scholarly journals The impact of a pharmacist-managed dosage form conversion service on ciprofloxacin usage at a major Canadian teaching hospital: a pre- and post-intervention study

2005 ◽  
Vol 5 (1) ◽  
Author(s):  
Bradley P Ho ◽  
Tim TY Lau ◽  
Robert M Balen ◽  
Terryn L Naumann ◽  
Peter J Jewesson
Keyword(s):  
Teaching Hospital ◽  
Dosage Form ◽  
Intervention Study ◽  
Post Intervention ◽  
The Impact

scholarly journals Assessment of Direct Oral Anticoagulant Prescribing and Monitoring Pre- and Post-Implementation of a Pharmacy Protocol at a Community Teaching Hospital

2017 ◽  
Vol 52 (3) ◽  
pp. 207-213 ◽  
Author(s):  
Christina Miele ◽  
Mary Taylor ◽  
Aditi Shah
Keyword(s):  
Teaching Hospital ◽  
Vitamin K Antagonists ◽  
Intervention Group ◽  
Adult Patients ◽  
Patient Specific ◽  
Post Intervention ◽  
Appropriate Prescribing ◽  
The Impact ◽  
Post Intervention Group ◽  
Community Teaching

Background Direct oral anticoagulants (DOACs) have become popular alternatives to vitamin K antagonists for the treatment and prevention of thromboembolic diseases; however, there are limited data regarding the appropriate use of DOACs in clinical practice. To ensure safety and efficacy of these medications, it is important that decisions regarding their use in patients rely on the available evidence. Objective The purpose of this study was to evaluate the appropriateness of DOAC prescribing in adult patients before and after the implementation of a pharmacist-driven DOAC protocol. Methods Data were collected on adult patients admitted to a community teaching hospital who received DOAC therapy for at least 2 days between January and March 2015 (pre-intervention group) and between January and March 2016 (post-intervention group). These data were analyzed to measure inappropriately prescribed DOACs, defined based on DOAC indication, renal function, drug interactions, and other pertinent patient-specific factors. Prior to the start of data collection for the post-intervention group, a pharmacist-driven protocol was developed and implemented. DOAC education was provided to pharmacists, including an evidence-based prescribing table to guide appropriate DOAC therapy. Comparisons were made between the pre-intervention and post-intervention groups to determine the impact of the pharmacist-driven service on appropriate DOAC prescribing. Results Fifty patients were analyzed in the pre-intervention group compared with 85 patients in the post-intervention group, with a total of 333 and 816 doses administered, respectively. Of the total doses administered, 32.4% were considered inappropriate in the pre-intervention group compared with 13.8% in the post-intervention group (adjusted odds ratio [OR], 0.42, 95% CI, 0.19-0.96; p = 0.039). Conclusions Implementing a pharmacist-driven DOAC service significantly improved appropriate prescribing of these agents. Provider education regarding DOAC use is essential to further increase appropriate prescribing of DOACs, optimize patients' therapy, and prevent adverse drug events.

scholarly journals Effects of introducing a walk-in clinic on ambulatory care sensitive hospitalisations among asylum seekers in Germany: a single-centre pre–post intervention study using medical records

BMJ Open ◽  
2019 ◽  
Vol 9 (12) ◽  
pp. e027945
Author(s):  
Celina Lichtl ◽  
Kayvan Bozorgmehr
Keyword(s):  
Ambulatory Care ◽  
Incidence Rate ◽  
Asylum Seekers ◽  
Time Trends ◽  
Intervention Study ◽  
Post Intervention ◽  
Rate Ratios ◽  
The Impact ◽  
Reception Centre ◽  
Ambulatory Care Sensitive

