Moreover, a comparison of post-implementation quarter one data with the corresponding data from the previous year highlighted even more significant reductions in the quantity of expired medications (203 fewer items, reflecting a 31.1% decrease) and associated wholesale acquisition costs ($2548 USD reduction, signifying a 33.0% decrease) within the satellite areas. Conclusions: This study underscores the potential advantages of employing a standardized process to proactively reallocate medications prior to their expiration, thereby enabling their utilization in other hospital sections. Future endeavors could concentrate on the wider implementation of similar workflows throughout different hospital locations and the broader enterprise.","PeriodicalId":13002,"journal":{"name":"Hospital Pharmacy","volume":"30 11","pages":""},"PeriodicalIF":0.7,"publicationDate":"2023-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138949701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inadvertent Injection of Ciprofloxacin Instead of Ropivacaine Through Epidural Catheter","authors":"Régis Fuzier, G. Salvignol, Gwenaël Ferron, Carine Lacroix, Philippe Izard","doi":"10.1177/00185787231217163","DOIUrl":"https://doi.org/10.1177/00185787231217163","url":null,"abstract":"Purpose: Patient harm is often due to medication errors related to neuraxial and peripheral misconnection. We report a case of inadvertent injection of ciprofloxacin into the epidural space and discuss the strategies that could prevent such an incident. Summary: A 74-year-old woman presented a recurrence of an ovarian cancer. The recent discovery of an intrabdominal recurrence on CT-scan led us to propose a new surgical procedure. A thoracic epidural analgesia was performed prior to general anesthesia. Postoperative pain was controlled with patient-controlled epidural analgesia (PCEA) with ropivacaine-epinephrine. During the first night, abdominal pain appeared. During the second day, a nurse discovered that the bag connected to the pump contained ciprofloxacin and not ropivacaine. After aspiration of 2.5 ml sent to laboratory for analysis, the epidural catheter was removed. The investigation revealed the different causes leading to such an error. Three days after, the patient returned home, without any adverse symptoms. Conclusion: This is the first report of the inadvertent administration of ciprofloxacin into the epidural space via a patient-controlled epidural analgesia technique. As there is no effective treatment for such errors, we discuss the neurological risk of ciprofloxacin and prevention strategy mainly based on organizational and human factors.","PeriodicalId":13002,"journal":{"name":"Hospital Pharmacy","volume":"46 4","pages":""},"PeriodicalIF":0.7,"publicationDate":"2023-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138955401","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychological Distress and its Association With Job Satisfaction Among Hospital Pharmacists in Vietnam","authors":"V. D. Tran, Kieu Nghi Ngo, Thi Ngoc Nga Pham, Tran Nhat Phong Dao, Thi Quyen Truong, D. T. Huynh, M. Le, V. V. Dorofeeva, R. S. Dewey","doi":"10.1177/00185787231198168","DOIUrl":"https://doi.org/10.1177/00185787231198168","url":null,"abstract":"Background: No previous studies have examined the relationship between stress, anxiety, and depression among pharmacists in Vietnam. Objectives: This study aims to investigate the correlation between stress, anxiety, depression, and job satisfaction among hospital pharmacists in Vietnam. Methods: The study comprised a 12-month cross-sectional survey in Can Tho City, Vietnam, with 11 conveniently selected hospitals. Out of 305 the distributed questionnaires, 303 were completed (99.3% response rate). The 21-item depression, anxiety, and stress scale (DASS-21) assessed stress, anxiety, and depression (21 items), while job satisfaction was measured using a 44-item questionnaire. Results: The study revealed a prevalence of 15.5% for stress, 27.1% for anxiety, and 20.5% for depression among hospital staff. Additionally, the majority of hospital staff (72.9%) reported being satisfied with their job. Those with more than 2 children (95% CI = 1.183-14.519) were nearly 4 times as likely to experience higher stress. Female respondents (95% CI = 1.34-5.92) and those who rented (95% CI = 1.05-3.55) were more likely to encounter anxiety. Those living outside Can Tho City (95% CI = 1.32-9.88) were at a 3.61 times higher risk of depression, while individuals who had been working at the hospital for 5 to 10 years (95% CI = 0.17-0.82) had