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Usp Compliance: A Hazardous Drug Safe Handling Ppe Toolkit For Infusion Nurses, Cynthia Huff 2020 The University of San Francisco

Usp Compliance: A Hazardous Drug Safe Handling Ppe Toolkit For Infusion Nurses, Cynthia Huff

Doctor of Nursing Practice (DNP) Projects

Problem: Safety concerns have existed for more than 40 years about how hazardous drug (HD) exposure contributes to long- and short-term adverse health outcomes for healthcare workers (HCWs). Careless handling may cause toxic residues to infiltrate hospital environments and patient care areas, and can even be traced to patients’ homes. New government regulations will require healthcare organizations to minimize exposure risks to HCWs by fully implementing the U.S. Pharmacopeia (USP) Convention Chapter 800: Hazardous Drugs: Handling in Healthcare Settings (USP, 2016) on December 1, 2019. According to Polovich and Olsen (2017), “The implementation of the USP <800> Standards will represent ...


The Teaching Of Performance Enhancing Drugs In U.S. Schools And Colleges Of Pharmacy, Sara Dorothy Green 2020 University of Mississippi

The Teaching Of Performance Enhancing Drugs In U.S. Schools And Colleges Of Pharmacy, Sara Dorothy Green

Honors Theses

The teaching of performance enhancing drugs in U.S. schools and colleges of pharmacy is necessary to better help patients who are athletes especially those who compete in high-level athletics such as the Olympics or the National Collegiate Athletic Association (NCAA). There is no master list for banned substances, they differ for each organization and have many exceptions. Pharmacists can play a key role in preventing unintentional disqualifications of athletes as there are many medications considered performance enhancing drugs including some supplements and stimulants. For example, commonly used cold medications may contain pseudoephedrine hydrochloride, a banned substance in the world ...


Does It Get Any Worse Than Acne? It Does, Actually. An In-Depth Review Of Accutane’S Regulatory History., Bridget A. Betts 2020 University of Mississippi

Does It Get Any Worse Than Acne? It Does, Actually. An In-Depth Review Of Accutane’S Regulatory History., Bridget A. Betts

Honors Theses

Isotretinoin, most often recognized by the brand name Accutane®, is regarded by many patients and prescribers as the miracle cure for acne. Its unsurpassed efficacy is paired with serious risk of adverse events and birth defects, which poses ethical questions regarding its safety and necessity. Its regulatory history established precedent in Food and Drug Administration Risk Evaluation and Mitigation Strategies and brought awareness to the sharp dangers of teratogenic drug use.

This medication came as a breakthrough solution to patients that suffered years of unsuccessful regimens for the treatment of acne vulgaris. Some question the risk-benefit evaluation of such a ...


Improving Diabetes Self-Management Developing A Patient Decision Aid To Improve Patient Education, Morgan Baker 2020 University of Mississippi

Improving Diabetes Self-Management Developing A Patient Decision Aid To Improve Patient Education, Morgan Baker

Honors Theses

Type 2 diabetes is a complex disease that affects a large population of people. It is imperative that efforts are made to develop more effective and inclusive treatment strategies for patients with this condition. A promising approach being studied is the utilization of community pharmacists to individualize and implement diabetes self-management training and education. The objective of this study is to develop a preliminary version of a patient decision aid (PDA) designed to evaluate patient knowledge and behavior towards diabetes self-management for use in the community pharmacy setting. The study design used to achieve this objective was a cross-sectional survey ...


An Evaluation Of The Treatment Of Asthma In The State Of Mississippi Using Hedis Quality Control Measures, Kyle Kantor 2020 University of Mississippi

An Evaluation Of The Treatment Of Asthma In The State Of Mississippi Using Hedis Quality Control Measures, Kyle Kantor

Honors Theses

Introduction: Asthma is an inflammatory condition of the lungs that can have significant impacts on a patient’s quality of life. Asthma attacks can be very uncomfortable and even deadly in some cases. The objective of this study is to evaluate the treatment of asthma in the state of Mississippi and to describe the disparities between demographics to help healthcare providers identify patients who might be at risk for poor treatment and help those patients receive quality healthcare. Methods: The data was retrospectively collected from January to December 2014 Mississippi Centers for Medicare and Medicaid Services claims data. This study ...


How Do Pharmacies Evaluate Cleanroom Automation Systems?, Kenneth Maxik, Craig Kimble, Alberto Coustasse, Chris Booth 2020 Marshall University

How Do Pharmacies Evaluate Cleanroom Automation Systems?, Kenneth Maxik, Craig Kimble, Alberto Coustasse, Chris Booth

Pharmacy Practice & Administration

Many pharmacies have implemented or considered implementing cleanroom automation or compounding systems. Intravenous (IV) admixture automation is one of the newest areas of technology that has been applied to pharmacy workflow. Manufacturers tout systems for reducing errors reaching patients. Clinical literature supports that cleanroom technology can aid in patient safety.