ObjectiveMeasuring the effect of introducing a walk-in clinic on ambulatory care sensitive (ACS) hospitalisations among asylum seekers in a large state reception- and registration centre.Design and settingPre–post intervention study using anonymous account data from a university hospital functioning as referral facility for a state reception- and registration centre in the third largest German federal state.ParticipantsWe included all asylum seekers residing in the reception centre and admitted to the referral hospital between 2015 to 2017.InterventionsEstablishment of an interdisciplinary walk-in clinic in the reception centre (02/2016).Main outcome measuresInternational lists for ACS conditions for both adults and children were adapted and used to calculate the prevalence of ACS conditions among the population (primary outcome measure). The impact of the intervention on the outcome was analysed using a segmented Poisson regression to calculate incidence-rate ratios with respective 95% CIs, adjusted for age, sex and admission.ResultsThe prevalence of ACS hospitalisations changed over time, as did the effect of age, sex and quarter of admission. Introducing the walk-in clinic reduced the prevalence of ACS hospitalisations among asylum seekers compared with the period before establishment of the clinic (incidence-rate ratios (IRR)=0.80 (0.65 to 1.00), p=0.054), but the effect was attenuated after adjustment for time trends. The average difference in prevalence of ACS hospitalisations compared with the period before establishment of the clinic, corrected for pre-existing time trends, age and sex of asylum seekers was IRR=1.03 ((0.69 to 1.55), p=0.876).ConclusionsA walk-in clinic in reception centres may be effective to reduce ACS hospitalisations, but our study could not prove evidence for a measurable effect after full adjustment for time trends. Further research, ideally with parallel control groups, is required to establish evidence for the effectiveness of walk-in clinics in reception centres on reducing ACS hospitalisations.

scholarly journals P033: To choose or not to choose: evaluating the impact of a Choosing Wisely knowledge translation initiative on urban and rural emergency physician guideline awareness

CJEM ◽  
2017 ◽  
Vol 19 (S1) ◽  
pp. S89
Author(s):  
K. Chandra ◽  
P.R. Atkinson ◽  
J. Fraser ◽  
H. Chatur ◽  
C. Adams
Keyword(s):  
Knowledge Translation ◽  
Sample Size ◽  
Teaching Hospital ◽  
Small Sample ◽  
Choosing Wisely ◽  
Rural Setting ◽  
Rural Site ◽  
Urban Site ◽  
Post Intervention ◽  
The Impact

Introduction: Choosing Wisely is an innovative approach to address physician and patient attitudes towards low value medical tests; however, a knowledge translation (KT) gap exists. We aimed to quantify the baseline familiarity of emergency medicine (EM) physicians with the Choosing Wisely Canada (CWC) EM recommendations. We then assessed whether a structured KT initiative affected knowledge and awareness. Methods: Physicians working in urban (tertiary teaching hospital, Saint John, NB) and rural (community teaching hospital, Waterville, NB) emergency departments were asked to participate in a survey assessing awareness and knowledge of the first five CWC EM recommendations before an educational intervention. The intervention consisted of a 1-hour seminar reviewing the recommendations, access to a video cast and departmental posters. Knowledge was assessed by asking respondents to identify 80% or more of the recommendations correctly. Physicians were surveyed again at a 6-month follow up period. The Fisher exact test was used for statistical analyses. A sample size of 36 was required to detect a 30% change with an alpha of 0.05 and a power of 80%. Results: At the urban site, 16 of 25 (64%) physicians responded to the pre- and 14 of 26 (53.8%) responded to the post-intervention survey. Awareness of the EM recommendations did not increase significantly (81.3% pre; 95% CI 56.2-94.2 vs. 92.9% post; 66.4-99.9; p=0.60). There was a weak trend towards improved knowledge with 62.5% (38.5-81.6) of physicians responding correctly initially, and 85.7% (58.8-97.2; p=0.23) after the intervention. At the rural site, 8 of 11 (72.7%) physicians responded to the pre- and post-intervention survey. There was a trend towards improved awareness, (25% pre; 6.3-59.9 vs. 75% post; 40.1-93.7; p=0.13), with 50% (21.5-78.5) responding correctly pre, and 87.5% (50.8-99.9; p=0.28) after the intervention. Conclusion: We have described the current awareness and knowledge of the CWC EM recommendations. Limited by our small sample size, we report a trend towards increased awareness and knowledge at 6 months following our KT initiative in a rural setting where there was a low baseline awareness. At the urban site where baseline knowledge was high, changes seen were less significant. Further work will look at the effectiveness of our initiative on physician practice.

