A two-year initiative, commencing in 2013, saw a clinical pharmacy surveillance tool piloted and then extended to encompass 154 hospitals within the health system. For the next six years, a comprehensive analysis was undertaken to monitor hospital uptake of the technology, alterations to drug regimens, the timeframe for pharmacist interventions, the performance of clinical pharmacy, and the ROI.
From 2015 to the year 2021, clinical surveillance technology was implemented in an increasing number of hospitals, ultimately reaching 177 hospitals in total. Simultaneously, the number of frontline clinical pharmacist drug therapy modifications more than doubled, and the time required for pharmacists to respond to alerts decreased from 139 hours to a significantly faster 26 hours. From 2015 onward, a 12% rise was observed in the proportion of patients treated with vancomycin, whose therapy was shortened by three days, while the proportion of patients with a urinary tract infection (UTI) receiving fluoroquinolone therapy decreased by 25%. An annual return on investment of 1129 was directly attributable to cost savings realized in both hard and soft dollars.
Following the implementation of the revamped pharmacy service model, pharmacists demonstrated enhanced efficiency, resulting in improved patient outcomes.
The revamped pharmacy services model fostered improved pharmacist efficiency, thus leading to demonstrably better outcomes for patients.
MMC, or Mitomycin C, a commonly used chemotherapeutic agent, is instrumental in treating diverse cases of solid tumors. Rare cutaneous adverse events associated with MMC are possible; however, if improperly infused subcutaneously, this vesicant can cause tissue necrosis, sloughing, erythema, and ulceration. A definitive approach to MMC extravasation injuries hinges on the degree of cutaneous manifestation, which may involve stopping the infusion, removing the catheter, and, in certain cases, requiring surgical debridement.
A case of a 70-year-old female with extensive soft-tissue damage from extravasated MMC required hospital admission and surgical removal of the implanted venous access device, a critical intervention.
Injuries stemming from extravasation, particularly those caused by vesicant drugs like MMC, are often characterized by local skin inflammation and irritation. Various cutaneous and soft tissue conditions, from redness to open wounds and finally to tissue demise (necrosis), might be indications of MMC extravasation. The potentially damaging, although rare, complication of chemotherapy infusions in cancer patients needs to be acknowledged.
Skin irritation and inflammation, as local symptoms, are often observed in extravasation injuries associated with vesicant drugs, exemplified by MMC. The skin and soft tissues can exhibit a spectrum of alterations following MMC extravasation, from redness to sores to tissue death. Recognition of this rare but potentially damaging chemotherapy complication is crucial for cancer patients.
Appropriate application of proton pump inhibitors (PPIs) and histamine type 2-receptor antagonists (H2RAs) is a critical component in maintaining hospital patient safety and quality, as inappropriate continuation during care transitions can compromise patient well-being. In this study, we detail how targeted quality improvement strategies influence the reduction of unnecessary acid suppression use among hospitalized patients within a large health system.
System-wide quality improvement initiatives began on January 1, 2018, in a large health system, focusing on minimizing the unnecessary use of proton pump inhibitors (PPIs) and histamine type 2-receptor antagonists (H2RAs). Targeted strategies, initially a component of the PPI deprescribing Institute for Healthcare Improvement (IHI) International Innovators Network, were later augmented to include H2RAs for patients in the hospital setting. PDS-0330 compound library inhibitor Hospital-based methods to decrease PPI and H2RA prescriptions included establishing consistent pathways for stress ulcer prevention, adjusting orders based on evidence, providing technological support, and assuring clinical pharmacy metrics achieved their objectives. The impact of implemented strategies on PPI/H2RA days of therapy (DOT) per 1000 patient days was assessed through a longitudinal study, extending from the first quarter of 2017 to the fourth quarter of 2021.
Implementation of quality improvement strategies led to a consistent 79-day decrease in PPI/H2RA DOTs per 1,000 patient days every quarter during the four-year period. The average PPI/H2RA DOT per one thousand patient days showed a decrease between the first quarter of 2017 (592) and the fourth quarter of 2021 (439). Forty-five hospitals (comprising 28% of the total) achieved a 10% reduction in their combined PPI/H2RA DOT rates per 1000 patient days in the final quarter of 2018. Within the fourth quarter of 2020, a noteworthy 97 hospitals (constituting 87% of the evaluated facilities) met the benchmark of deprescribing PPI/H2RA medications in at least 40% of suitable patients after an Intensive Care Unit (ICU) stay.
