Development of a Pharmacy Technician–Driven Program to Improve Vaccination Rates at an Academic Medical Center

Background: Influenza and pneumococcal disease contribute substantially to the burden of preventable disease in the United States. Despite quality measures tied to immunization rates, health systems have struggled to achieve these targets in the inpatient setting. Pharmacy departments have had success through implementation of pharmacist standing order programs (SOP); however, these initiatives are labor-intensive and have not resulted in 100% immunization rates. Objective: The objective of this study was to evaluate a pilot utilizing pharmacy technician interventions, in combination with a nursing SOP, to improve vaccination rates of hospitalized patients for influenza and pneumococcal disease. Methods: A process was developed for pharmacy technicians to identify patients who were not previously screened or immunized during the weekend days on the Cardiovascular Progressive Care unit at the University of Kansas Health-System. Targeted pharmacy technician interventions consisted of phone call reminders and face-to-face discussions with nursing staff. The primary study outcome was the change in immunization compliance rates between the control and intervention groups. Results: Influenza vaccine rates showed a statistically significant increase from 72.2% (52 of 72) of patients during the control group to 92.9% (65 of 70, P = .001) of patients during the intervention group. A pneumococcal vaccination rate of 81.3% (61 of 75) was observed in the control group, compared with 84.3% (59 of 70) of patients in the intervention group ( P = .638). Conclusion: An improvement in inpatient influenza immunization rates can be achieved through targeted follow-up performed by pharmacy technicians, in combination with a nursing-driven SOP.

Download Full-text

Pharmacist Impact on Pneumococcal Vaccination Rates through Incorporation of Immunization Assessment into Critical Pathways in an Acute Care Setting

Hospital Pharmacy ◽

10.1177/001857870203701011 ◽

2002 ◽

Vol 37 (10) ◽

pp. 1050-1054 ◽

Cited By ~ 11

Author(s):

Jill True Robke ◽

Mark Woods ◽

Sabine Heitz

Keyword(s):

Pneumococcal Infection ◽

Intervention Group ◽

Pneumococcal Vaccination ◽

Control Group ◽

Effective Prevention ◽

Critical Pathways ◽

Vaccination Rates ◽

Immunization Rates ◽

Patient Consent ◽

The Impact

Despite the availability of effective prevention and treatment measures, pneumococcal infection continues to be a significant source of morbidity and mortality. This study evaluated the impact of incorporating the assessment of pneumococcal vaccination status into selected critical pathways of at-risk patients. In a prospective, nonblinded, parallel-group trial, adult inpatients on four critical pathways were randomized into intervention or control groups. Nursing personnel screened all patients for previous pneumococcal vaccination. A pharmacist would then screen all patients for pneumococcal disease risk factors. If vaccination was indicated in the intervention group, the pharmacist educated the patient and/or caregiver, obtained patient consent, and asked the patient's physician for permission to immunize. No further action was undertaken with the control patients. A total of 231 patients were enrolled in the study (107 intervention, 124 control). Initial immunization rates were 46.8% in the control group and 56.1 % in the intervention group. Forty-six patients in the control group and 39 patients in the intervention group were eligible (unvaccinated with indication) for vaccination. Thirty-two (82.1%) of the patients in the intervention group were counseled and 19 (59.4%) were vaccinated. The overall vaccination rates were 73.8% in the intervention group and 56.1% in the control group (P < 0.001). Results indicate that incorporating assessment of pneumococcal immunization status into critical pathways is an effective way to improve immunization rates.

Download Full-text

The individual empowerment program improves glycemic and lipid controls in admitted type 2 DM patients

Diabetes Mellitus ◽

10.14341/dm8339 ◽

2018 ◽

Vol 21 (2) ◽

pp. 113-117

Author(s):

Ampornpan Theeranut ◽

Nonglak Methakanjanasak ◽

Pattama Surit ◽

Wasana Ruaisungnoen ◽

Kittisak Sawanyawisuth ◽

...