a lower risk of depression. Increased depression (aOR = 0.441; 95% CI = 0.21-0.94) was linked to job dissatisfaction. Conclusion: Depression was significantly associated with job dissatisfaction. The study findings suggest that management agencies should implement prevention and intervention strategies to reduce mental health issues among hospital pharmacists.","PeriodicalId":13002,"journal":{"name":"Hospital Pharmacy","volume":"15 11","pages":""},"PeriodicalIF":0.7,"publicationDate":"2023-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139000489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Comparison of Inventory Management Models in Automated Dispensing Cabinets at a Large Academic Medical Center","authors":"Thomas Walczyk, John D. Hill, Carla Gill, Lisa Hurowitz, David Stimler, Gary Flax, Christopher Boreen, Edward Lau","doi":"10.1177/00185787231214416","DOIUrl":"https://doi.org/10.1177/00185787231214416","url":null,"abstract":"Purpose: To compare and evaluate 2 methods of inventory management in automated dispensing cabinets (ADCs). Methods: Ten profiled ADCs had 2 inventory management models implemented over 2 months. Implementation of the models on each ADC involved adjustment of par levels (desired accessible quantities of medication) and removal of medications not used in the past 90 days or more. The par levels of 5 ADCs were adjusted using a formula developed based on the economic order quantity model. The par levels of the other 5 ADCs were adjusted using a formula based on historical average daily usage. The study endpoints include stock out rate, vend:fill ratio, quantity of expired medications, and inventory carrying cost. Results: The total of number of medications stocked in the 10 ADCs was reduced from 3035 in a 2-month pre-implementation period to 2932 in a 2-month post-implementation period yielding a reduction of inventory carrying cost by $11 011. The mean stock out rate in both study groups increased and vend:fill ratio decreased after implementation. The quantity of expired medications increased in the modified economic order quantity formula inventory management model and decreased in the average daily usage inventory management model. Conclusion: The implementation of 2 inventory management models on ADCs had a negative impact on stock out rate and vend:fill ratio, a mixed impact on quantity of expired medications, and a positive impact on inventory carrying cost reduction.","PeriodicalId":13002,"journal":{"name":"Hospital Pharmacy","volume":"10 4","pages":""},"PeriodicalIF":0.7,"publicationDate":"2023-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138979325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Empowering Nursing Students to Prevent Medication Error-Related Harms: A Step Toward Improving Patient Safety","authors":"H. Deswal, Niti Mittal, Jyoti Kaushal, Sumit Kumar, Pankaj Kaushik","doi":"10.1177/00185787231213806","DOIUrl":"https://doi.org/10.1177/00185787231213806","url":null,"abstract":"Aim: Existing gaps in nursing curriculum particularly related to medication management such as administration and monitoring increase the propensity of nurses to commit medication errors during clinical practice. The present training program was conducted with an aim to sensitize and educate undergraduate nursing students on medication errors’ related aspects. Methods: The participants were students pursuing bachelors nursing degree course (second and third year). The training “Medication errors: Role of Nurse practitioners” comprised of blended teaching methods such as theme lectures, hands on training exercises, small group case‑based learning, role plays, and nursing officer’s practical experiences. The participants’ knowledge and perception about medication errors were assessed at baseline (pre-intervention phase) and 1 week after program (post-intervention phase) with the help of a structured self-administered questionnaire in English language. Results: A total of 110 nursing students participated in the program. Post program there was a consistent increase in the number of correct responses to all knowledge-based questions with a significant improvement in knowledge scores from baseline [Baseline: (mean ± SD) 12.62 ± 2.33; Post-training: 18.52 ± 2.22; P < .001]. There was a positive change in the perception about medication errors among students. The participants rated the overall quality of program as excellent [66 (60%)] or very good [40 (36.4%)]. More than 90% agreed on its applicability in their future practice. Conclusions: The training was quite successful in educating