Safety of Intravenous Push Ertapenem Compared to Intravenous Piggyback at a Tertiary Academic Medical Center

2021 ◽  
pp. 089719002110383
Author(s):  
Michael J. Corrado ◽  
Andrew Riselli ◽  
Kevin C. McLaughlin ◽  
Paul M. Szumita ◽  
Kevin E. Anger
Keyword(s):  
Medical Center ◽  
Academic Medical Center ◽  
Healthcare Systems ◽  
Institutional Review Board ◽  
P Value ◽  
Single Center ◽  
Infusion Site ◽  
Patients Âgés ◽  
Institutional Review ◽  
Academic Medical

Background: Recent shortages of intravenous (IV) fluids have resulted in healthcare systems converting administration of many medications from IV piggyback (IVPB) to IV push (IVP). Administering medications via IVP presents numerous advantages; however, IV site reactions such as phlebitis and infiltration may occur. Objective: The objective of this analysis is to evaluate the infusion site safety of ertapenem given as peripheral IVP compared to IVPB in adult patients. Methods: This was an institutional review board–approved, single-center, retrospective study. Patients, ages 18 or older, receiving IV ertapenem were identified. The major endpoints analyzed were IV site reactions including phlebitis and infiltration. The Naranjo Nomogram was utilized to assess the causality of the reactions to determine the likelihood of whether the event was caused by the medication itself or other factors. Results: To date, 283 administrations (92 patients) in the IVP group and 319 administrations (82 patients) in the IVPB group were analyzed. There were 13 IV site reactions compared to 8 in the IVP vs IVPB group, respectively ( P-value = 0.16). Ten of the events in the IVP group were deemed “possible” and 2 deemed “doubtful,” while the remaining event was considered “probable” per the Naranjo Nomogram. Of the events in the IVPB group, all 8 were found to be “possible.” Conclusion: The administration of IVP ertapenem showed comparable rates of infusion site reactions compared to IVPB. Implementation of IVP ertapenem appears to be associated with infusion site safety similar to IVPB and should be considered safe to administer.

scholarly journals Integrity of clinical information in computerized order requisitions for diagnostic imaging

2018 ◽  
Vol 25 (12) ◽  
pp. 1651-1656 ◽  
Author(s):  
Ronilda Lacson ◽  
Romeo Laroya ◽  
Aijia Wang ◽  
Neena Kapoor ◽  
Daniel I Glazer ◽  
...  
Keyword(s):  
Medical Center ◽  
Academic Medical Center ◽  
Clinical Information ◽  
Clinical Decision ◽  
Accurate Diagnosis ◽  
Institutional Review Board ◽  
Institutional Review ◽  
Academic Medical ◽  
Potential Impact ◽  
Kappa Agreement

Abstract Objective Assess information integrity (concordance and completeness of documented exam indications from the electronic health record [EHR] imaging order requisition, compared to EHR provider notes), and assess potential impact of indication inaccuracies on exam planning and interpretation. Methods This retrospective study, approved by the Institutional Review Board, was conducted at a tertiary academic medical center. There were 139 MRI lumbar spine (LS-MRI) and 176 CT abdomen/pelvis orders performed 4/1/2016-5/31/2016 randomly selected and reviewed by 4 radiologists for concordance and completeness of relevant exam indications in order requisitions compared to provider notes, and potential impact of indication inaccuracies on exam planning and interpretation. Forty each LS-MRI and CT abdomen/pelvis were re-reviewed to assess kappa agreement. Results Requisition indications were more likely to be incomplete (256/315, 81%) than discordant (133/315, 42%) compared to provider notes (p < 0.0001). Potential impact of discrepancy between clinical information in requisitions and provider notes was higher for radiologist’s interpretation than for exam planning (135/315, 43%, vs 25/315, 8%, p < 0.0001). Agreement among radiologists for concordance, completeness, and potential impact was moderate to strong (Kappa 0.66-0.89). Indications in EHR order requisitions are frequently incomplete or discordant compared to physician notes, potentially impacting imaging exam planning, interpretation and accurate diagnosis. Such inaccuracies could also diminish the relevance of clinical decision support alerts if based on information in order requisitions. Conclusions Improved availability of relevant documented clinical information within EHR imaging requisition is necessary for optimal exam planning and interpretation.

