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emergency department pharmacist

Christopher A Knefelkamp, Christopher M Degenkolb
An analysis of antimicrobial agents used for urinary tract infections found effective initial empiric coverage, but fluoroquinolones were used in a majority of patients who may have been better served with narrower spectrum agents.
July 2018: Federal Practitioner: for the Health Care Professionals of the VA, DoD, and PHS
Jaclyn M Stoffel, Regan A Baum, Adam J Dugan, Abby M Bailey
Purpose: The purpose of this survey-based research project is to identify factors, including prior training, institution demographics, and pharmacist prioritization of services that may impact variability in practice among emergency medicine (EM) pharmacists. Methods: An electronic survey was available for 6 weeks. Participants were contacted through professional membership directories. Survey questions addressed EM pharmacist training and institution demographics...
February 8, 2019: American Journal of Health-system Pharmacy: AJHP
Charlotte Quintens, Thomas De Rijdt, Tine Van Nieuwenhuyse, Steven Simoens, Willy E Peetermans, Bart Van den Bosch, Minne Casteels, Isabel Spriet
BACKGROUND: To improve medication surveillance and provide pharmacotherapeutic support in University Hospitals Leuven, a back-office clinical service, called "Check of Medication Appropriateness" (CMA), was developed, consisting of clinical rule based screening for medication inappropriateness. The aim of this study is twofold: 1) describing the development of CMA and 2) evaluating the preliminary results, more specifically the number of clinical rule alerts, number of actions on the alerts and acceptance rate by physicians...
February 11, 2019: BMC Medical Informatics and Decision Making
Elsie Rizk, Joshua T Swan, Ohbet Cheon, A Carmine Colavecchia, Lan N Bui, Bita A Kash, Sagar P Chokshi, Hua Chen, Michael L Johnson, Michael G Liebl, Ezekiel Fink
Purpose: The purpose of this project was to develop a set of valid and feasible quality indicators used to track opioid stewardship efforts in hospital and emergency department settings. Methods: Candidate quality indicators were extracted from published literature. Feasibility screening excluded quality indicators that cannot be reliably extracted from the electronic health record or that are irrelevant to pain management in the hospital and emergency department settings...
February 1, 2019: American Journal of Health-system Pharmacy: AJHP
Benjamin Y Urick, Joel F Farley
OBJECTIVES: The objective of this study was to evaluate the relationship between patients' demographics, health status, and health resource use and attribution to a pharmacy participating in an enhanced services network. METHODS: Enhanced services pharmacies were defined by participation in a North Carolina enhanced services network and an associated grant-funded payment model for enhanced services. Pharmacy enrollment in the payment model began in March of 2015...
January 31, 2019: Journal of the American Pharmacists Association: JAPhA
C J Cabilan, Mary Boyde, Elizabeth Currey
OBJECTIVE: To evaluate the effectiveness of pharmacist-led discharge medication counselling using a structured, multimodal educational strategy with teach-back (intervention) against standard care. METHODS: This was a quasi-experimental study in a public, metropolitan ED. Participants discharged home with new medications were allocated to receive the intervention or standard care using convenience sampling. Participant characteristics (i.e. age, sex, socio-economic status, medications) and health literacy were collected...
January 25, 2019: Patient Education and Counseling
Zachary Drapkin, Troy E Madsen, Nicholas Weaver, Joyce V Soprano
OBJECTIVES: The aim of this study was to determine whether emergency department (ED) providers are able to accurately assess whether a child with a laceration needs tetanus prophylaxis. METHODS: We conducted an 8-month prospective cross-sectional study of children presenting with a laceration to a pediatric ED. We asked ED providers whether tetanus prophylaxis was necessary. An ED pharmacist accessed the Utah Statewide Immunization Information System (USIIS), and we assessed the accuracy of the ED provider's determination of necessary tetanus prophylaxis compared with USIIS records...
January 29, 2019: Pediatric Emergency Care
Taylor J Holland, Jonathan Penm, Michael Dinh, Sohileh Aran, Betty Chaar
INTRODUCTION AND AIMS: Opioid overdose is an increasing burden world-wide and is a major cause of death in Australia. To reduce the number of opioid-related deaths, access to take-home naloxone has expanded in Australia and is now accessible without prescription. Emergency departments (ED) could be ideal settings for the distribution of take-home naloxone, due to regular encounters with patients who experience opioid overdoses. The aim of this study was to gain insight into ED physicians' and pharmacists' perspectives on take-home naloxone in the ED setting...