A four-year initiative for quality improvement, with a targeted focus, saw a decrease in unnecessary proton pump inhibitor (PPI) and histamine H2-receptor antagonist (H2RA) use within a large healthcare system. Through continuous measurement evaluation and the yearly setting of new clinical pharmacy metric goals, successful deprescribing was achieved and further improvements were encouraged.
Over four years, targeted quality improvement efforts in a major health system led to a decrease in the overuse of proton pump inhibitors (PPIs) and histamine H2-receptor antagonists (H2RAs). Through a continuous process of evaluating measured results and setting new, annual clinical pharmacy targets, significant progress in deprescribing was achieved.
In the treatment of a multitude of conditions and illnesses, medications are the cornerstone. immunoaffinity clean-up The guest editorial board, filled with pride, showcases the intricate details of medication management and the talented pharmacists who tirelessly ensure both safety and efficacy. This issue of the HCA Healthcare Journal of Medicine, a special edition, is fully dedicated to pharmacy services, with a particular emphasis on pharmacist medication management research and education for improving patient and colleague safety throughout the healthcare spectrum.
An adverse drug reaction, DRESS syndrome, manifests as a life-threatening, multi-organ condition involving eosinophilia and systemic symptoms. This rare reaction occurs in approximately 1 in 1000 to 1 in 10,000 high-risk drug administrations.
A senior lady, experiencing a gradual loss of strength, sought hospital care, revealing a widespread, erythematous, flat skin rash that had been present across a majority of her body for the past three days. Within the span of the subsequent three days, the patient experienced a rapid decline, manifesting as disorientation, coupled with a sudden onset of left-sided weakness. Leukocytosis, thrombocytopenia, and eosinophilia were also observed, alongside the development of liver and kidney failure, and ultimately, hypoxia. Intravenous ampicillin, administered during a prior stay for a urinary tract infection, led to a diagnosis of DRESS syndrome, as evidenced by the observed clinical and histological changes. Systemic corticosteroids were initiated without delay afterward, however, the patient ultimately succumbed to the complications resulting from DRESS syndrome.
At present, there are no randomized controlled trials investigating treatment options for DRESS, which results in a lack of evidence-based treatment recommendations. DRESS syndrome's possible complications include viral reactivation, though its exact prevalence and relationship remain ambiguous. While high-dose intravenous corticosteroids were begun early in her course of treatment, the patient nonetheless succumbed to the complications of Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) syndrome. Investigating the interplay between viral reactivation and the treatment of DRESS syndrome requires further research.
No randomized trials currently exist to evaluate treatments for DRESS, leaving a void in evidence-based guidelines. The possibility of viral reactivation as a complication of DRESS syndrome has been proposed, but its true incidence and association with the syndrome remain uncertain. High-dose intravenous corticosteroids, administered early on, unfortunately failed to prevent the patient from succumbing to complications stemming from DRESS syndrome. Subsequent studies examining the treatment approaches for DRESS syndrome and its relationship with viral reactivation are necessary.
Interprofessional education remains a focal point for growth, as emphasized by organizations that accredit professional degree programs at higher educational institutions. To offer optimal care in both acute and outpatient settings, healthcare teams should deepen their understanding of each other's roles, implement collaborative strategies, and concentrate on the primary needs of the patients. Shared decision-making approaches in clinical settings, coupled with collaborative efforts from pharmacists and increased communication between team members and patients, will inevitably diminish medical errors, elevate patient safety, and augment the patient's quality of life.
All industries, without exception, are experiencing the growth of diversity, equity, and inclusion (DEI), with healthcare being a notable example. wound disinfection The prevailing sociopolitical atmosphere of 2020 led to a widespread acknowledgement of diversity, equity, and inclusion as a critical concern for many organizations. Academia, professional organizations, and healthcare systems/companies form the fundamental components of DEI education within the pharmacy field. In order to rectify the disparities encountered by students, pharmacy professional organizations must project a voice that promotes inclusivity. This article examines the concepts of diversity, equity, and inclusion (DEI) in pharmacy, illustrated through the varied perspectives of three influential pharmacy leaders.
My investigation of 'Locked Within' examines my experiences with Western and alternative medicine, revealing their combined effectiveness in achieving holistic well-being.