June 19th 2024
A survey of health system specialty pharmacy employees found that hybrid work significantly improved quality of life and workplace productivity.
Immigrants fueling demand for interpreters
December 11th 2006According to the U.S. Census Bureau, every 31 seconds a limited-English speaker enters the United States. For the approximately 48 million residents who speak a language other than English at home, that language barrier looms large when they visit an emergency room or are admitted to a hospital.
Does nicotine replacement therapy hurt ICU patients?
December 11th 2006A recent study by researchers at the Mayo Clinic College of Medicine has raised questions about the safety of administering nicotine replacement therapy (NRT) to smokers in the intensive care unit (ICU). Until now, use of NRT was not thought to be associated with serious adverse events. In fact, the Agency for Healthcare Research & Quality (AHRQ) recommends smoking cessation treatment for hospitalized patients.
Two hospitals share award for propofol use
December 11th 2006As propofol utilization increases, so do the safety risks of fast-acting anesthesia. Readily adaptable oversight procedures for propofol management by clinical pharmacists have led to the awarding of medication safety awards to two hospitals by the Delaware Valley Healthcare Council in Philadelphia (DVHC).
JCAHO, ADA launch battle against inpatient diabetes
December 11th 2006Recognizing that health systems are failing to success-fully manage inpatient diabetes, the Joint Commission on Accreditation of Healthcare Organizations and the American Diabetes Association (ADA) joined forces recently to implement the inpatient diabetes certification of distinction program.
Clinical Twisters: Are drugs nixing weight loss?
December 11th 2006A 59-year-old Caucasian woman, D.P., is seen regularly in your hospital's diabetes clinic. Daily medications include glipizide ER (Glucotrol XL, Pfizer) 10 mg, pioglitazone (Actos, Takeda) 45 mg, metformin ER (Glucophage XR, Bristol-Myers Squibb) 500 mg, citalopram 40 mg, ezetimibe/simvastatin (Vytorin 10/80, Merck/Schering-Plough), aspirin 81 mg, lisinopril 40 mg. Glycemic control appears good (A1c=7.0), but she has gained >40 lb. in four years (BMI=33). Despite a Jenny Craig diet (1,200 calorie/day) for six months, plus three weekly sessions with a personal trainer, she has lost only 2 lb. D.P. saw a blog claiming pioglitazone causes weight gain-she believes that is her problem. Her physician asks your opinion. What do you say?
Experts urge caution over use of methadone
December 11th 2006Recent news reports linking methadone with a number of casualties, including that of the actress Anna Nicole Smith's son, have fostered the idea that the substance is a "killer" or dangerous drug of abuse. This is a bit paradoxical since methadone has been successfully used in heroin detoxification programs for decades.
Outpatient parenteral therapy growing, study says
December 11th 2006Pharmacists who see a move toward outpatient parenteral therapy are riding the latest shift in patient care. A new report from the Emerging Infections Network (EIN) found that OPAT, outpatient parenteral antimicrobial therapy, has become the de facto standard of care in most hospitals. EIN is part of the Infectious Diseases Society of America.
Clinical Q & A: What's the latest in vaccine therapy
The focus of medicine lies not only in searching for viable treatments and cures for existing ailments but also in the prevention of disease. Vaccination induces immunity after an antigen is introduced to the body. This antigen usually consists of a live attenuated organism, an inactivated organism, a toxoid, or parts of an organism (acellular and subunit). The antigen is incapable of resulting in the full-blown manifestation of the disease, but it is potent enough to generate the formation of antibodies to protect against future illness. Traditionally, vaccination has been used to combat the spread of infectious diseases, such as cholera, rabies, polio, measles, and hepatitis. And this is still the case.
Can interventions halt severe sepsis progression?
November 20th 2006Protocolized Care for Early Septic Shock (ProCESS), a new multicenter research consortium, is beginning a large-scale study to determine whether specific interventions can halt the progression to severe sepsis or septic shock. Every year, about 750,000 people in the United States are affected with severe sepsis and about 200,000 people die from it. Sepsis is a syndrome characterized by a systemic response to infection that can rapidly lead to death. It is the leading cause of death in noncoronary intensive care units.