January 29, 2019: Drug and Alcohol Review
Lauren N Fay, Lauren M Wolf, Kasey L Brandt, G Robert DeYoung, Adam M Anderson, Nnaemeka E Egwuatu, Lisa E Dumkow
Purpose: While many programs have demonstrated pharmacist-led antimicrobial stewardship successes in inpatient and emergency department (ED) settings, there is a paucity of literature exploring these initiatives in urgent care (UC) sites. This study aimed to determine the impact of implementing a pharmacist-led antimicrobial stewardship program (ASP) in the UC setting. Methods: A retrospective quasi-experimental study was conducted evaluating UC patients with positive urine or wound cultures following discharge...
January 25, 2019: American Journal of Health-system Pharmacy: AJHP
Drayton A Hammond, Payal K Gurnani, Alexander H Flannery, Keaton S Smetana, Jennifer C Westrick, Ishaq Lat, Megan A Rech
A framework for evaluating pharmacists' impact on cost avoidance in the intensive care unit (ICU) and emergency department (ED) has not been established. This scoping review was registered (CRD42018091217) and conducted to identify, aggregate, and qualitatively describe the highest quality evidence for cost avoidance generated by clinical pharmacists on interventions performed in an ICU or ED. Searches were conducted in PubMed, Scopus, CINAHL, Cochrane CENTRAL Register of Controlled Trials, and Cochrane Database of Systematic Reviews from inception until April 2018...
January 21, 2019: Pharmacotherapy
Eric A Wright, Jove H Graham, Daniel Maeng, Lorraine Tusing, Lori Zaleski, Richard Martin, Rick Seipp, Bruce Citsay, Bette McDonald, Kelly Bolesta, Kim Chaundy, Charles J Medico, Steve Gunderman, Fred Leri, Kelly Guza, Rebecca Price, Christina Gregor, Dean T Parry
OBJECTIVES: To determine the impact of pharmacist-provided continuous care and electronic communication on readmissions among a group of high-risk patients. DESIGN: Pragmatic interventional study with 5:1 matched control. SETTING AND PARTICIPANTS: Patients discharged from any of 4 hospitals with chronic obstructive pulmonary disease, pneumonia, heart failure, acute myocardial infarction, or diabetes within Pennsylvania. Patients in the intervention group received consultative services from inpatient pharmacists before discharge and inpatient-to-community pharmacist communication of hospitalization information facilitated with the use of a secure messaging system...
January 14, 2019: Journal of the American Pharmacists Association: JAPhA
Billy Sin, Christine Ciaramella, Greg Stein, Shalom Butel, Holly Thompson, Sylvie de Souza, Robert DiGregorio
STUDY OBJECTIVE: The objective of this retrospective descriptive study was to quantify clinical activities performed by pharmacists in an advanced pharmacy practice model in the emergency department (ED). METHODS: Data from January 2015 to August 2017 extracted from the department of pharmacy's electronic documentation system and the hospital's electronic medical record were collected and reviewed. Cost savings was derived from the system with adaptation from the previous literature and had been validated by our institution's administration as an acceptable reflection of the impact for activity...
January 13, 2019: Journal of Pharmacy Practice
Justin Grill, Caleb Bryant, Kyle Markel, Samuel J Wisniewski
PURPOSE: To describe quantitatively the impact on physician efficiency when an Emergency Medicine Clinical Pharmacist (EMCP) is available to Emergency Department (ED) physicians while working under a collaborative care agreement in a Michigan-based Health System. METHODS: Four EMCPs each logged and categorized their time during 14 ten hour shifts, for a total of 56 shifts or 560 total hours worked. There were nine categories observed including: culture call back, urine, blood, or other culture follow up, antibiotic changes, patient call-backs, pharmacy call backs, critically ill, and general questions...
December 18, 2018: American Journal of Emergency Medicine
Diane L Lorenzetti, Hude Quan, Kelsey Lucyk, Ceara Cunningham, Deirdre Hennessy, Jason Jiang, Cynthia A Beck
BACKGROUND: Physician chart documentation can facilitate patient care decisions, reduce treatment errors, and inform health system planning and resource allocation activities. Although accurate and complete patient chart data supports quality and continuity of patient care, physician documentation often varies in terms of timeliness, legibility, clarity and completeness. While many educational and other approaches have been implemented in hospital settings, the extent to which these interventions can improve the quality of documentation in emergency departments (EDs) is unknown...