nursing students on medication errors. There is a constant need to educate nurses and other healthcare providers including doctors and pharmacists on medication safety related aspects with an ultimate goal to improve patient safety.","PeriodicalId":13002,"journal":{"name":"Hospital Pharmacy","volume":"56 12","pages":""},"PeriodicalIF":0.7,"publicationDate":"2023-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138596722","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is Sacubitril/Valsartan a Superior Agent in Heart Failure With Reduced Ejection Fraction? A Review of Randomized Comparative Trials","authors":"J. Rindone, Chadwick K. Mellen, Megan Goldenstein","doi":"10.1177/00185787231212619","DOIUrl":"https://doi.org/10.1177/00185787231212619","url":null,"abstract":"Background: The PARADIGM HF trial showed sacubitril/valsartan (SV) to be superior to enalapril in patients with reduced ejection fraction (HFrEF). Since its publication, several other randomized trials have compared SV to either an angiotensin converting enzyme inhibitor (ACEI) or angiotensin receptor blocker (ARB) in HFrEF which showed conflicting results regarding mortality, hospitalizations, and quality of life scoring. Objective: To review randomized comparative trials of SV to either ACEI or ARB in patients with HFrEF. Methods: PubMed and Embase databases were used to identify randomized comparative trials. The text terms sacubitril, angiotensin neprilysin, and LCZ696 were used for both searches. Meta-analysis, retrospective, adhoc, and cohort studies were excluded. Results: 1476 and 3983 citations were reviewed on PubMed and Embase, respectively. Of these, 11 randomized comparative trials to either ACEI or ARB were included for analysis. The mortality/quality of life benefits of SV over enalapril in the PARADIGM HF were not corroborated in any of the other trials. The effect of hospitalizations for heart failure was inconsistent among trials. Exercise tolerance was not improved with SV versus enalapril. Conclusion: The results of the PARADIGM HF trial have largely not been confirmed in subsequent randomized comparative trials.","PeriodicalId":13002,"journal":{"name":"Hospital Pharmacy","volume":"67 31","pages":""},"PeriodicalIF":0.7,"publicationDate":"2023-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138594856","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Benefits of Accepting Infectious Diseases Pharmacist Recommendations: A 5-Year Outcome Study in a Multihospital System","authors":"Taylor Babiarz, Justin Schmetterer, K. Merrick, Tanja Jelic, Thomas Roberts","doi":"10.1177/00185787231213807","DOIUrl":"https://doi.org/10.1177/00185787231213807","url":null,"abstract":"Background: Infectious diseases (ID) pharmacists are pivotal members of antimicrobial stewardship teams. Prospective audit and feedback is a strong recommendation by The Infectious Diseases Society of America Guidelines for Antimicrobial Stewardship Programs (ASP). Utilizing customized ASP intervention documentation tools known as “ivents” in Epic, we aimed to assess the impact of interventions by measuring outcomes that were accepted compared to those that were rejected in a multihospital health system over 5 years. Methods: A multicenter, retrospective cohort study was conducted to compare clinical outcomes among intensive care unit (ICU) and non-ICU patients with accepted and rejected ASP interventions over 5 years from October 2015 to December 2020. Outcomes measured included antibiotic days of therapy per 1000 patient days (DOT/1000 PD), antibiotic doses per 1000 patient days (doses/1000 PD), hospital length of stay (LOS), in-hospital mortality, hospital-acquired Clostridioides difficile infection (HA-CDI), community-onset C. difficile infection (CO-CDI) within 30 days, and hospital readmission within 30 days. Coarsened exact matching (CEM) was used as a non-parametric matching method to balance covariates between groups and to control for confounding. Results: ASP recommendations by ID pharmacists were well-received by providers in a multihospital system over 5 years as evidenced by an overall acceptance rate of 92%. Acceptance of ASP interventions was associated with substantial reductions in antibiotic utilization without adversely affecting mortality or hospital readmissions. While high-risk C. difficile antibiotic use increased significantly due to frequent de-escalation to ceftriaxone among non-ICU patients with accepted interventions, rates of HA-CDI and CO-CDI within 30 days did not worsen. Furthermore, hospital LOS was notably shorter by an average