The Canadian journal of hospital pharmacy最新文献

{"title":"A Baby Step Toward Planetary Health: A Collaborative Quality Improvement Initiative to Reduce Single-Use Plastics in a Pharmacy and Neonatal Intensive Care Unit.","authors":"Gurneet Rana, Brandi Newby","doi":"10.4212/cjhp.3575","DOIUrl":"https://doi.org/10.4212/cjhp.3575","url":null,"abstract":"","PeriodicalId":94225,"journal":{"name":"The Canadian journal of hospital pharmacy","volume":"77 3","pages":"e3575"},"PeriodicalIF":0.0,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11361308/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142305284","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inspiring Students to Become Healthcare-System Pharmacists.","authors":"Ema Ferreira","doi":"10.4212/cjhp.3675","DOIUrl":"https://doi.org/10.4212/cjhp.3675","url":null,"abstract":"","PeriodicalId":94225,"journal":{"name":"The Canadian journal of hospital pharmacy","volume":"77 3","pages":"e3675"},"PeriodicalIF":0.0,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11361307/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142305289","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prescribing Trends for Oral Vancomycin and Fidaxomicin after Guideline and Formulary Changes in Ontario, Canada: An Interrupted Time-Series Analysis.","authors":"Mira Maximos, Colleen Maxwell, John-Michael Gamble","doi":"10.4212/cjhp.3560","DOIUrl":"10.4212/cjhp.3560","url":null,"abstract":"<p><strong>Background: </strong><i>Clostridioides difficile</i> is a pathogen causing diarrheal illness, which can be treated with vancomycin or fidaxomicin.</p><p><strong>Objective: </strong>To evaluate changes in monthly prescription volumes for oral vancomycin and fidaxomicin in Ontario community pharmacies following implementation of the 2017 and 2021 updates to guidelines from the Infectious Diseases Society of America (IDSA) and Society for Healthcare Epidemiology of America (SHEA) and after a 2019 provincial formulary change for vancomycin.</p><p><strong>Methods: </strong>An interrupted time-series analysis was conducted from November 2015 to October 2021 using monthly projected prescription volumes obtained from IQVIA's Compuscript database. Level and slope (trend) changes in prescribing were assessed using segmented linear regression.</p><p><strong>Results: </strong>The volume of vancomycin prescriptions increased by 74 prescriptions per month (95% confidence interval [CI] 16 to 132) following implementation of the 2017 guideline update and by 73 prescriptions per month (95% CI 13 to 133) after the 2019 formulary change; however, no statistically significant changes were observed after implementation of the 2021 guideline update. No significant trend changes were observed for fidaxomicin.</p><p><strong>Conclusion: </strong>Guidelines and formulary changes were correlated with increased volume of vancomycin prescriptions.</p>","PeriodicalId":94225,"journal":{"name":"The Canadian journal of hospital pharmacy","volume":"77 3","pages":"e3560"},"PeriodicalIF":0.0,"publicationDate":"2024-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11285109/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141984231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Standardized Orders for Salbutamol and Ipratropium: Do They Lead to Waste and Irrational Prescribing?","authors":"Lillian Lo, Aaron M Tejani","doi":"10.4212/cjhp.3561","DOIUrl":"10.4212/cjhp.3561","url":null,"abstract":"","PeriodicalId":94225,"journal":{"name":"The Canadian journal of hospital pharmacy","volume":"77 3","pages":"e3561"},"PeriodicalIF":0.0,"publicationDate":"2024-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11285107/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141984232","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characterizing the Perceived Need for Advanced Clinical Pharmacy Training in British Columbia.","authors":"Lillian Cao, Karen Dahri, Michael Legal","doi":"10.4212/cjhp.3562","DOIUrl":"10.4212/cjhp.3562","url":null,"abstract":"<p><strong>Background: </strong>Currently in Canada there are limited opportunities for advanced clinical pharmacy training after a year 1 residency. Advanced training programs currently in existence are year 2 residencies, clinical Master's degrees, and Fellowships.</p><p><strong>Objectives: </strong>To characterize the perceived need for advanced clinical pharmacy training in British Columbia and to determine the desired educational competencies to be gained through advanced training.</p><p><strong>Methods: </strong>Current pharmacy residents (academic year 2021/22) and residency graduates of the past 5 years (2017-2021), together referred to as early career pharmacists or ECPs, were surveyed. Provincial health authority pharmacy leaders who hire clinical pharmacists were also surveyed and invited to participate in key informant interviews.</p><p><strong>Results: </strong>Eighty-four ECPs and 22 pharmacy leaders participated in the surveys (estimated response rates 26% and 35%, respectively). Eleven (13%) of the ECPs had already completed advanced clinical training, and an additional 24 (29%) planned to pursue such training within 5 years. Sixteen (73%) of the pharmacy leaders had experienced difficulties in filling advanced practice positions over the previous 3 years due to a lack of qualified applicants, and 21 (95%) believed that more advanced training positions should be offered. The majority of ECPs interested in advanced training (39/60, 65%) chose year 2 residency as their preferred program, and 20 (91%) of the pharmacy leaders agreed that British Columbia should offer year 2 residencies. Both ECPs and leaders rated clinical skills and knowledge as the most important educational competencies.