Publication of Pharmacy Residency Research: A 12-Year Cohort From an Academic Medical Center

2021 ◽  
pp. 089719002110212
Author(s):  
Joshua T. Swan ◽  
Elsie Rizk ◽  
Namhee Kwak ◽  
Jessica Guastadisegni ◽  
Nathaniel Thompson-Moore ◽  
...  
Keyword(s):  
Statistical Analysis ◽  
Research Training ◽  
Medical Center ◽  
Academic Medical Center ◽  
Institutional Review Board ◽  
Research Projects ◽  
High Quality Research ◽  
Residency Programs ◽  
Institutional Review ◽  
Academic Medical

Background: Pharmacy residency programs provide research training experiences to residents, and publication is considered an indicator of high-quality research experiences. Objective: This study described attributes of pharmacy residents, residency programs, and residency major research projects and their associations with the outcome of publication in a peer-reviewed journal. Methods: Pharmacy residents who graduated from one academic medical center between 2001 and 2012 were invited to participate via an electronic survey distributed in February 2014. The survey collected attributes of the resident, residency program, and research project. The outcome of publication was self-reported by residents in 2014 and updated in July 2019 using a validated search strategy. Results: This study included 53 resident graduates representing 66 major pharmacy residency projects. Eighteen (27%) projects were published, occurring at an average of 13.8 months after residency graduation. The outcome of publication was more likely for residents with human subjects research experience prior to PGY1 training, residency programs that cultivated resident expertise in Institutional Review Board submission and statistical analysis, and projects with Institutional Review Board approval, a larger number of co-investigators, non-pharmacy co-investigators, and a larger sample size. Conclusion: This cohort of residents, programs, and projects at an academic medical center identified many modifiable attributes that were associated with successful publication of resident research projects. Unfortunately, residency projects rarely used study design features that attenuate bias. Residents and preceptors were perceived as having limited expertise with statistical analysis and database management, which underscores the need to develop research infrastructure to enhance research training for pharmacy students, residents, and preceptors.

Reflection of an IRB Chair

1994 ◽  
Vol 3 (4) ◽  
pp. 506-509 ◽  
Author(s):  
Kenneth Craig Micetich
Keyword(s):  
Medical Center ◽  
Academic Medical Center ◽  
Nursing School ◽  
Institutional Review Board ◽  
Cancer Center ◽  
Medical Sciences ◽  
School Of Medicine ◽  
Institutional Review ◽  
Academic Medical ◽  
Chicago Medical

I have been a member of the Loyola University of Chicago, Medical Center Institutional Review Board (IRB) for 12 years and Chair for the last 4 years. The Medical Center Campus is a full-service academic medical center, providing tertiary and primary care to Chicago and its western suburbs. The campus houses a 520bed hospital, outpatient facilities, a cancer center, the graduate medical sciences, a nursing school, and the Loyola University Stritch School of Medicine.

scholarly journals Aprepitant and Fosaprepitant Use in Children and Adolescents at an Academic Medical Center

2014 ◽  
Vol 19 (2) ◽  
pp. 127-131 ◽  
Author(s):  
Alexandra Shillingburg ◽  
Lisa Biondo
Keyword(s):  
Children And Adolescents ◽  
Pediatric Patients ◽  
Medical Center ◽  
Academic Medical Center ◽  
Retrospective Chart Review ◽  
Primary Prophylaxis ◽  
Emetogenic Chemotherapy ◽  
Record System ◽  
Patients Âgés ◽  
Academic Medical

OBJECTIVE: To describe the use of aprepitant and fosaprepitant, a neurokinin 1 (NK-1) receptor inhibitor, in children and adolescents at a large academic medical center, for the prevention and management of chemotherapy-induced nausea and vomiting (CINV). METHODS: A retrospective chart review was conducted using an electronic medical record system to evaluate the use of aprepitant and fosaprepitant in all pediatric patients that were discharged from a single academic medical center between February 25, 2009 and May 25, 2012. RESULTS: Twenty-six patients were included in this review and received a total of 287 doses over the span of 114 cycles. Mean age was 10.1 years, with a range of 11 months to 17 years old. In 16 of 26 patients, aprepitant was used as the primary prophylaxis. Of those patients who received primary prophylaxis, 6 of 16 received it for highly emetogenic chemotherapy, and 10 of 16 received it for moderately emetogenic chemotherapy. Intravenous fosaprepitant was used in 7 of 26 patients, ages 13 to 17 (median 14) years old. No adverse effects attributable to aprepitant were reported. CONCLUSIONS: Use of aprepitant and fosaprepitant in pediatric patients appeared to be well tolerated. No currently published reports data using aprepitant in a patient younger than 32 months old, whereas we reported its use in patients as young as 11 months old.