Keyword(s):

Intervention Group ◽

Control Group ◽

P Value ◽

Inpatient Setting ◽

Short Term ◽

The Mean ◽

The Individual ◽

Diabetes Patients ◽

Empowerment Program

Aim. To evaluate the short-term effects of the empowerment program on glycemic and lipid profiles in an inpatient setting for DM type 2 patients. Materials and methods. This was a quasi-experimental study conducted between October 2013 and June 2015. We enrolled diabetes patients admitted to the hospital, age over 35 years, and HbA1c 7%. During the admission, the intervention group received the empowerment course three times prior to discharge, the control group received standard diabetes and nursing care. All patients body weight, HbA1c, HDL-c, and LDL levels were evaluated at three and six months after discharge. All outcomes were compared between the control and intervention group. Results. A total of 57 diabetes patients participated in the study, with 27 in the intervention group and 30 in the control group. The intervention group had significantly higher HbA1c levels than the control group (10.3% vs 8.0%; p value 0.001). After discharge, the mean HbA1c and LDL-c levels of the intervention group were significantly lower than those of the control group at three and six months, while the mean HDL-c level of the intervention group was significantly higher than that of the control group at six months (1.54 vs 1.29 mmol/L; p value 0.001). The average body mass index of the intervention group was also significantly lower than that of the control group at six months (22.74 vs 25.54 kg/m2; p value = 0.016). Conclusion. The individual empowerment program improved short-term glycemic and lipid outcomes in admitted diabetes mellitus patients.

Download Full-text

Supporting Children Who Experience Domestic Violence: Evaluating the Child Witness to Domestic Violence Program

Journal of Interpersonal Violence ◽

10.1177/08862605211035874 ◽

2021 ◽

pp. 088626052110358

Author(s):

Erin C. Schubert

Keyword(s):

Domestic Violence ◽

Intervention Group ◽

Well Being ◽

The United States ◽

Control Group ◽

Child Witness ◽

Negative Consequences ◽

Emotional Symptoms ◽

Child Gender ◽

The Impact

Impacting 1 in 4 children in the United States, childhood exposure to domestic violence predicts myriad negative sequelae. Intervening post exposure is critical to help children and their protective parent heal and avoid long-term negative consequences. Children aged 2-17 and their mothers who were victims of domestic violence participated in a 12-week group program delivered by domestic violence agency staff that provides psychoeducation on the impact of trauma and domestic violence and aims to improve parent and child well-being. The impact of the Child Witness to Domestic Violence (CWDV) program was tested in an intervention group ( n = 69 children, 33 mothers) who participated in CWDV and control group ( n = 80 children, 39 mothers) consisting of children whose mothers received adult-focused domestic violence services but were not enrolled in CWDV or other child-focused services. Multiple regression analyses controlling for child gender, child age, mother’s age, and the outcome of interest at time 1 found that participation in CWDV program significantly predicted better child functioning as indicated by less hyperactivity ( B = –.85, p = .06), fewer negative emotional symptoms ( B = –1.14, p = .01), and fewer total behavioral difficulties ( B = –2.48, p = .02) as well as higher maternal hope ( B = .57, p = .03). These data provide promising evidence of the impact of a brief, replicable group intervention that promotes healing and well-being among children and parents exposed to domestic violence. Limitations include a quasi-experimental design and reliance on maternal report.

Download Full-text

Teaching physicians the GPGP method promotes deprescribing in both inpatient and outpatient settings

Therapeutic Advances in Drug Safety ◽

10.1177/2042098619895914 ◽

2019 ◽

Vol 10 ◽

pp. 204209861989591

Author(s):

Aaron Jason Bilek ◽

Yuval Levy ◽

Haneen Kab ◽

Pavel Andreev ◽

Doron Garfinkel

Keyword(s):