</p><p><strong>Conclusions: </strong>Pharmacy leaders expressed a need for more pharmacists with advanced clinical pharmacy training, and many ECPs were interested in pursuing such advanced training. Most respondents preferred the year 2 residency, with the most common goal being to improve clinical competencies.</p>","PeriodicalId":94225,"journal":{"name":"The Canadian journal of hospital pharmacy","volume":"77 3","pages":"e3562"},"PeriodicalIF":0.0,"publicationDate":"2024-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11285110/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141984228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dexamethasone Use to Reduce Mechanical Ventilation and Bronchopulmonary Dysplasia in the Neonatal Intensive Care Unit.","authors":"Sandeep Padam, Brandi Newby, Luo Lora Wang","doi":"10.4212/cjhp.3523","DOIUrl":"10.4212/cjhp.3523","url":null,"abstract":"<p><strong>Background: </strong>Ventilator-dependent neonates are at risk of bronchopulmonary dysplasia (BPD), a chronic lung disease. Dexamethasone may be used to facilitate extubation and reduce the incidence of BPD.</p><p><strong>Objectives: </strong>To determine the efficacy of dexamethasone in reducing the incidence of established BPD at 36 weeks postmenstrual age (PMA); to establish the rate of extubation success; to determine the factors affecting extubation success; and to describe complications associated with dexamethasone therapy.</p><p><strong>Methods: </strong>A chart review was conducted at Surrey Memorial Hospital, in Surrey, British Columbia, for neonates who received dexamethasone to reduce the development of BPD between July 1, 2016, and June 30, 2022.</p><p><strong>Results: </strong>A total of 47 neonates met the inclusion criteria. Of the 45 neonates still alive at 36 weeks PMA, all (100%) had BPD. Use of dexamethasone led to extubation success for 21 (47%) of these 45 neonates. The mean PMA at dexamethasone initiation was 30.7 weeks for neonates with extubation success, compared with 28.6 weeks for those with extubation failure (<i>p</i> = 0.001). Complications occurred in 43 (91%) of the 47 neonates.</p><p><strong>Conclusions: </strong>BPD occurred in all of the neonates, despite a 47% extubation success rate. The timing of dexamethasone initiation was associated with extubation success. Further research is required to determine the dose and timing of dexamethasone needed to reduce the incidence of BPD.</p>","PeriodicalId":94225,"journal":{"name":"The Canadian journal of hospital pharmacy","volume":"77 3","pages":"e3523"},"PeriodicalIF":0.0,"publicationDate":"2024-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11285111/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141984229","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nova Scotia Health COVID-19 Non-severe Therapy Consult Service: Lessons from a Hospital Pharmacy-Based Model.","authors":"Tasha D Ramsey, Mackenzie d'Entremont-Harris, Lisa Nodwell, Barbara Goodall, Lisa Barrett","doi":"10.4212/cjhp.3578","DOIUrl":"10.4212/cjhp.3578","url":null,"abstract":"","PeriodicalId":94225,"journal":{"name":"The Canadian journal of hospital pharmacy","volume":"77 3","pages":"e3578"},"PeriodicalIF":0.0,"publicationDate":"2024-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11285108/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141984230","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"True Rate of Allergy among Pediatric Inpatients with Penicillin Allergy Labels (TRIAL).","authors":"Natasha Kwan, Kristopher Kang, Roxane R Carr, Raymond Mak, Ashley Roberts, Falla Jin, Jeffrey N Bone, S Rod Rassekh, Tiffany Wong","doi":"10.4212/cjhp.3531","DOIUrl":"10.4212/cjhp.3531","url":null,"abstract":"<p><strong>Background: </strong>Penicillin allergy is a common drug allergy diagnosis in pediatric patients; however, upon appropriate allergy testing, many of these patients are found not to have a true allergy. For patients with a reported allergy, alternative antibiotics are prescribed, which are less effective, more toxic, or more expensive. There is a lack of data evaluating allergies in hospitalized children and comparing allergy assessments conducted by pediatric allergists and pharmacists.</p><p><strong>Objective: </strong>To estimate the percentage of pediatric patients admitted with reported penicillin allergy who did not have a true penicillin allergy.</p><p><strong>Methods: </strong>This single-centre prospective cohort study included inpatients between 6 months and 17 years of age, with a documented penicillin allergy, who were admitted to the general pediatric and oncology units of a tertiary care children's hospital between November 2019 and March 2023. The allergy history, evaluation, and risk categorization were performed by pharmacists. The history was reviewed with the allergist, and the patient was then referred, underwent skin testing, or received oral amoxicillin challenge with monitoring for 1 hour.</p><p><strong>Results: </strong>Thirty patients were included, of whom 29 (97%) had delabelling of their penicillin allergy. Four patients (13%) had delabelling on the basis of history alone, without risk assessment. Twenty-five (83%) of the patients were assessed as having low risk; 24 of these had delabelling following oral challenge, and 1 did not complete the oral challenge because of transfer to another hospital. One patient (3%) was assessed as having moderate risk, with delabelling on the basis of results of skin testing and oral challenge. The pharmacist's and allergist's risk assessments were in agreement in 29 (97%) of the 30 cases.