Impact of Health Education on Mothers' Knowledge of Preventive Health Practices

1997 ◽  
Vol 27 (4) ◽  
pp. 199-202 ◽  
Author(s):  
Mubina Agboatwalla ◽  
Dure Samin Akram
Keyword(s):  
Health Education ◽  
Breast Feeding ◽  
Intervention Study ◽  
Intervention Group ◽  
Preventive Health ◽  
Slum Area ◽  
Post Intervention ◽  
Community Based ◽  
Significant Difference ◽  
The Impact

A prospective community-based intervention study was conducted in a slum area of Karachi, Pakistan, with the objective of evaluating the impact of health education on the knowledge of mothers. One hundred and fifty households were studied in the intervention and the same in the non-intervention group. The post intervention knowledge scores of the mothers showed a significant difference of P < 0.05. Nearly 50.7% mothers in the intervention group knew of at least four diseases against which vaccination is given as compared to the non-intervention group ( P < 0.05). Similarly, mothers in the intervention group were more aware about the advantages of breast feeding, signs of dehydration, measures for prevention of measles and tuberculosis as compared to the non-intervention group ( P < 0.05). Finally, a comparison was made between the pre- and post-intervention scores between the two groups. The score in the non-intervention group changed from 11.5 to 16.1 ( P > 0.05) as compared to the intervention group in which it changed from 10.2 to 32.2 ( P < 0.05).

scholarly journals Impact of Electronic Prescription on Prescribing Errors

2021 ◽  
pp. 212-220
Author(s):  
Ameen M. Almohammadi ◽  
Huda M. Al-Dhahri ◽  
Shroug H. Al-Harbi
Keyword(s):  
Study Design ◽  
Intervention Study ◽  
Dosage Forms ◽  
Electronic Prescribing ◽  
Prescribing Errors ◽  
Post Intervention ◽  
Electronic Prescription ◽  
Prescription Errors ◽  
Trade Names ◽  
The Impact

Aims: There are series of medical errors that can be prevented by taking precautions.             Therefore, the study evaluates the impact of the electronic prescribing system on prescription errors. Study Design:  A pre-post study design was conducted. Place and Duration of Study: The study was conducted at outpatient pharmacy services of a teaching hospital in Jeddah city. Methodology: Prescriptions were evaluated for the presence of the essential prescription elements such as patient information, drug name, dose, frequency, strength, and other prescription completeness parameters. Results: In the pre-intervention study, 1182 handwritten prescriptions were evaluated, and 6627 errors were detected from these prescriptions. The length of the pre-and post-intervention period was two weeks each. The most prevalent prescribing errors were that of medications written without defined dosage forms were recorded 1653 (55.90%) time followed by prescriptions written by trade names 1493 (22.5%), without route of administration 1266 (19.1%), and without specified duration 1009 (15.2%). However, 1512 prescriptions were evaluated in the post-intervention study, among which 339 errors were detected. The errors included prescriptions written without diagnosis (5.09%), or without doctor’s name or stamp (1.52%), written by trade names (4.49%), without defined dosage forms (4.29%), and without specified duration (2.84%). Conclusion: The study concluded that E-prescribing eliminated prescription errors that resulted from handwritten prescriptions.

scholarly journals 1054. Impact of Prospective Review and Feedback with Peer Comparison on Carbapenem Utilization by Physicians Practicing at a Community Teaching Hospital

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S372-S372
Author(s):  
Rossana M Rosa ◽  
Amanda Bushman
Keyword(s):  
Teaching Hospital ◽  
Behavioral Interventions ◽  
Secondary Outcome ◽  
Inpatient Setting ◽  
Post Intervention ◽  
Monthly Basis ◽  
Stewardship Program ◽  
Prescribing Trends ◽  
The Impact ◽  
Community Teaching