of 1 day for non-ICU patients with accepted interventions, which resulted in substantial cost avoidance of $7 631 400. Conclusion: Collaboration with ID pharmacists to optimize antimicrobial stewardship was associated with significant reductions in antibiotic utilization, costs, and hospital LOS without worsening patient outcomes.","PeriodicalId":13002,"journal":{"name":"Hospital Pharmacy","volume":"37 17","pages":""},"PeriodicalIF":0.7,"publicationDate":"2023-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138597838","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"International Branch Campuses and Pharmacy Education in Low-Middle-Income Countries","authors":"Seif El Hadidi","doi":"10.1177/00185787231196770","DOIUrl":"https://doi.org/10.1177/00185787231196770","url":null,"abstract":"","PeriodicalId":13002,"journal":{"name":"Hospital Pharmacy","volume":"19 1","pages":""},"PeriodicalIF":0.7,"publicationDate":"2023-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139212789","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antibiotic Stewardship: A Handshaking Strategy Among Physicians and Pharmacists to Improve therapeutic Outcomes in Hematology-Oncology","authors":"Kashif Ali, Sadia Shakeel, A. K. Dhiloo, Mehwish Wajdi, Fakhsheena Anjum, S. Ansari","doi":"10.1177/00185787231196774","DOIUrl":"https://doi.org/10.1177/00185787231196774","url":null,"abstract":"Background: Infections are highly susceptible in patients with hematological malignancies due to immune suppression, immunosuppressive therapies and disease progression. Rational use of antibiotics following Antimicrobial Stewardship (AMS) guidelines in early detection and response to infection is significant to improve patient care. Objectives: The present study was conducted to determine the impact of clinical pharmacists’ interventions (PIs) on antibiotics usage in hematology-oncology set up in Karachi, Pakistan. Methodology: An observational prospective study was conducted for a period of 4 months in a well-known 75-bed teaching hospital, specializing in bone marrow transplantation in Karachi, Pakistan without a structured Antimicrobial stewardship programs (ASPs). The information was gathered from patient medical histories, laboratory, and microbiological records. Results: A total of 876 PIs (1 to 5 per patient) were implemented. Dose modifications or interval changes accounted for the major interventions (n = 190, 21.6%). The majority of all recommendations were related to antipseudomonal β-lactams, aminoglycosides, sulfamethoxazole-trimethoprim and vancomycin. Overall, 94.3% (n = 876) of the 928 PIs were accepted. Conclusion: The PIs and the high physician acceptance rate may be useful for improving the safe use of antibiotics, lowering their toxicity, lowering the need for special-vigilance medications and potentially improving patient care.","PeriodicalId":13002,"journal":{"name":"Hospital Pharmacy","volume":"24 1","pages":""},"PeriodicalIF":0.7,"publicationDate":"2023-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139210441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Managing Grief for Pharmacy Leaders","authors":"Geoffry A. Genna, John D. Hill, Thomas S. Achey","doi":"10.1177/00185787231212623","DOIUrl":"https://doi.org/10.1177/00185787231212623","url":null,"abstract":"Grief is everywhere and affects individuals and teams in many different ways. The negative effects may not only be felt by the individual, but they can disrupt a team or an entire organization. While grief is common, understanding how to interact with others who are grieving is not. As leaders within healthcare institutions, pharmacists encounter many individuals and teams that are experiencing grief. The sources of grief can arise from pharmacy team members, other healthcare providers, patients, or our own personal experiences. This literature review introduces grief, where it comes from, and how it is emotionally and physically expressed in individuals. It discusses grief’s disruptive nature and how to effectively communicate with those grieving to limit disturbances to individual, team, and organizational performance. Understanding what grief is, how it manifests in individuals and teams, and how to navigate a grieving workplace are vital skills for pharmacy leaders and will enable a more productive workplace.","PeriodicalId":13002,"journal":{"name":"Hospital Pharmacy","volume":"76 1","pages":""},"PeriodicalIF":0.7,"publicationDate":"2023-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139236245","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}