The Use Of Urine Drug Testing For Risk Stratification And Efficacious Drug Monitoring In Pain Management Settings, Ahmad I. Hasan, Kareem Elhage, Brendan Farley, Khaled J. Saleh 2020 Wayne State University

The Use Of Urine Drug Testing For Risk Stratification And Efficacious Drug Monitoring In Pain Management Settings, Ahmad I. Hasan, Kareem Elhage, Brendan Farley, Khaled J. Saleh

Medical Student Research Symposium

Objective: To understand the current landscape of urine drug testing (UDT) guidelines as part of risk assessment for opioid abuse, and to offer recommendations towards adopting universal screening guidelines.

Background: There has been an opioid epidemic within the United States, and the role of prescription opioids has been well established. Despite proposed recommendations, there has yet to be a published universal screening guideline on the use of UDT in the setting of opioid abuse risk stratification as well as postoperative drug monitoring.

Methods: We explored current guidelines for UDT on two levels. First, we explore general indications for UDT within ...


Pharmacist-Prescribed Birth Control: A Policy Analysis, Brianna Full 2020 University of Nebraska at Omaha

Pharmacist-Prescribed Birth Control: A Policy Analysis, Brianna Full

Student Research and Creative Activity Fair

Although unintended pregnancy in the United States has steadily decreased from 2008, rates are still unacceptably high as almost half (42%) of all pregnancies are not wanted or timed correctly (Finer & Zolna). In 2011, 2.8 million of the 6.1 million pregnancies in the United States each year were unintended. Public health professionals are worried about unintended pregnancy because research shows that unwanted or mistimed pregnancies come with associations to adverse maternal and child health outcomes, such as delayed prenatal care, premature birth, and negative physical and mental health effects for children (Frost, Frohwirth & Zolna, 2016). Also, two-thirds (68 ...


Opioids In The Las Vegas Metro, Elia Del Carmen Solano-Patricio, Caitlin Saladino, William E. Brown 2020 University of Nevada, Las Vegas

Opioids In The Las Vegas Metro, Elia Del Carmen Solano-Patricio, Caitlin Saladino, William E. Brown

Health

In 2014, Nevada was one of 7 states selected to participate in a national policy coalition to reduce prescription drug abuse. As a result, the Nevada Department of Health and Human Services (DHHS) and the Southern Nevada Health District (SNHD) created a data dashboard to track opioid prescriptions and opioid-involved overdose incidents. This Fact Sheet synthesizes state-level data from the Nevada Opioid Overdose Surveillance Dashboard and focuses on the Las Vegas Metropolitan Statistical Area (MSA). The data track opioid prescription rates as they correlate to opioid-involved overdose deaths, emergency room visits, and hospitalizations.


Opioids In Nevada, Peter Grema, Caitlin Saladino, William E. Brown 2020 University of Nevada, Las Vegas

Opioids In Nevada, Peter Grema, Caitlin Saladino, William E. Brown

Health

This Fact Sheet presents data from the Washington Post’s Drug Enforcement Administration (DEA) database on opioid shipments in the United States and provides information pertaining to Nevada and each of its 17 regions (16 counties and one independent city). This Fact Sheet compares the Washington Post’s opioid shipment data with opioid prescription rates relative to Nevada’s population in 2010.


Hypertension And Diabetes Treatment Affordability And Government Expenditures Following Changes In Patient Cost Sharing In The "Farmacia Popular" Program In Brazil: An Interrupted Time Series Study, Isabel Cristina Martins Emmerick, Monica Rodrigues Campos, Rondineli Mendes. da Silva, Luisa Arueira Chaves, Andrea Damaso Bertoldi, Dennis Ross-Degnan, Vera Lucia Luiza 2020 University of Massachusetts Medical School

Hypertension And Diabetes Treatment Affordability And Government Expenditures Following Changes In Patient Cost Sharing In The "Farmacia Popular" Program In Brazil: An Interrupted Time Series Study, Isabel Cristina Martins Emmerick, Monica Rodrigues Campos, Rondineli Mendes. Da Silva, Luisa Arueira Chaves, Andrea Damaso Bertoldi, Dennis Ross-Degnan, Vera Lucia Luiza

Surgery Publications

BACKGROUND: Increasing medicines availability and affordability is a key goal of Brazilian health policies. "Farmacia Popular" (FP) Program is one of the government's key strategies to achieve this goal. Under FP, antihypertension (HTN) and antiglycemic (DM) medicines have been provided at subsidized prices in private retail settings since 2006, and free of charge since 2011. We aim to assess the impact of sequential changes in FP benefits on patient affordability and government expenditures for HTN and DM treatment under the FP, and examine their implications for public financing mechanisms and program sustainability.

