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At least 865 records · Page 48Linked to original sources
PubMed2007

Computerized indicators of potential drug-related emergency department and hospital admissions.

OBJECTIVES: To computerize indicators of potential drug-related emergency department and hospital admissions and to report the incidence of these potential drug-related morbidities for a managed care organization. STUDY DESIGN: Retrospective review of healthcare organizations' pharmacy and administrative claims databases. METHODS: Thirty-nine indicators were coded and were used in an automated search of claims data. The indicators of potential drug-related morbidities comprised a pattern of care and an associated adverse outcome. Poisson distribution regression analysis was performed to assess the association of patient factors with indicator positives. RESULTS: The incidence densities for indicator positives were 1.96 (95% confidence interval, 1.60-2.40) per 1000 patient-years in the general population and 13.6 (95% confidence interval, 8.8-20.2) per 1000 patient-years among older persons. Age, male sex, number of medical conditions, and number of medications from different classes were associated with an increased rate of indicator positives. CONCLUSIONS: Indicators of potential drug-related morbidities can be fully automated and used to search through medical and pharmacy claims. The indicators investigated in this study show promise as a quality improvement tool and should be further developed and evaluated.

Adolescent↗
PubMed1989

Clinical career ladders: St. Vincent Hospital and Health Care Center.

The career ladder program developed for pharmacists at St. Vincent Hospital and Health Care Center (SVH), a 625-bed community hospital, is described. Before 1986 the only advancement program for pharmacists at SVH was a traditional managerial one. The need for a system that would reward outstanding pharmacists both professionally and financially and prevent increases in turnover led to the development of a three-tiered ladder system in which clinical expertise and participation in elective professional activities are important keys to advancement. All baccalaureate-level pharmacists are hired at level I. Level II represents the standard of pharmacy practice at SVH. Pharmacists promoted to level III have made a major contribution. Advancement is contingent upon the accumulation of points awarded for performance evaluations, elective activities, and tenure. In addition to distributive and clinical duties, level II and III pharmacists must participate in special projects or on committees. Promoted pharmacists must accumulate additional points annually to remain at the higher level. The program was objected to by some staff members who believed that it would cut into personal time and give certain pharmacists preferred work schedules. Nevertheless, several promotions have quickened interest in the program, and participation in advancement-related activities has increased. The career ladder program has stimulated employees' professional and financial growth, enhanced the quality and quantity of pharmaceutical services, and averted potential increases in staff turnover.

Career Mobility↗
PubMed1990

Preparation and evaluation of 99mTc-t-butylisonitrile (99mTc-TBI) for myocardial imaging: a kit for hospital radiopharmacy.

A previous method was modified to obtain [99mTc(TBI)6]+ by reacting Zn(TBI)2Br2 directly with 99mTcO4- in the presence of Sn2+ ions. [Cu(TBI)4]Cl was next used as a source of TBI. On reaction with 99mTcO4- and Sn2+ ions for 3 min at 100 degrees C, [99mTc(TBI)6]+ product of radiochemical purity greater than 90% and yield greater than 70% was obtained. Data of biodistribution in rats (2-2.5% in heart) and biokinetics in rabbits were satisfactory. The kit formulation was found to be stable and also safe for administration.

Animals↗
PubMed2001

Incidence and risk factors of preparation errors in a centralized cytotoxic preparation unit.

OBJECTIVE: A major objective of centralized preparation is to improve the quality of the final product, and thus their safety for the patient. Few data are available concerning errors occurring during preparation and the risk factors associated with the errors. To assess risk factors associated with preparation errors in a centralized cytotoxic preparation unit. DESIGN: Medication errors were detected during preparation (self-education by technicians) or at the time of control (qualitative and semi-quantitative). For each preparation, several potential risk factors were studied. Univariate analysis was carried out using Chi-2 or Fisher exact tests. Variables with p < 0.15 associated in univariate analysis were entered in a stepwise regression model. In an overall analysis, all types of error were considered. In a second analysis, only major errors (errors associated with drug, dose or major incompatibility) were studied. RESULTS: Analysis included 30,819 preparations. Overall and major error rates were respectively 0.45% and 0.19%. The number of bottles (more than one), the volume of active solution (more than 50 ml) and the daily workload were the major risk factors identified by successive univariate and multivariate analysis. CONCLUSION: Low rates of medication errors compared to previous studies were reported. Major preparation errors were principally related to drug labeling (dose/bottle and concentration) and workload. Preparation mistakes appeared to have many causes. These results could be used to revise the general organization and determine a suitable purchasing policy.

Antibiotics, Antineoplastic↗
PubMed2004

Severe acute respiratory syndrome (SARS): the pharmacist's role.

OBJECTIVES: After two outbreaks of severe acute respiratory syndrome (SARS) occurred in Toronto, Ontario, Canada, from March-June 2003, we reviewed the unexpected role and responsibilities of pharmacists during these two crises, and present strategies for better crisis preparedness. METHODS AND RESULTS: Pharmacists were actively involved in battling the SARS crises. After conducting extensive literature searches and evaluations, pharmacists prepared administration and dosing guidelines for the two investigational drugs, ribavirin and interferon alfacon-1, that were being used to treat the syndrome. They provided direct patient care under modified conditions. They revised drug distribution procedures and developed new ones to meet more stringent infection-control standards. Collaborative teamwork with key stakeholders was important in accomplishing tasks in an efficient and timely manner. Regular communication with health care staff took place internally and externally. Education and updated information for pharmacists was crucial. CONCLUSION: Pharmacists can play a vital role during crises in the areas of drug distribution, drug information, and direct patient care. Collaborative teamwork and close communication are keys to success. Pharmacists must be proactive and take a leadership role in assuming pharmacy-related responsibilities. By evaluating what worked and what didn't, pharmacists can develop procedures for future crises requiring pharmacy support.

