Pharmacy Administration, Policy and Regulation Commons^™

Evaluation And Continuation Of Oncology Nurse Mentorship Program, Gurpreet K. Kang

Master's Projects and Capstones

Problem: Newly hired nurses on a busy inpatient leukemia and lymphoma subspeciality unit experienced challenges after transitioning into specialty oncology practice. This resulted in decreased confidence, increased risk of medication errors, and a 40% unit-based annual turnover rate. The cost of replacing one staff nurse is $61,000.  Exit interviews determined root causes of turnover rates, nurse confidence.

Context: A quality improvement program was envisioned to optimize patient and organizational outcomes on a 25-bed inpatient unit to evaluate and sustain an oncology nurse mentorship program.

Interventions: Over one year, cohort 1 (n=8) and follow up 2^nd cohort (n=7) was implemented …

Perceived Effects Of Verbal Orders On In-Patient Medication Reconciliation And Safety: A Multi-Center Cross-Sectional Study, Yahaya Jafaru, Abubakar K. Sahabi, Mohammed M. Sani

Pharmacology and Clinical Pharmacy Research

Medication reconciliation presents significant challenges for healthcare professionals, particularly due to communication gaps that contribute to patient safety incidents. The aim of the study was to investigate the perceived effect of verbal orders on in-patient medication reconciliation and safety. The study was a cross-sectional survey with nurse employees of the three tertiary hospitals in Kebbi State, Nigeria as population of the study. The instrument for the data collection was a 21-items researcher-constructed self-administered questionnaire. Chi-square and binomial regression analysis were used in data analysis. Over two-thirds (70.7%) of the respondents reported a negative perceived effect on the patient’s compliance. The …

Gender Differences In Administration Of Tpa In Treatment Of Ischemic Stroke, Christina Annerino

CURE Proceedings

As medicine and pharmacology advance through the years, new life-saving treatments are studied or discovered every day, and a medical emergency is no longer a death sentence. Even with conditions as serious as ischemic stroke, there is hope for survival and rehabilitation with the ‘clot-busting’ drug, tissue plasminogen activator, colloquially known as ‘tPA’. tPA is a thrombolytic agent, a substance that acts on fibrin in clots to dissolve them so they can no longer cause ischemia in blood vessels that results in a stroke. (Vega, 2022). tPA is an extremely effective treatment for ischemic stroke, demonstrated in 2013 by a …

Pharmacy Services Reboot Roadmap: Resiliency During The Covid-19 Pandemic, L. Hayley Burgess, Joan S. Kramer, Brian Moran, Mandelin Cooper, Christine Dunn, Edward Murray, Karla M. Miller

HCA Healthcare Journal of Medicine

Planning for resumption of patient care services during and following the impact of novel coronavirus disease-2019 (COVID-19) while controlling costs are essential for pharmacy services resiliency. Implementation of a pharmacy services reboot roadmap across a 179 hospital health-system is described. The roadmap encompassed eight key areas: pharmacy leadership, staffing and scheduling, clinical pharmacy services, medication safety, medication supply, regulatory and compliance, team support opportunities, and financial stewardship. A supporting checklist and volume-based staffing plan are included as examples to assist pharmacy leaders in planning optimal pharmacy services support as patient volumes increase, particularly in the emergency department, surgical services and …

Medication Safety During Transitions Of Care:The Importance Of Checklists In Preventing Patient Harm, Laressa Bethishou, Olivia Lounsbury, Donna Prosser

Pharmacy Faculty Articles and Research

There is a need to optimize patient safety as patients navigate through the healthcare system. With each transition of care, patients are vulnerable to changes that may cause adverse effects, including changes in their healthcare team, health status, and medications. The Centers for Medicare & Medicaid Services (CMS) defines a transition of care as “the movement of a patient from one setting of care to another.” While the concept itself may seem simple, this definition fails to capture the many potential handoff complications which classify these transitions as high risk for patients. With 67% of patients facing unintended medication discrepancies …

Regulatory Gaps In Drug Compounding: Implications For Patient Safety, Innovation, And Fraud, Joanna Shepherd

Faculty Articles

Drug compounding is the practice of mixing, combining, or altering drug ingredients to create a product that meets the medical needs of a patient whose needs cannot otherwise be met with commercially-available products. Compounding is essential for patients that are allergic to certain ingredients or cannot tolerate the route of administration or dosage form of a commercially-available drug. Compounding may also enable pharmacists to supply medications when there is a shortage of commercially-available drugs. For example, amid the nationwide shortage of generic liquid Tamiflu and growing flu deaths in early 2018, pharmacists around the country used Tamiflu capsules to compound …

Increasing Bedside Medication Safety In An Intensive Care Setting, Natasha Stankiewicz, Jonathan Archibald, Scu 2, Mark Parker, Stephen Tyzik, Suneela Nayak, Ruth Hanselman, Amy Sparks

Operations Transformation

A PERFORMANCE IMPROVEMENT PROJECT FOR INCREASED BEDSIDE MEDICATION SAFETY

The convenience of having certain medications directly available at bedside has long been a priority for a medical intensive care nursing team in an academic tertiary medical center.

