Assessment of a pharmacy technician medication history program

American Journal of Health-System Pharmacy ◽

10.1093/ajhp/zxaa312 ◽

2020 ◽

Author(s):

Danielle E Baker ◽

Meredith K Hollinger ◽

Katherine D Mieure

Keyword(s):

Medical Center ◽

Academic Medical Center ◽

Time Frame ◽

Medication List ◽

Medication History ◽

Prescribing Pattern ◽

Medication Discrepancies ◽

Time Service ◽

Pharmacy Technician ◽

Academic Medical

Abstract Purpose To determine the percentage of unintentional prior-to-admission (PTA) medication list discrepancies captured by second-source verification. Methods A prospective, randomized, controlled intervention was conducted on all patients admitted to a large academic medical center with a PTA medication list completed by a pharmacy technician from December 2018 through January 2019. Excluded patients included those admitted as observation status or discharged prior to the time of second-source verification. The following data was collected: patient’s medical record number, age, admission date and time, service admitted to, date and time of completed PTA medication list, date and time of second-source verification, type of second-source verification, medication name, dose, route, frequency, formulation, and confidence level of pharmacy technician completing the initial PTA medication list. Second-source verification was conducted on all medications from a patient’s PTA medication list after completion by a pharmacy technician. Results There were a total of 992 medications from the 200 randomly assigned patients with a completed PTA medication list by a pharmacy technician during the study time frame. Of these medications, 116 (11.7%) contained a discrepancy identified by second-source verification. The most common type of discrepancy was omission (67%) followed by dosing, frequency, and formulation. The median time to complete second-source verification was 9 minutes (interquartile range, 5-17 minutes). Conclusion Second-source verification at the time of hospital admission helps identify medication discrepancies and may improve medication use safety and prescribing pattern and, accordingly, may contribute to reducing medication errors.

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In-Practice Endocrine Surgery Fellowship: A Novel Training Model

Otolaryngology ◽

10.1177/0194599820962791 ◽

2020 ◽

pp. 019459982096279

Author(s):

Hien T. Tierney ◽

Leslie S. Eldeiry ◽

Jeffrey R. Garber ◽

Chia A. Haddad ◽

Mark A. Varvares ◽

...

Keyword(s):

Thyroid Carcinoma ◽

Medical Center ◽

Academic Medical Center ◽

Training Model ◽

Time Frame ◽

Fellowship Training ◽

Endocrine Surgery ◽

Community Practice ◽

Senior Surgeon ◽

Academic Medical

Objective Endocrine surgery is an expanding field within otolaryngology. We hypothesized that a novel endocrine surgery fellowship model for in-practice otolaryngologists could result in expert-level training. Study Design Qualitative clinical study with chart review. Setting Urban community practice and academic medical center. Methods Two board-certified general otolaryngologists collaborated with a senior endocrine surgeon to increase their endocrine surgery expertise between March 2015 and December 2017. The senior surgeon provided intensive surgical training to both surgeons for all of their endocrine surgeries. Both parties collaborated with endocrinology to coordinate medical care and receive referrals. All patients undergoing endocrine surgery during this time frame were reviewed retrospectively. Results A total of 235 endocrine surgeries were performed. Of these, 198 thyroid surgeries were performed, including 98 total thyroidectomies (48%), 90 lobectomies (45%), and 10 completion thyroidectomies (5%). Sixty cases demonstrated papillary thyroid carcinoma, 11 follicular thyroid carcinoma, and 4 medullary thyroid carcinoma. Neck dissections were performed in 14 of the cases. Thirty-seven parathyroid explorations were performed. There were no reports of permanent hypoparathyroidism. Thirteen patients (5.5%) developed temporary hypoparathyroidism. Six patients (2.5%) developed postoperative seroma. Three patients (1.3%) developed postoperative hematomas requiring reoperation. One patient (0.4%) developed permanent vocal fold paralysis, and 3 patients (1.3%) had temporary dysphonia. Thirty-five of 37 (94.5%) parathyroid explorations resulted in biochemical resolution of the patient’s primary hyperparathyroidism. Conclusion This is the first description of a new fellowship paradigm where a senior surgeon provides fellowship training to attending surgeons already in practice.

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Medication Histories in Critically Ill Patients Completed by Pharmacy Personnel

Annals of Pharmacotherapy ◽

10.1177/1060028018825483 ◽

2019 ◽

Vol 53 (6) ◽

pp. 596-602

Author(s):

Bridgette L. Kram ◽

Morgan A. Trammel ◽

Shawn J. Kram ◽

Sandy E. Wheeley ◽

Ben G. Mancheril ◽

...