October 25, 2018: BMC Emergency Medicine
Brian Chan, Samuel T Edwards, Meg Devoe, Richard Gil, Matthew Mitchell, Honora Englander, Christina Nicolaidis, Devan Kansagara, Somnath Saha, P Todd Korthuis
BACKGROUND: Medically complex urban patients experiencing homelessness comprise a disproportionate number of high-cost, high-need patients. There are few studies of interventions to improve care for these populations; their social complexity makes them difficult to study and requires clinical and research collaboration. We present a protocol for a trial of the streamlined unified meaningfully managed interdisciplinary team (SUMMIT) team, an ambulatory ICU (A-ICU) intervention to improve utilization and patient experience that uses control populations to address limitations of prior research...
December 14, 2018: Addiction Science & Clinical Practice
Mhd Wasem Alsabbagh, Sherilyn K D Houle
BACKGROUND: Pharmacists have been shown to be beneficial for inclusion in emergency department (ED) services; however, little has been done to assess these benefits with pharmacists having even wider scopes of practice, including limited prescribing authority. OBJECTIVES: The aims of this study were to determine the proportion of ED visits that can potentially be managed by pharmacists, the most prevalent conditions within these cases, and the factors associated with patients presenting with such cases to the ED...
December 7, 2018: Research in Social & Administrative Pharmacy: RSAP
André Gillibert, Nicolas Griffon, Matthieu Schuers, Kristell Hardy, Amine Elmerini, Catherine Letord, Pascal Staccini, Stefan J Darmoni, Jacques Benichou
INTRODUCTION: The pharmaceutical record system (PRS) is a French nationwide centralized electronic database shared among all community pharmacists listing all drugs dispensed by community pharmacists in the last four months. The objective of this study, the Medication Assessment Through Real time Information eXchange - Distributed Pharmaceutical Record System (MATRIX - DPRS) study, was to assess the clinical impact of the PRS upon granting access to physicians in three hospital specialties: anesthesiology, emergency medicine and geriatrics...
January 2019: International Journal of Medical Informatics
David E Zimmerman, Jordan R Covvey, Branden D Nemecek, Anthony J Guarascio, Laura Wilson, Henry R Freedy, Mohamed H Yassin
OBJECTIVE: To compare pharmacist-led prescribing changes and associated 30-day revisit rates across different regimens for patients discharged from an emergency department (ED) with a diagnosis of community-acquired pneumonia (CAP). METHODS: An observational, retrospective cohort analysis was conducted of patients who were discharged from an ED over a 4-year period with a diagnosis of CAP. Patient demographics, clinical characteristics, antibiotic selection and comorbidity and condition severity scores were collected for two cohorts: 2012-13 (before protocol change) and 2014-15 (post-protocol change)...
December 11, 2018: International Journal of Pharmacy Practice
Stephanie A Woo, Amber Cragg, Maeve E Wickham, David Peddie, Ellen Balka, Frank Scheuermeyer, Diane Villanyi, Corinne M Hohl
BACKGROUND: There is a high degree of variability in assessing the preventability of adverse drug events, limiting the ability to compare rates of preventable adverse drug events across different studies. We compared three methods for determining preventability of adverse drug events in emergency department patients and explored their strengths and weaknesses. METHODS: This mixed-methods study enrolled emergency department patients diagnosed with at least one adverse drug event from three prior prospective studies...
December 4, 2018: BMC Medical Research Methodology
Benjamin Y Urick, Stefanie P Ferreri, Charles Shasky, Trista Pfeiffenberger, Troy Trygstad, Joel F Farley
INTRODUCTION: As value-based and alternative payment models proliferate, there is growing interest in measuring pharmacy performance. However, little research has explored the development and implementation of systems to measure pharmacy performance. Additionally, systems that currently exist rely on process and surrogate outcome measures that are not always relevant to patients and payers. PROGRAM DESCRIPTION: This article describes the process used to design and implement a performance measurement program for a group of enhanced services pharmacies in North Carolina...
December 2018: Journal of Managed Care & Specialty Pharmacy
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