METHODS: Longitudinal, retrospective study using interrupted time ...


Utilization Of A Community Pharmacy-Based Service For The Treatment Of Uncomplicated Urinary Tract Infections In Scotland, Robert Borchardt 2020 University of Kentucky

Utilization Of A Community Pharmacy-Based Service For The Treatment Of Uncomplicated Urinary Tract Infections In Scotland, Robert Borchardt

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Introduction: In November 2013, Scotland piloted a program in Grampian for the treatment of Urinary Tract Infections (UTIs) in community pharmacies, increasing health access for patients and reducing general practitioner workload. This program became known as ‘Pharmacy First’ and was later implemented nationwide in November 2017. This paper seeks to understand utilization of the Pharmacy First program across Scotland by patients and potential barriers to access.

Methods: Using data from the Prescribing Information System collected by the National Health Service of Scotland from July 2013 to April 2019, orders for uncomplicated UTIs were gathered by examining all nitrofurantoin and trimethoprim ...


Dalbavancin In The Community Emergency Department, Wesley Johnson 2020 University of Kentucky

Dalbavancin In The Community Emergency Department, Wesley Johnson

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Introduction

Dalbavancin is an antibiotic within the class of medications known as lipoglycopeptides. This medication is given to patients presenting to the hospital with acute skin and skin-structure infections (ABSSSI). This is a unique medication because it is given as a one-time dose in the outpatient setting and it could prevent patients from requiring admission to the hospital.

Methods

The emergency department (ED) at Good Samaritan community hospital performed a trial period with dalbavancin and data was collected from November 2018 to March 2020. Retrospective chart review was performed to obtain patient data and outcomes. Patients would be contacted by ...


The Impact Of Bone Marrow Transplantion On Patients With Psychiatric Diagnoses: Medication Adherence Assessment, Brittany Galop 2020 University of Kentucky

The Impact Of Bone Marrow Transplantion On Patients With Psychiatric Diagnoses: Medication Adherence Assessment, Brittany Galop

Theses and Dissertations--Pharmacy

Objectives: We investigated whether there is a measurable difference in medication utilization for psychiatric conditions before and after bone marrow transplantation (BMT). Previous studies have identified a potential association between psychiatric conditions and immune function. We hypothesized that medication utilization for psychiatric diagnoses would be impacted by BMT.

Methods: This study was a retrospective, quasi-experimental cohort design. De-identified data was compiled from the Truven database for patients ranging from January 2009 through December 2016. Two measurements of medication utilization, proportion of days covered (PDC) and medication possession ratio (MPR) were calculated for each included Medispan-defined class of medications before analyzing ...


"Adapt And Overcome": The Relationship Between Emergency Departments And The Opioid Epidemic, Victoria Ashley Clarke 2020 Vassar College

"Adapt And Overcome": The Relationship Between Emergency Departments And The Opioid Epidemic, Victoria Ashley Clarke

Senior Capstone Projects

In my thesis, I argue that the opioid epidemic poses challenges but also opportunities for emergency departments to assess and improve their performance under duress for the betterment of future generations and ailments to come. I first delve into the history of emergency medicine as a specialty to put its recent emergence into context. Subsequently, I will discuss the opioid epidemic, its origin, and various causes that have contributed to its relevance and significance in public health. Then, I will examine data from emergency departments throughout the United States to track performance. After, I will describe opioid overdose cases from ...


Utility Of Push Dose Vasopressor In The Emergency Department, Paul Nguyen, Daniel Giddings, Scott Dietrich, Kathryn Merkel 2019 HCA Healthcare

Utility Of Push Dose Vasopressor In The Emergency Department, Paul Nguyen, Daniel Giddings, Scott Dietrich, Kathryn Merkel

Emergency Medicine

Purpose: The purpose of this study is to evaluate push dose vasopressor (PDV) usage patterns, efficacy, and safety in a single community hospital emergency department when used for rapid sequence intubation (RSI). Pre-intubation hypotension is a positive correlator to incidences of cardiac arrest. Precautions should be in place to prevent and treat hypotension during emergent intubation. The emerging strategy of utilizing PDV in emergency department (ED) patients is an underexplored and potentially efficacious option.