Family Practice ◽

Inappropriate Medication ◽

Intervention Group ◽

Prescribing Patterns ◽

Control Group ◽

Inpatient Setting ◽

Geriatric Population ◽

Drug Classes ◽

Inpatient Settings ◽

Important Means

Background In complex older patients, inappropriate medication use and polypharmacy (IMUP) are commonplace and increasing exponentially. Reducing IMUP is a challenge in multiple clinical contexts, including acute admission and family practice, due to several key barriers. In the global effort against this epidemic, educational programs geared toward changing physicians’ prescribing patterns represent an important means of promoting deprescribing. Methods This is a nonrandomized, controlled interventional study investigating polypharmacy outcomes and prescribing patterns in patients whose physicians were trained in the Good Palliative-Geriatric Practice (GPGP) method, an algorithm for the reduction of polypharmacy, with patients whose physicians were not. Training involved a one-time, full-day workshop led by a senior geriatrician. Two separate settings were examined. In the inpatient setting, one internal medicine ward was trained and compared with another ward which was not trained. In the family practice setting, 28 physicians were trained and compared with practices of 15 physicians not trained. Patients were above the age of 70, representative of the general geriatric population, and not terminally ill. Results In the inpatient arm, the intervention group ( n = 100) experienced a decrease in medications prescribed from admission to discharge of 18.5%, compared with a decrease of 1.9% in the control group ( n = 100, difference between groups p < 0.0001). In the outpatient arm, the intervention group ( n = 100) experienced a decrease in medication number of 6.1% compared with 0.07% in the control group ( n = 100, difference between groups p = 0.001) over a 6-month period. Preferential decreases in specific drug classes were observed in both groups, including benzodiazepines, psychotropics, and antihypertensives. Conclusions A one-time educational intervention based on GPGP can change prescribing patterns in both outpatient and inpatient settings leading to a moderate reduction in polypharmacy. Future work should focus on longitudinal interventions, and longer-term clinical outcomes such as morbidity, mortality, and quality of life.

Download Full-text

Promotion of the influenza vaccination to hospital staff during pre-employment health check: a prospective, randomised, controlled trial

Journal of Occupational Medicine and Toxicology ◽

10.1186/s12995-020-00285-w ◽

2020 ◽

Vol 15 (1) ◽

Author(s):

Michael Currat ◽

Catherine Lazor-Blanchet ◽

Giorgio Zanetti

Keyword(s):

Influenza Vaccine ◽

Influenza Vaccination ◽

Healthcare Workers ◽

Vaccination Campaign ◽

Intervention Group ◽

Vaccination Rate ◽

Health Check ◽

Control Group ◽

Vaccination Rates ◽

Newly Hired

Abstract Background Vaccination is the most effective prevention of seasonal influenza. Despite its recommendation and active promotion, vaccination coverage remains low among healthcare staff. The goal of the study was to test if a pre-employment health check is a good opportunity to promote future vaccination against influenza among healthcare workers newly hired by a university hospital. Methods All new hospital employees active at the bedside who underwent a pre-employment health check between the end of 2016’s influenza epidemic and the start of the next influenza vaccination campaign were randomly allocated to a control group or an intervention group. The intervention consisted of a semi-structured dialog and the release of an information leaflet about influenza and influenza vaccination during the check-up, and the shipment of a postcard reminder 2 weeks before the next vaccination campaign. Vaccination rates during the campaign were compared among the two groups. Results Three hundred fifty-seven employees were included. Vaccination rates were similar in both groups: 79/172 (46%) in the control and 92/185 (50%) in the intervention group. A significantly higher rate of vaccination was noted among physicians (70/117, 60%) than among other employees (101/240, 42%, p = 0.001). In a pre-defined exploratory analysis among physicians, the vaccination rate was higher in the intervention group (36/51, 71%) than in the control group (34/65, 52%, p = 0.046). Conclusions Promotion of the influenza vaccine during pre-employment health check did not improve the vaccination rate of newly hired hospital healthcare workers overall during the next influenza vaccination campaign. Results suggest a favourable impact on the vaccination rate of physicians. Thus, there may be an interest in using communication strategies tailored to the different categories of healthcare workers to promote the influenza vaccine during pre-employment health check. Trial registration ClinicalTrials, NCT02758145. Registered 26 April 2016.

Download Full-text

Influencing cardiovascular health habits in the rural, deep south: results of a cluster randomized trial

Health Education Research ◽

10.1093/her/cyy052 ◽

2019 ◽

Vol 34 (2) ◽

pp. 200-208

Author(s):

Laurie S Abbott ◽

Elizabeth H Slate ◽

Jennifer L Lemacks

Keyword(s):