</p><p><strong>Conclusions: </strong>Pediatric patients, including those with oncologic malignancies, are often mislabelled as having a penicillin allergy. Pharmacists are able to accurately determine true allergy risk and delabel penicillin allergies for pediatric patients in the hospital setting.</p>","PeriodicalId":94225,"journal":{"name":"The Canadian journal of hospital pharmacy","volume":"77 3","pages":"e3531"},"PeriodicalIF":0.0,"publicationDate":"2024-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11210598/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141581984","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of a Competency Assessment Framework for Pharmacy Residents Participating in High-Fidelity Simulation and Creation of the SIMPHARM Assessment Tool.","authors":"Patrick Jf Deschênes, My Hanh Luu Hoai, Justine Rinfret, Sarah Pelletier, Alessandra Stortini, Rachel Therrien, Marie-Kim Héraut, Pascaline Bernier, John Nam-Kha Nguyen","doi":"10.4212/cjhp.3552","DOIUrl":"10.4212/cjhp.3552","url":null,"abstract":"<p><strong>Background: </strong>Simulations are used to improve professional practice across multiple health professions; however, the application of simulations in pharmacy curricula has been limited by a lack of evidence.</p><p><strong>Objectives: </strong>To delineate the competencies of pharmacy residents needed to assess their progress while participating in a high-fidelity simulation training program and to create a reliable assessment tool based on these competencies.</p><p><strong>Methods: </strong>A literature review was conducted, followed by application of a modified Delphi method. An assessment tool based on the results of these activities was drafted (in French). A second modified Delphi process was carried out to assess the reliability of the tool, and the tool was modified accordingly.</p><p><strong>Results: </strong>The literature search yielded a total of 2670 articles, of which 289 were included for analysis. The first modified Delphi process involved 19 experts in the first round and 10 experts in the second round. The Cronbach α was 0.866 (95% confidence interval [CI] 0.713-0.960), indicating good reliability. A total of 7 competencies were retained for inclusion in the SIMPHARM assessment tool: professionalism, leadership, teamwork, communication, critical thinking, preparation and packaging of medications, and pharmaceutical calculations. The second modified Delphi process involved 9 experts in the first round and 11 experts in the second round. The final Cronbach α was 0.877 (95% CI 0.741-0.960).</p><p><strong>Conclusions: </strong>To the authors' knowledge, this was one of the largest studies exploring pharmacy competencies in the context of simulations. This work yielded a reliable framework for the assessment of pharmacy residents' competencies. This assessment tool may help evaluators in assessing the competencies of pharmacy trainees after simulation training.</p>","PeriodicalId":94225,"journal":{"name":"The Canadian journal of hospital pharmacy","volume":"77 3","pages":"e3552"},"PeriodicalIF":0.0,"publicationDate":"2024-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11210595/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141581981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Addition of a Novel Qualitative Technique to Standard Quantitative Practices for Evaluation of Hazardous Drug Exposure in a Canadian Hospital Setting.","authors":"Raminder Grewal, Albert Karas, Sumit Goyal","doi":"10.4212/cjhp.3509","DOIUrl":"10.4212/cjhp.3509","url":null,"abstract":"<p><strong>Background: </strong>Current recommendations from regulatory authorities suggest quantitative surface sampling for detection of hazardous drugs at least once every 6 months. A more frequent and efficient process for hazardous drug testing might reduce the safety risks associated with exposure to these agents.</p><p><strong>Objectives: </strong>The primary objective was to assess the findings of surface testing based on traditional quantitative sampling methods relative to the findings of qualitative surface sample testing with the BD HD Check system. The secondary objectives included assessment of the ease of integrating qualitative sampling into pharmacy protocols and identification of opportunities to enhance patient and staff education and safety.</p><p><strong>Methods: </strong>Samples from 23 unique surfaces were tested concurrently once a month for 5 months using a quantitative surface sampling method and the qualitative BD HD Check system on adjacent 12 inch × 12 inch (30.5 cm × 30.5 cm) surface areas. The presence or absence of cyclophosphamide, methotrexate, and/or doxorubicin contamination was assessed by each of the 2 testing methods. The BD HD Check system was also assessed for ease of use and efficiency.</p><p><strong>Results: </strong>Ten areas of contamination were identified over the 5-month period. Nine were detected by the BD HD Check system and one by the quantitative system. The BD HD Check system was easy to use, with results available in less than 10 minutes per area tested.</p><p><strong>Conclusions: </strong>The BD HD Check system allows for more timely identification of surface contamination with hazardous drugs than the standard sampling protocol. The discrepancy in results between the 2 methods of hazardous drug surface sampling requires further investigation.</p>","PeriodicalId":94225,"journal":{"name":"The Canadian journal of hospital pharmacy","volume":"77 3","pages":"e3509"},"PeriodicalIF":0.0,"publicationDate":"2024-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11210593/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141581978","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}