Anti-Infective Agents↗
PubMed1999

Diabetes and disenrollment in a health maintenance organization setting: a 4-year longitudinal study with a matched cohort.

OBJECTIVE: The increasing enrollment of Medicare beneficiaries in health maintenance organizations (HMOs) in recent years has caused concern about whether HMOs and their providers have created an unfavorable environment for members who are chronically ill. This study was designed to examine whether there are any differences in disenrollment rates among enrollees with diabetes and enrollees without diabetes. RESEARCH DESIGN AND METHODS: This was a 4-year longitudinal follow-up study with a matched cohort. Medicare beneficiaries (aged > or =65 years) with diabetes identified through pharmacy records in 1994 were matched with a comparison group according to age, sex, comorbidities, and type of provider groups in an HMO in California. RESULTS: The overall distribution of the characteristics of members in the diabetic and matched nondiabetic group is almost identical. The matched-pair chi2 tests indicated that there were no statistical differences in disenrollment rates between diabetic and nondiabetic members during all three follow-up periods (P = 0.16-0.85). CONCLUSIONS: We found that the HMO members with diabetes did not disenroll from the HMO at a higher rate than those without diabetes. The findings should alleviate some of the concern that HMOs and their contracted providers have created an unattractive environment for members who have chronic diseases such as diabetes.

Aged↗
PubMed2004

Health care's most wired. A wired exchange.

There was a time when innovation in health care information technology meant being at the cutting edge of managerial systems. Hospitals made significant investments in financially oriented technology. In the past five years, the investment in clinical IT appears to have outstripped the investment in managerial systems, including enterprise resource planning aimed at improving the supply chain.

Benchmarking↗
PubMed1989

Anabolic steroid legislation Act 249 of 1989.

Health care professionals are urged to be alert to the potential for adverse effects common to the use of anabolic steroids by athletes and others, including high school and college students active in varsity sports or body lifting. The Department of Health, Division of Pharmacy Services and Drug Control asks for cooperation and assistance in helping combat the illegal diversion by physicians and pharmacies of these hazardous drugs and to ensure that these drugs are available to patients only through legitimate channels. Act 249 of 1989 was enacted to prevent the distribution and use of illegal anabolic steroids and growth hormones and for purposes of defining and setting penalties for the illegal use.

Anabolic Agents↗
PubMed2002

Does knowledge count? Attitudes toward smoking among medical, nursing, and pharmacy students in Hungary.

Despite the fact that cigarette smoking in East Europe is a major health problem, no effective health policy responses have been developed thus far. Health care professionals represent a valuable resource for tobacco control. Therefore, we wanted to obtain information about the acceptance of smoking among medical, nursing and pharmacy students (n = 270) in Szeged, Hungary. The self-administered questionnaire contained items on smoking behavior, beliefs and attitudes related to smoking. Chi2-test were used to determine differences in the attitudes among students. Smoking was the most frequent among nursing students, followed by medical students. Pharmacy students not only reported smoking the least but they also showed the most acceptable attitudes toward smoking. The high frequency of smoking among students suggests that they themselves are unable to cope with avoiding the dangers of smoking. Moreover, responses reflect a generally poor appreciation of responsibility that health care professionals have in prevention. There is a need for an increasing emphasis on smoking-related attitude formation among medical and nursing students.

Adult↗
PubMedDate not supplied

Implementing a bioterrorism response plan in your pharmacy.

Pharmacies and other types of health care facilities need emergency response plans. Pharmacists need to stay current on biologic and other agents that can be used as agents of mass destruction and their clinical management. Local plans should incorporate federal resources that can be used in emergencies, but the time required for these resources to be organized, delivered, and distributed needs to be considered. Pharmacists are urged to assist with inventories of available health care facilities, supplies, and medications. Planning needs to be coordinated with local emergency preparedness officials.

Bioterrorism↗
PubMed1995

Neonatal nursing staff time involved with medication-related activities.

A work sampling study involving 1920 observations derived from 48 2-hour observation periods is described. Approximately one-tenth of neonatal nurse time was spent on medication-related activities. just over one-third of this time involved medication preparation. It is suggested that the use of a pharmacy medication preparation service may be more cost-effective.

Chi-Square Distribution↗
PubMed1983

Effect on drug costs of implementing decentralized drug distribution.

The drug costs associated with a centralized drug-distribution system were compared with those of a newly implemented decentralized unit dose and i.v. admixture system in a university teaching hospital. Three months before and three months after implementation and stabilization of the new drug-distribution system, the mean drug cost per patient day was determined for each of 22 nursing stations. Variations in drug use were monitored to eliminate the influence of patient mix or treatment protocol. Data from 2 of the 22 nursing stations were excluded from analysis because of large variations in drug use. Twelve nursing stations demonstrated lower drug costs per patient day with the new drug-distribution system. Overall, an 18% reduction in drug costs per patient day was achieved. In this hospital, a decentralized drug-distribution system was associated with lower drug costs than the traditional distribution system.

Costs and Cost Analysis↗
PubMed1985

Improving patient-oriented pharmacy services: what the individual pharmacist can do.

How individual pharmacists can improve patient-oriented services is described. Pharmacists practicing on patient-care units should assess how they can, by meeting the needs of other health-care providers, contribute to better drug therapy. They should examine how changes in the drug distribution system can allow more flexibility for providing services on the patient-care unit. They should promote appropriate drug use by identifying problems and bringing these to the attention of the providers involved. Individual pharmacists can be assigned to patient-care units to coordinate drug therapy and patient education. They should document their activities. Individual pharmacists can take responsibility not only for their own actions but also for the actions of other health-care professionals associated with drug therapy.

Humans↗