Purpose： Evaluate the implementation of a large hospital system vancomycin dosing guideline in a community hospital with pharmacist vancomycin management. Design： Single center, retrospective and prospective quality...Purpose： Evaluate the implementation of a large hospital system vancomycin dosing guideline in a community hospital with pharmacist vancomycin management. Design： Single center, retrospective and prospective quality assessment study. Methods： Pharmacist-managed vancomycin therapy was evaluated pre and post-implementation of a new dosing guideline in a study population of 586 from one community hospital. Results： Of the study population, 274 patients evaluated pre-implementation were compared to 312 patients post-implementation of the large hospital-system guideline （46.8% and 53.2%, respectively）. There was no significant difference in demographics between both patient populations. Days of vancomycin therapy was shorter in the post-implementation group （4.32 ＋ 2.241） versus the pre-implementation group [（4.81 ±2.764）, p = 0.018]. Days to goal trough was longer in the post-implementation group （3.51 ±1.622） compared to the pre-implementation group [（3.09 ±2.046）, p = 0.054]. A post-hoe regression analysis was conducted, showing that age, days of vancomycin therapy and goal trough are predictors for 77% of cases within the post-implementation group. Conclusion： The implementation of a new vancomycin dosing guideline significantly impacted days of vancomycin therapy and days to goal trough in patients on vancomycin managed by pharmacists. Our results encourage completion of future studies utilizing the regression analysis data, which may impact the future care of patient on vancomycin managed by pharmacists.展开更多
The primary objective of this study is to assess the impact of a pharmacist-implemented protocol on number of post-operative alvimopan doses. The secondary objective of this study is to assess LOS （length of stay）, ...The primary objective of this study is to assess the impact of a pharmacist-implemented protocol on number of post-operative alvimopan doses. The secondary objective of this study is to assess LOS （length of stay）, in days, before and after protocol implementation. A retrospective chart review was conducted from October 2015 through March 2016 for all laparoscopic colorectal surgeries. Number of post-operative alvimopan doses received and LOS was recorded for each patient that received at least one dose of alvimopan. Comparative data, before protocol implementation, from November 2014 through June 2015 were analyzed against the study data. Number of post-operative alvimopan doses and LOS were recorded. The mean number of doses was 6.41 in the comparator group and 4.25 in the study group （probability size P 〈 0.001）, which did meet statistical significance. Although the secondary objective was not statistically significant, LOS slightly decreased as the mean LOS was 5.01 days in the comparator group versus 4.49 days in the study group （P = 0.256）. At the current price of $120 per capsule, close to $30,000 was saved during the study period, projecting an annual cost savings of approximately $68,000. Results from this study show that pharmacists can play a vital role in cost savings and ensuring appropriate use of certain high-risk medications, like alvimopan, without increasing overall length of stay.展开更多
Purpose： To evaluate the implementation of a pharmacy-led tobacco cessation medication education protocol at discharge in a community hospital. Design： Single center, retrospective quality assessment study. Methods...Purpose： To evaluate the implementation of a pharmacy-led tobacco cessation medication education protocol at discharge in a community hospital. Design： Single center, retrospective quality assessment study. Methods： A retrospective review of a pharmacy-led protocol was completed from November 2016 through April 2017. Data from one year prior to implementation of the protocol was analyzed against the study group. Results： A total of 607 tobacco cessation medication education interventions were made during the study period, 379 patients （62.4%） were given an OTC （Over The Counter） NRT （Nicotine Replacement Therapy） recommendation upon discharge and 148 （24.4%） were referred to the Ohio Tobacco Quit Line. TJC （The Joint Commission） TOB-3/3a measure was met in 44.1% of patients during the study period compared to 0% in the comparator group. Of the 75 patients who were reached via follow-up phone call, 23 （30.7%） purchased an OTC NRT and 22 （29.3%） completely quit using tobacco. Conclusions： Pharmacy-led tobacco cessation interventions during hospitalizations have a positive impact on TJC TOB-3/3a quality measure results and quit rates post-discharge. Our results encourage future studies in this area to further establish the importance of pharmacist involvement in tobacco cessation, specifically in the hospital setting.展开更多