Keyword(s):

Critically Ill ◽

Medical Center ◽

Phase 1 ◽

Academic Medical Center ◽

Median Number ◽

Phase 2 ◽

Medication History ◽

Medication Discrepancies ◽

Critically Ill Adults ◽

Ill Adults

Background: Although critically ill adults often have extended hospital lengths of stay and are at high risk of having medication-related adverse events, the value of medication histories in these patients remains underreported. Objective: To assess the feasibility of performing medication histories in critically ill adults and to establish the frequency of and characterize identified discrepancies. Methods: This prospective study included patients admitted to 4 intensive care units (ICUs) in a large academic medical center and was conducted in 2 phases. In phase 1, medication histories were conducted over a 5-week period by clinical pharmacists to assess feasibility. In phase 2, medication histories were conducted over a 3-week period by a pharmacy technician. Medication discrepancies, defined as any difference between the documented and pharmacy personnel–identified home medication list, were aggregated in both phases and adjudicated for severity. Results: In phase 1, 127 medication histories were completed (42.3% of admitted patients). Impaired cognition was the most common barrier encountered; however, 76% of patients were able to have a history completed if an attempt was made. In phase 2, a medication history was completed for 176 patients (58.9% of admitted patients). In aggregate, 1155 discrepancies were identified, with 78.2% of patients having a discrepancy. The median number of discrepancies per patient was 3 (interquartile range = 1-5); 11 life-threatening, 101 serious, and 326 significant discrepancies were identified. Conclusion and Relevance: A pharmacy personnel–based medication history program in the ICU is feasible and assists in the discovery of medication discrepancies with the potential for patient harm.

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Reliability and Construct Validity of the Complexity Compression Questionnaire

Journal of Nursing Measurement ◽

10.1891/1061-3749.22.2.291 ◽

2014 ◽

Vol 22 (2) ◽

pp. 291-301 ◽

Cited By ~ 1

Author(s):

Ronda G. Hughes ◽

Linda Fridlington ◽

Polly Ryan

Keyword(s):

United States ◽

Factor Analysis ◽

Organizational Change ◽

Construct Validity ◽

Medical Center ◽

Academic Medical Center ◽

Time Frame ◽

Factor Solution ◽

Health Records ◽

Academic Medical

Background and Purpose: The purpose of the study was to evaluate the reliability and construct validity of the Complexity Compression Questionnaire (CCQ), a 28-item instrument designed to explain nurses’ experiences when assuming multiple responsibilities in a compressed time frame. Methods: Data were obtained from 607 registered nurses in an academic medical center in the midwestern United States who participated in a larger study on system-wide organizational change involving upgrading electronic health records. Results: Cronbach’s alpha for the 26-item CCQ, was .91. Exploratory factor analysis supported a 5-factor solution that explained 53.6% of the variance. Conclusions: The CCQ may be a useful tool for measurement of the effects of organizational change on the complexity of the work of nurses.

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Implementation of a Volunteer Reiki Program at an Academic Medical Center in the Midwest

Journal of Holistic Nursing ◽

10.1177/0898010120907734 ◽

2020 ◽

Vol 38 (4) ◽

pp. 400-409

Author(s):

Priscilla Jurkovich ◽

Sara Watson

Keyword(s):

Medical Center ◽

Academic Medical Center ◽

Time Frame ◽

Care Plans ◽

Academic Medical ◽

Average Change ◽

Research Findings ◽

Life Force ◽

Frame Method ◽

Minute Session

Background: Reiki is a universal life-force energy that promotes healing and relaxation. Reiki requires no equipment or technology, is noninvasive, does not interfere with conventional treatments, is appropriate for all ages, and has no known medical contraindications. There is an emerging preference for nonopioid therapies for symptom management. Within an integrative person-centered holistic care model, nursing care plans include a patient’s whole narrative with physical, mental, emotional, and spiritual elements. The Evidence-Based Practice PICOT Question: Will hospitalized patients of any age (population) receiving one 20-minute session of Reiki (intervention) compared with usual care (comparison) report a change from prerating symptom score (outcome) at the completion of the 20-minute session (time frame)? Method: A total of 1,278 patients received a 20-minute Reiki session with volunteer, certified Reiki practitioners from September 2017 through October 2019. Results: The average symptom prescore was 5.52 and postscore was 2.25, thus showing an average change of −3.17. Conclusions: The authors presented the results that were consistent with research findings from the literature review suggesting that Reiki can decrease pain, general discomfort, anxiety, insomnia, and nausea.

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Drug purchase price volatility in an academic medical center

American Journal of Health-System Pharmacy ◽

10.1093/ajhp/zxaa422 ◽

2021 ◽

Author(s):

Armando Cortes ◽

Megan Park ◽

Bryan C McCarthy

Keyword(s):

Drug Price ◽

Medical Center ◽

Academic Medical Center ◽

Time Frame ◽

Purchase Price ◽

Price Changes ◽

Price Increases ◽

Academic Medical ◽

Price Trends ◽

The Impact

Abstract Purpose Inpatient drug purchase price trends at an 811-bed academic medical center are described. Summary Recent highly publicized drug price increases by pharmaceutical manufacturers have generated public interest in regulatory solutions to reduce drug costs. Monitoring drug price changes through internal dashboards has been demonstrated to aid in purchasing decisions to reduce the impact of drug price changes on inpatient pharmacy drug budgets. In this research, University of Chicago Medicine created an internal dashboard to detail specific inpatient drug purchase price trends. Dashboard data input included all medications purchased through the organization’s group purchasing organization over a 25-month time frame. A total of 69,245 drug purchases of 2,432 unique medications and/or dosage strengths were analyzed in the study. Within the 25-month time period, 706 medications (29%) had a net drug purchase price increase, while 898 (37%) had a net drug purchase price decrease. The range of net price percentage changes for medications with price increases was 0.01% to 733.6%; the range for medications with price decreases was 0.01% to 97.5%. Conclusion Relative to previous purchase prices, drug purchase prices decreased or remained the same more often than they increased over a 25-month time frame. However, drug purchase price percentage changes were far greater for medications whose prices increased rather than decreased.

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