Abstract Background Behavioral interventions such as peer comparison have shown to reduce inappropriate antibiotic utilization in outpatient settings. We aimed to estimate the impact of prospective review and feedback with periodic peer comparison on carbapenem use by physicians in an inpatient setting. Methods Interrupted time series study conducted at a 400-bed community teaching hospital with an Antimicrobial Stewardship Program (ASP) in place since 2012. Prospective review and feedback is the ASPs main strategy. Carbapenem use is not restricted. The intervention was limited to internal medicine residents, system-employed hospitalists, critical care specialists, surgery residents and surgery attendings directly supervising residents. Each carbapenem day of therapy (DOT) was reviewed by an infectious diseases (ID) physician or ID pharmacist and classified as adequate, suboptimal unnecessary or inappropriate. For the purposes of peer comparison, each DOT was attributed to the physician directly responsible for patient care on the day a carbapenem was administered. Among patients admitted to teaching services, both the resident and their supervising attending were deemed responsible. Individual physicians’ proportions of adequate use were calculated and compared with the aggregate proportion of adequate use by service, i.e., hospitalists were compared with other hospitalists. An email summarizing utilization metrics and comparing to their peers was sent on a monthly basis. The main outcome of interest was hospital-wide carbapenem use measured in DOT per thousand patient-days. Carbapenem DOT use by service was a secondary outcome. Changes in post-intervention trends were calculated as incidence rate ratios (IRR). Results Following the onset of the intervention there were no changes in hospital-wide trends of carbapenem use (IRR 1.04; 95% CI 0.98–1.10; P = 0.21) (Figure 1). Analysis of carbapenem use by service showed prescribing trends remained stable within services, with IRR in medical service of 0.98 (95% CI 0.92–1.05; P = 0.61) and IRR in the surgical service of 1.05 (95% CI 0.99–1.13; P = 0.11) (Figures 2 and 3). No changes were seen in proportions of adequate use. Conclusion Addition of peer comparison to an ASP utilizing prospective review and feedback did not decrease carbapenem use. Disclosures All authors: No reported disclosures.

scholarly journals The impact of a rapid molecular identification test on positive blood cultures from critically ill with bacteremia: A pre-post intervention study

PLoS ONE ◽  
2019 ◽  
Vol 14 (9) ◽  
pp. e0223122 ◽  
Author(s):  
Alexia Verroken ◽  
Noémie Despas ◽  
Hector Rodriguez-Villalobos ◽  
Pierre-François Laterre
Keyword(s):  
Critically Ill ◽  
Molecular Identification ◽  
Intervention Study ◽  
Blood Cultures ◽  
Post Intervention ◽  
Identification Test ◽  
The Impact

scholarly journals Impact of ‘HIV-related stigma-reduction workshops’ on knowledge and attitude of healthcare providers and students in Central India: a pre-test and post-test intervention study

BMJ Open ◽  
2020 ◽  
Vol 10 (4) ◽  
pp. e033612 ◽  
Author(s):  
Anna Machowska ◽  
Babu Lal Bamboria ◽  
Courtney Bercan ◽  
Megha Sharma
Keyword(s):  
Intervention Study ◽  
Healthcare Providers ◽  
Central India ◽  
Post Intervention ◽  
Stigma Reduction ◽  
Knowledge And Attitudes ◽  
Stigma And Discrimination ◽  
Related Stigma ◽  
Knowledge And Attitude ◽  
The Impact

IntroductionPeople living with HIV and AIDS (PLWHA) experience stigma and discrimination throughout their life. The consequences of stigma and discrimination are severe when enacted by healthcare providers (HCPs), and result in a delay in or poor adherence to treatment. Studies have demonstrated the presence of stigmatising behaviours among HCPs, yet only a few have presented the impact of interventions on the knowledge and attitude of practising (clinicians and nurses) and future (students) HCPs.ObjectivesTo evaluate knowledge, attitudes and infection risk perceptions related to HIV/AIDS among practising and future HCPs in central India. In addition, the impact of the ‘HIV-related stigma-reduction workshop’ using a pre-intervention and post-intervention study design was evaluated.Settings and participantsThe study was conducted in 2016 at two tertiary-care hospitals and three healthcare colleges in central India. Overall, 650 HCPs (75 clinicians and 211 nurses) and students (205 medical, 123 nursing and 36 Diploma in Medical and Laboratory Technology (DMLT)) voluntarily participated in the study.InterventionThe educational intervention comprised of training in epidemiology, the transmission and treatment of the HIV infection, the rights of PLWHA, the duties of HCPs and the use of standard precautions.ResultsAt pre-intervention, DMLT students had the lowest and clinicians the highest knowledge scores (24% and 45%, respectively). The stigmatised attitude was reflected in all groups, the lowest among clinicians (21%) and the highest among DMLT students (34%). Improvement in the post-intervention knowledge scores was the highest in medical students (36%) and the lowest among clinicians (16%). The participants’ attitudes improved between 3% and 17% across all groups.ConclusionsSignificant post-intervention improvements were seen in both knowledge and attitudes in all groups. Students had a higher tendency to improve than HCPs. Further long-term studies are needed to evaluate the sustainability of the improvements in knowledge and attitudes of the participants.

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