Nurses’ perception of ethical climate at a large academic medical center

2016 ◽  
Vol 25 (6) ◽  
pp. 724-733 ◽  
Author(s):  
Donna Lemmenes ◽  
Pamela Valentine ◽  
Patricia Gwizdalski ◽  
Catherine Vincent ◽  
Chuanhong Liao
Keyword(s):  
Ethical Climate ◽  
Ethical Issues ◽  
Medical Center ◽  
Academic Medical Center ◽  
Care Hospital ◽  
Specialty Area ◽  
Work Settings ◽  
Institutional Review ◽  
Academic Medical ◽  
Nurses Perceptions

Background: Nurses are confronted daily with ethical issues while providing patient care. Hospital ethical climates can affect nurses’ job satisfaction, organizational commitment, retention, and physician collaboration. Purpose: At a metropolitan academic medical center, we examined nurses’ perceptions of the ethical climate and relationships among ethical climate factors and nurse characteristics. Design/participants: We used a descriptive correlational design and nurses ( N = 475) completed Olson’s Hospital Ethical Climate Survey. Data were analyzed using STATA. Ethical considerations: Approvals by the Nursing Research Council and Institutional Review Board were obtained; participants’ rights were protected. Results: Nurses reported an ethical climate total mean score of 3.22 ± 0.65 that varied across factors; significant differences were found for ethical climate scores by nurses’ age, race, and specialty area. Conclusion: These findings contribute to what is known about ethical climate and nurses’ characteristics and provides the foundation to develop strategies to improve the ethical climate in work settings.

Mannitol for the prevention of cisplatin-induced nephrotoxicity: A retrospective comparison of hydration plus mannitol versus hydration alone in inpatient and outpatient regimens at a large academic medical center

2016 ◽  
Vol 23 (6) ◽  
pp. 422-428 ◽  
Author(s):  
Robert P Williams ◽  
Brandon W Ferlas ◽  
Paul C Morales ◽  
Andy J Kurtzweil
Keyword(s):  
Serum Creatinine ◽  
Primary Outcome ◽  
Medical Center ◽  
Academic Medical Center ◽  
Toxicity Data ◽  
Average Increase ◽  
Institutional Review ◽  
Academic Medical ◽  
Retrospective Comparison ◽  
Quasi Experimental

Background Cisplatin-induced nephrotoxicity is a dose limiting adverse effect that occurs in nearly one-third of patients. Mannitol administration has been used as a means to negate this toxicity. Data regarding the efficacy of mannitol use in this context are conflicting and limited. Objective The aim of this study is to evaluate the effect of mannitol on renal function and describe the incidence of cisplatin-induced nephrotoxicity. Methods This study is a quasi-experimental retrospective analysis approved by the Institutional Review Board of inpatient and outpatient adults receiving cisplatin doses ≥40 mg/m2. The primary outcome was mean change in serum creatinine from baseline. Secondary outcomes included incidences of various grades of nephrotoxicity. Results A total of 313 patients (95 treated with mannitol and 218 without) were evaluated. The average increase in serum creatinine (mg/dL) was lower in patients who received mannitol versus those who did not (0.30 vs. 0.47; 95% confidence interval for difference, 0.03 to 0.31; P = 0.02). Grade 2 or higher nephrotoxicity occurred less frequently in patients who received mannitol versus those who did not (8% vs. 17%; P = 0.04). Non-gynecologic regimens and those who received doses ≥70 mg/m2 of cisplatin had lower rates of grade 2 or higher nephrotoxicity with mannitol (6% vs. 23%; P = 0.001, and 7% vs. 22%; P = 0.03, respectively). Conclusion The use of mannitol reduces the incidence and severity of nephrotoxicity in patients treated with cisplatin. The results of the study suggest mannitol may be most effective when used with non-gynecologic regimens and with cisplatin doses ≥70 mg/m2.