Health Program ◽

Mixed Model ◽

Cardiovascular Health ◽

Linear Mixed Model ◽

Intervention Group ◽

The United States ◽

Control Group ◽

Cvd Risk ◽

Health Habits ◽

Cluster Randomized

Abstract Cardiovascular disease (CVD) is a major cause of death among people living in the United States. Populations, especially minorities, living in the rural South are disproportionately affected by CVD and have greater CVD risk, morbidity and mortality. Culturally relevant cardiovascular health programs implemented in rural community settings can potentially reduce CVD risk and facilitate health behavior modification. The purpose of this study was to examine the effects of a cardiovascular health promotion intervention on the health habits of a group of rural African American adults. The study had a cluster randomized controlled trial design involving 12 rural churches that served as statistical clusters. From the churches (n = 6) randomized to the intervention group, 115 participants were enrolled, received the 6-week health program and completed pretest–posttest measures. The 114 participants from the control group churches (n = 6) did not receive the health program and completed the same pretest–posttest measures. The linear mixed model was used to compare group differences from pretest to posttest. The educational health intervention positively influenced select dietary and confidence factors that may contribute toward CVD risk reduction.

Download Full-text

Wage Premiums as a Means to Evaluate the Labor Market for Pharmacy Technicians in the United States: 1997–2018

Pharmacy ◽

10.3390/pharmacy8010042 ◽

2020 ◽

Vol 8 (1) ◽

pp. 42 ◽

Cited By ~ 2

Author(s):

David P. Zgarrick ◽

Tatiana Bujnoch ◽

Shane P. Desselle

Keyword(s):

United States ◽

Labor Market ◽

Supply And Demand ◽

Consumer Price Index ◽

The United States ◽

Health Care Team ◽

Skilled Workers ◽

Pharmacy Technician ◽

Wage Premiums ◽

Pharmacy Technicians

Pharmacy technicians are integral members of the health care team, assisting pharmacists and other health professionals in assuring safe and effective medication use. To date, evaluation of the labor market for pharmacy technicians has been limited, and relatively little has been evaluated regarding trends in wages. The objective of this research is to use US Bureau of Labor Statistics (US BLS) data to evaluate changes in pharmacy technician wages in the United States from 1997 to 2018 relative to changes in the US consumer price index (CPI). Median hourly wages for pharmacy technicians were collected from US BLS data from 1997 to 2018. Median hourly wages were compared to expected hourly wages, with the difference, a wage premium, indicative of imbalances in the supply and demand of labor. Both positive and negative wage premiums were observed, with most positive wage premiums occurring prior to 2007 and most negative wage premiums observed after 2008. Differences in wage premiums were also observed between technicians working in various practice settings. Given the median length of employment of pharmacy technicians, it is likely that the majority of technicians working in US pharmacies have not experienced increases in their wages relative to what would be expected by changes in the CPI. This has occurred at a time when pharmacies and pharmacists are asking more of their pharmacy technicians. Researchers and pharmacy managers must continue to evaluate the pharmacy technician labor market to assure that technician wage and compensation levels attract an adequate supply of sufficiently skilled workers.

Download Full-text

A Motion-Activated Video Game for Prevention of Substance Use Disorder Relapse in Youth: Pilot Randomized Controlled Trial (Preprint)

10.2196/preprints.11716 ◽

2018 ◽

Author(s):

Lorien C Abroms ◽

Marc Fishman ◽

Hoa Vo ◽

Shawn C Chiang ◽

Victoria Somerville ◽

...

Keyword(s):

Substance Use ◽

Substance Use Disorder ◽

Video Game ◽

Addiction Treatment ◽

Intervention Group ◽

Body Motion ◽

Control Group ◽

Inpatient Setting ◽

Game Play ◽

Treatment As Usual

BACKGROUND Body motion-activated video games are a promising strategy for promoting engagement in and adherence to addiction treatment among youth. OBJECTIVE This pilot randomized trial (N=80) investigated the feasibility of a body motion–activated video game prototype, Recovery Warrior 2.0, targeting relapse prevention in the context of a community inpatient care program for youth. METHODS Participants aged 15-25 years were recruited from an inpatient drug treatment program and randomized to receive treatment as usual (control) or game play with treatment as usual (intervention). Assessments were conducted at baseline, prior to discharge, and at 4 and 8 weeks postdischarge. RESULTS The provision of the game play intervention was found to be feasible in the inpatient setting. On an average, participants in the intervention group played for 36.6 minutes and on 3.6 different days. Participants in the intervention group mostly agreed that they would use the refusal skills taught by the game. Participants in the intervention group reported attending more outpatient counseling sessions than those in the control group (10.8 versus 4.8), but the difference was not significant (P=.32). The game had no effect on drug use at 4 or 8 weeks postdischarge, with the exception of a benefit reported at the 4-week follow-up among participants receiving treatment for marijuana addiction (P=.04). CONCLUSIONS Preliminary evidence indicates that a motion-activated video game for addiction recovery appears to be feasible and acceptable for youth within the context of inpatient treatment, but not outpatient treatment. With further development, such games hold promise as a tool for the treatment of youth substance use disorder. CLINICALTRIAL ClinicalTrials.gov NCT03957798; https://clinicaltrials.gov/show/NCT03957798 (Archived by WebCite at http://www.webcitation.org/78XU6ENB4)