However, it was apparent to new staff and leadership that there was a lack of awareness and interest in securing medications within the department. This posed a risk to patients, families, visitors and colleagues.

Baseline metrics on patient safety were collected and a root cause analysis was conducted. Countermeasures included increased education of medication safety as well as a instituting a KPI which …

A Course On Patient Safety: Pharmacy Student And Community Partner Perceptions, Maryam Noureldin, Chelsea M. Anderson, Patricia L. Darbishire

Purdue Journal of Service-Learning and International Engagement

The authors of this article developed and piloted a three-week intensive elective course for students in their third professional years in the Doctor of Pharmacy program. The goal of this course was to provide students with an opportunity to apply patient safety concepts in a real-world setting using service-learning as the pedagogy and to evaluate student perceptions of the course for potential implementation in the curriculum. Seven pharmacy students were enrolled in the pilot course and divided into three groups. Each group of two to three students was assigned to one of three predetermined community partner sites. Students were instructed …

The Effects Orthostatic Hypotension Has On Falls: A Study Done In San Francisco With The Patient Population Of The Veterans Affairs Hospital, Sherry A. Ballard Ms.

Master's Projects and Capstones

The Effects Orthostatic Hypotension has on Falls: A Study Done in San Francisco Represented

Population of the Veterans Affairs Hoapital

The global AIM of this project is to Identify patients that are at risk for Orthostatic Hypotension (OH) with in the first 24 hours of addmission. It was identified that 50% of the falls over the last 4 quarters at the VA were OH related. The patients were not identified as a fall risk and over half of them had fallen multiple times. After performing a nursing survey online, a SWOT analysis, and a Root Cause Analysis using a fishbone …

Prescriptions For Bedtime Sedatives After The Introduction Of A General Admission Order Set At An Academic Health Center: The Potential And Pitfalls Of Order Sets., Areeba Kara, Alex N. Isaacs, Sarah A. Nisly

Scholarship and Professional Work – COPHS

OBJECTIVE:

This study describes the impact of modifications to a general admission order set on physician prescribing of 2 as-needed or pro re nata (PRN) bedtime sedatives.

METHODS:

The hospitalists at our institution have used a general medical admission order set since 2005. Zolpidem was the only as-needed (PRN) bedtime sedative option on the order set until trazodone was added in December 2008. Trazodone is preferred over zolpidem in the geriatric population. We identified patients admitted by the hospitalists between January 2007 and August 2013 who were prescribed with either zolpidem or trazodone as a PRN sedative. Patient demographics, date …

Standardized Competencies For Parenteral Nutrition Prescribing: The American Society For Parenteral And Enteral Nutrition Model, Peggi Guenter, Joseph I. Boullata, Phil Ayers, Jane Gervasio, Ainsley Malone, Erica Raymond, Beverly Holcombe, Michael Kraft, Gordon Sacks, David Seres, Parenteral Nutrition Safety Task Force, American Society For Parenteral And Enteral Nutrition (A.S.P.E.N.)

Scholarship and Professional Work – COPHS

Parenteral nutrition (PN) provision is complex, as it is a high-alert medication and prone to a variety of potential errors. With changes in clinical practice models and recent federal rulings, the number of PN prescribers may be increasing. Safe prescribing of this therapy requires that competency for prescribers from all disciplines be demonstrated using a standardized process. A standardized model for PN prescribing competency is proposed based on a competency framework, the American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.)–published interdisciplinary core competencies, safe practice recommendations, and clinical guidelines. This framework will guide institutions and agencies in developing and maintaining …

A.S.P.E.N. Parenteral Nutrition Safety Consensus Recommendations: Translation Into Practice, Phil Ayers, Stephen Adams, Joseph Boullata, Jane Gervasio, Beverly Holcomb, Michael D. Kraft, Neil Marshall, Antoinette Neal, Gordon Sacks, David S. Seres, Patricia Worthington, Peggi Guenter

Scholarship and Professional Work – COPHS

Parenteral nutrition (PN) serves as an important therapeutic modality that is used in adults, children, and infants for a variety of indications. The appropriate use of this complex therapy aims to maximize clinical benefit while minimizing the potential risk for adverse events. Despite being classified and acknowledged as a high-alert medication,¹ only 58% of organizations have precautions in place to prevent errors and patient harm associated with PN.² Complications can occur as a result of the therapy and as the result of the PN process. The American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.) Parenteral Nutrition Safety Consensus …