Telemedicine visits result in a significantly lower rate of cancellations compared to in-person visits for interventional oncology clinic patients.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e13624-e13624
Author(s):  
Suken Shah ◽  
Stephen Barnett Solomon
Keyword(s):  
Interventional Oncology ◽  
Medical Center ◽  
Academic Medical Center ◽  
Cost Savings ◽  
P Value ◽  
Waiting Room ◽  
Academic Medical ◽  
Physician Time ◽  
Clinic Visits

e13624 Background: Telemedicine allows increased access to specialists, less time in a waiting room and on-demand options with little to no transportation costs. These changes have been accelerated by the COIVD-19 pandemic. The purpose of the study was to test the hypothesis that a virtual telemedicine clinic would significantly decrease no-show rates and cancellations compared to in-person visits for interventional oncology (IO) clinic patients. Methods: Telemedicine visits were performed by a physician or advanced practice provider (PA or NP) at a single institution, academic medical center including 5 regional sites to patients at home in multiple states. Total patients encounters and data from January 2020 to December 2020 were analyzed. Visit types included new visits and follow up visits. Phone only visits were excluded. Primary outcome measures were an analysis of total cancelled visits (both same day and rescheduled visits), completed visits, and total scheduled visits with calculation of the telemedicine and in-person cancellation rates. Results: There was a total of 9,044 IR clinic visits in 2020 from 6,348 unique patients across the MSK Main Campus and Regional Network. Of these clinic visits, 5586 were telemedicine visits and 3458 were in-person visits. There was a significant decrease in no show and cancellation rates for telemedicine patients (6.3%) compared to in-person visits (8.1%) (p-value <0.00001). Conclusions: Telemedicine visits resulted in a significantly lower rate of visit cancellation compared to in-person visits. This reduction in no-show and cancellation rates may yield significant cost savings by eliminating gaps in the interventional oncology clinic schedule to allow for more efficient use of physician time and resources.

Comparison of two different intravenous serotonin antagonists used for chemotherapy-induced nausea and vomiting prophylaxis in patients treated with moderately emetogenic risk regimens: A retrospective analysis from a large academic medical center

2020 ◽  
Vol 26 (8) ◽  
pp. 1964-1969
Author(s):  
Melissa Gamble ◽  
Elisabeth Carroll ◽  
Garth C Wright ◽  
Ashley E Glode
Keyword(s):  
Retrospective Review ◽  
Medical Center ◽  
Academic Medical Center ◽  
Emetogenic Chemotherapy ◽  
Nausea And Vomiting ◽  
Moderately Emetogenic Chemotherapy ◽  
Prophylactic Regimen ◽  
Nccn Guidelines ◽  
Institutional Review ◽  
Academic Medical

Introduction Chemotherapy-induced nausea and vomiting (CINV) can be a serious and debilitating adverse effect that is highly feared by cancer patients. For patients receiving moderately emetogenic chemotherapy regimens at our institution in the ambulatory infusion center, palonosetron was selected as the preferred serotonin (5-HT3) antagonist for CINV prophylaxis per the 2016 NCCN Guidelines, when a neurokinin1 antagonist was not included in the prophylactic regimen. The purpose of this study was to evaluate the efficacy of dexamethasone and palonosetron versus granisetron for the prevention of CINV in patients receiving moderately emetogenic chemotherapy regimens. Methods This study is an Institutional Review Board-approved, single-center retrospective review of electronic health records including patients who received moderately emetogenic chemotherapy regimens with CINV prophylaxis with dexamethasone and either palonosetron or granisetron. Results A total of 268 eligible patients were included in the study. Eighty-eight patients received palonosetron and 180 patients received granisetron as their 5-HT3 receptor antagonist between October 31, 2014 and October 31, 2016. There were no statistically significant differences between the two antiemetic groups for the primary outcome of presence of any change in day 1 intravenous prophylactic antiemetics. Nine (10.23%) palonosetron patients and 15 (8.33%) granisetron patients required a change in their day 1 intravenous prophylactic antiemetics ( P = 0.610). Conclusions Despite palonosetron’s better efficacy, longer half-life, and higher binding affinity, the results of this retrospective review demonstrates that the choice of serotonin antagonist, palonosetron or granisetron, did not result in a change in day 1 intravenous prophylactic antiemetics or antiemetic outpatient medications for patients undergoing moderately emetogenic chemotherapy regimens.

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