Download Full-text

Description of Position Ads for Pharmacy Technicians

Pharmacy ◽

10.3390/pharmacy8020088 ◽

2020 ◽

Vol 8 (2) ◽

pp. 88

Author(s):

Juanita A. Draime ◽

Emily C. Wicker ◽

Zachary J. Krauss ◽

Joel L. Sweeney ◽

Douglas C. Anderson

Keyword(s):

The United States ◽

Full Time ◽

Pharmacy Technician ◽

Uniform Definition ◽

Broad Variety ◽

Pharmacy Technicians ◽

Job Duties ◽

Definition Of ◽

Retail Setting

Pharmacy technician roles are evolving alongside the changing role of a pharmacist. There is currently no uniform definition of a pharmacy technician’s role in the pharmacy workforce. The objective of this study was to look at the United States-based pharmacy technician advertisement database from Pharmacy Week to find patterns and commonalities in the duties and qualifications of pharmacy technicians. A retrospective analysis was performed on fourteen days of pharmacy technician job listings from Pharmacy Week from the year 2018. Information obtained from the listings included job title, location, setting, type of job, job duties, and job requirements. Job duties and requirements were coded by themes. Fourteen days of data resulted in 21,007 individual position listings. A majority of the job listings were for full-time positions (96.4%) and most were in the retail setting (96.78%). The most common requirements were registration with State Board, high school diploma, ability to perform tasks, communication, and physical. The most common job duties were general office etiquette, performing tasks under the direct supervision of the pharmacist, and professionalism. This study provides a description of the evolving role of pharmacy technicians through the broad variety in expectations for requirements of pharmacy technician applicants and the duties they perform when hired.

Download Full-text

The Impact of Patient Education on the Quality of Inpatient Bowel Preparation for Colonoscopy

Canadian Journal of Gastroenterology ◽

10.1155/2010/718628 ◽

2010 ◽

Vol 24 (9) ◽

pp. 543-546 ◽

Cited By ~ 48

Author(s):

Greg Rosenfeld ◽

Darin Krygier ◽

Robert A Enns ◽

Janakie Singham ◽

Holly Wiesinger ◽

...

Keyword(s):

Patient Education ◽

Bowel Preparation ◽

Rating Scale ◽

Tertiary Care ◽

Intervention Group ◽

Control Group ◽

Inpatient Setting ◽

Care Hospital ◽

Patient Counselling ◽

The Impact

BACKGROUND: For patients requiring colonoscopy while admitted to hospital, achieving adequate cleansing of the colon is often difficult.OBJECTIVES: To assess the impact of patient education, in the form of both counselling and written instructions, on bowel cleanliness at colonoscopy.METHODS: A total of 38 inpatients at a tertiary care hospital in Vancouver, British Columbia, who were referred to the gastroenterology service for colonoscopy were enrolled in the present study. Sixteen patients were randomly assigned to the intervention group, while 22 patients comprised the control group. Both groups received a clear liquid diet and 4 L of a commercially available bowel preparation. The intervention group also received a brief counselling session and written instructions outlining the methods and rationale for bowel preparation before colonoscopy. Bowel cleanliness was assessed by the endoscopist using a five-point rating scale.RESULTS: The two groups were similar with respect to demographics, the indication for colonoscopy and findings at colonoscopy. The median bowel cleanliness scores in the control group and the enhanced-instruction group were 3.0 and 2.0, respectively (P=0.001).CONCLUSION: Patient counselling and written instructions are inexpensive, safe and simple interventions. Such interventions are an effective means of optimizing colonoscopy preparation in the inpatient setting.

Download Full-text