Methods: This study will be submitted to the Institutional Review Board for approval. This retrospective evaluation will identify critically ill patients receiving phenylephrine or epinephrine PDV ...


Impact Of Required Antibiotic Stop Dates And Indications On Length Of Treatment In Hospitalized Patients With Pneumonia, Amanda Haddad, Kathryn Hernando, Kayihura Manigaba, Abigail Antigua 2019 HCA Healthcare

Impact Of Required Antibiotic Stop Dates And Indications On Length Of Treatment In Hospitalized Patients With Pneumonia, Amanda Haddad, Kathryn Hernando, Kayihura Manigaba, Abigail Antigua

Infectious Disease

Purpose: The CDC Core Elements of Hospital Antibiotic Stewardship Programs recommends implementing policies to support optimal antibiotic prescribing including documentation of dose, duration and indication. On January 31, 2017, the study institution implemented new physician order entry screens in the electronic health record requiring the input of indication and duration on all antibiotic orders. The objective of this study is to determine if implementation of mandatory indication and duration for antibiotic orders decreases antibiotic duration of therapy in hospitalized patients with pneumonia.



Methods: This study was submitted to the Institutional Review Committee for approval. The clinical pharmacy surveillance platform, Vigilanz ...


Using Community Pharmacy Immunization Screening Forms To Identify Potential Immunization Opportunities, Albert T. Bach, Jeffery A. Goad 2019 Chapman University

Using Community Pharmacy Immunization Screening Forms To Identify Potential Immunization Opportunities, Albert T. Bach, Jeffery A. Goad

Pharmacy Faculty Articles and Research

Immunization screening forms are completed for each patient that is to be vaccinated in the pharmacy. Screening forms contain demographic and health questions, which are used to determine if a patient is contraindicated to receive a vaccine. The objective is to determine if patient responses to questions on these forms can be used to identify potential vaccine indications. De-identified data was retrospectively collected from 11 community pharmacies in California and Michigan that included basic demographics, answers to immunization screening questions, and vaccine(s) administered during that visit. The Advisory Committee on Immunization Practices (ACIP) recommendations were used to forecast vaccine ...


Improving Medication Information Presentation Through Interactive Visualization In Mobile Apps: Human Factors Design, Don Roosan, Yan Li, Anandi Law, Huy Truong, Mazharul Karim, Jay Chok, Moom Roosan 2019 Western University of Health Sciences

Improving Medication Information Presentation Through Interactive Visualization In Mobile Apps: Human Factors Design, Don Roosan, Yan Li, Anandi Law, Huy Truong, Mazharul Karim, Jay Chok, Moom Roosan

Pharmacy Faculty Articles and Research

Background: Despite the detailed patient package inserts (PPIs) with prescription drugs that communicate crucial information about safety, there is a critical gap between patient understanding and the knowledge presented. As a result, patients may suffer from adverse events. We propose using human factors design methodologies such as hierarchical task analysis (HTA) and interactive visualization to bridge this gap. We hypothesize that an innovative mobile app employing human factors design with an interactive visualization can deliver PPI information aligned with patients’ information processing heuristics. Such an app may help patients gain an improved overall knowledge of medications.

Objective: The objective of ...


Evaluating Controlled Substance Documentation In An Electronic Medical Record, Delora Brooks 2019 University of Missouri-St. Louis

Evaluating Controlled Substance Documentation In An Electronic Medical Record, Delora Brooks

Dissertations

The Centers for Disease Control and Prevention (CDC) directives issued in 2016 gave guidelines for safely prescribing opiates; however, primary source discussions about methods used for documenting opioid and controlled substance monitoring within an electronic medical record (EMR) are limited (Hussain, Nelson, Polston & Zheng, 2019). This leaves individual providers to determine the appropriate way to document. Inconsistent documentation may not protect providers or organizations from regulatory, civil or criminal liability. As stated by Raveesh, Nayak & Kumbar (2016), “The best way to handle medico-legal issues is by preventing them”. Even with the advent and widespread use of EMRs, documentation is still often limited to basics: diagnosis, medication, dosage, procedures, referrals, and follow up (Schneider, 2014). The purpose of this project was to implement a practice improvement change which included creation of a standardized template and a central location for documentation of controlled substance monitoring. This allowed providers to document, see the dates and results for urine drug screens (UDS) or pill counts, review any concurrent schedule II or III medications, and log prescription drug monitoring database (PDMD) checks. Data indicated an improvement in documentation frequency for UDS and PDMD checks at both 30 and 60 days; however, this increase was only statistically significant for UDS at 30 days with p = 0.004. The increase was not found to be statistically significant for either UDS or PDMD checks at 60 days.


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