文摘Purpose： Evaluate the implementation of a large hospital system vancomycin dosing guideline in a community hospital with pharmacist vancomycin management. Design： Single center, retrospective and prospective quality assessment study. Methods： Pharmacist-managed vancomycin therapy was evaluated pre and post-implementation of a new dosing guideline in a study population of 586 from one community hospital. Results： Of the study population, 274 patients evaluated pre-implementation were compared to 312 patients post-implementation of the large hospital-system guideline （46.8% and 53.2%, respectively）. There was no significant difference in demographics between both patient populations. Days of vancomycin therapy was shorter in the post-implementation group （4.32 ＋ 2.241） versus the pre-implementation group [（4.81 ±2.764）, p = 0.018]. Days to goal trough was longer in the post-implementation group （3.51 ±1.622） compared to the pre-implementation group [（3.09 ±2.046）, p = 0.054]. A post-hoe regression analysis was conducted, showing that age, days of vancomycin therapy and goal trough are predictors for 77% of cases within the post-implementation group. Conclusion： The implementation of a new vancomycin dosing guideline significantly impacted days of vancomycin therapy and days to goal trough in patients on vancomycin managed by pharmacists. Our results encourage completion of future studies utilizing the regression analysis data, which may impact the future care of patient on vancomycin managed by pharmacists.
文摘The primary objective of this study is to assess the impact of a pharmacist-implemented protocol on number of post-operative alvimopan doses. The secondary objective of this study is to assess LOS （length of stay）, in days, before and after protocol implementation. A retrospective chart review was conducted from October 2015 through March 2016 for all laparoscopic colorectal surgeries. Number of post-operative alvimopan doses received and LOS was recorded for each patient that received at least one dose of alvimopan. Comparative data, before protocol implementation, from November 2014 through June 2015 were analyzed against the study data. Number of post-operative alvimopan doses and LOS were recorded. The mean number of doses was 6.41 in the comparator group and 4.25 in the study group （probability size P 〈 0.001）, which did meet statistical significance. Although the secondary objective was not statistically significant, LOS slightly decreased as the mean LOS was 5.01 days in the comparator group versus 4.49 days in the study group （P = 0.256）. At the current price of $120 per capsule, close to $30,000 was saved during the study period, projecting an annual cost savings of approximately $68,000. Results from this study show that pharmacists can play a vital role in cost savings and ensuring appropriate use of certain high-risk medications, like alvimopan, without increasing overall length of stay.
文摘Purpose： To evaluate the implementation of a pharmacy-led tobacco cessation medication education protocol at discharge in a community hospital. Design： Single center, retrospective quality assessment study. Methods： A retrospective review of a pharmacy-led protocol was completed from November 2016 through April 2017. Data from one year prior to implementation of the protocol was analyzed against the study group. Results： A total of 607 tobacco cessation medication education interventions were made during the study period, 379 patients （62.4%） were given an OTC （Over The Counter） NRT （Nicotine Replacement Therapy） recommendation upon discharge and 148 （24.4%） were referred to the Ohio Tobacco Quit Line. TJC （The Joint Commission） TOB-3/3a measure was met in 44.1% of patients during the study period compared to 0% in the comparator group. Of the 75 patients who were reached via follow-up phone call, 23 （30.7%） purchased an OTC NRT and 22 （29.3%） completely quit using tobacco. Conclusions： Pharmacy-led tobacco cessation interventions during hospitalizations have a positive impact on TJC TOB-3/3a quality measure results and quit rates post-discharge. Our results encourage future studies in this area to further establish the importance of pharmacist involvement in tobacco cessation, specifically in the hospital setting.