Blood test cuts infection risk in transplant patients
November 20th 2006Over the years, long-term use of immunosuppressive medications has shown that they reduce morbidity and mortality in transplant patients. One of physicians' challenges is to balance the risk of organ rejection caused by underimmunosuppression with the risk of drug toxicity, secondary infections, and posttransplant lymphoproliferative disorders caused by overimmunosuppressing the patient.
New software enhances neonatal TPN
November 20th 2006NeoFax recently released an updated version of software for the preparation of total parenteral nutrition solutions for neonatal infants. Named WebApp, the software's data are based on what company officials say is the most widely used neonatal drug manual in the world- NeoFax: A Manual of Drugs Used in Neonatal Care-first published nearly 20 years ago.
Calif. law posts hospital medication errors on-line
November 20th 2006New legislation in California takes hospital reporting of serious medication errors to a new and very public level. Signed by the governor in late September, the law requires all hospital medical errors posing serious harm, including medication errors, to be posted on the state Department of Health Services' Web site. The Web site must include a description of the error, any corrective steps taken by the hospital or the state, and the name of the facility.
Is your hospital on Leapfrog's winner list?
November 20th 2006Suppose you were able to evaluate a hospital based on how well it has implemented quality and safety initiatives. The Leapfrog Group set out to do just that when it commissioned a survey to establish a national rating system that offers a broad assessment of a hospital's quality and safety. Fifty-nine hospitals have been named to Leapfrog's top hospitals list based on data from its survey.
Managing heart failure and transplants: Here's how
November 20th 2006The International Society for Heart & Lung Transplantation (ISHLT) has released the first international guidelines for managing heart failure (HF) patients prior to heart transplantation. HF is a serious condition in which the heart is unable to pump blood at a rate sufficient to meet the needs of the body. "The new guidelines will enhance the effectiveness of patient care, optimize patient outcomes, and improve overall cost by focusing resources on the most effective strategies," said Mariell Jessup, M.D., ISHLT task force chair and professor of medicine at the University of Pennsylvania Medical Center.
Clinical Twisters: Treating asthma/avoiding SVT
November 20th 2006A 20-year-old patient, T.C., managed in your hospital's asthma clinic has recently been diagnosed with paroxysmal supraventricular tachycardia (SVT). To control his asthma, T.C. uses a fluticasone 250 mcg/salmeterol 50 mcg inhaler (Advair Diskus, GlaxoSmithKline) regularly plus an albuterol inhaler as needed. T.C.'s physician suspects the beta agonists used to control asthma could be a factor in T.C.'s episodes of SVT. He requests a pharmacist consult about how best to deal with the asthma to prevent episodes of heart arrhythmia. What do you suggest?
Diabetes undertreated among hospital patients
November 20th 2006Diabetes is undertreated among inpatients, especially acute care patients, sometimes with devastating results. "Blood glucose levels are too often not treated as intensively as other medical conditions among floor patients," said Almut G. Winterstein, Ph.D., assistant professor of pharmacy health care administration at the University of Florida College of Pharmacy. "If hospitals made a more aggressive effort, it could save quite a significant number of lives."
Dasatinib added to guideline for CML
November 20th 2006Dasatinib (Sprycel, Bristol-Myers Squibb) is a new tyrosine kinase inhibitor for chronic myelogenous leukemia (CML). The Food & Drug Administration approved the drug in June, and now the National Comprehensive Cancer Network (NCCN) has added dasatinib to its CML guidelines.
Do drug-eluting stents carry thrombosis risk?
November 20th 2006Drug-eluting stents (DESs) greatly reduce the chances of restenosis, a gradual growth of abnormal cells within the stent. However, the results of a new study reveal that DESs may also put patients at a higher risk for a sudden and potentially fatal thrombosis.
New tablet manages breakthrough pain
November 20th 2006The Food & Drug Administration recently approved fentanyl buccal tablets (Fentora, Cephalon) for the management of breakthrough pain in cancer patients who are already receiving and who are tolerant to opioids for their underlying persistent cancer pain. Fentora is the first and only buccal tablet approved for this indication and is the first tablet formulation of the opioid fentanyl. It is also the first new medication approved for the treatment of breakthrough pain in opioid-tolerant patients with cancer since 1998.
Is your pharmacy providing 24/7 coverage?
November 20th 2006At most large tertiary care hospitals and academic medical centers, around-the-clock pharmacy service is relatively common. But in some small and rural hospitals, 24-hour, seven-day-a-week pharmacy coverage is not economically feasible or practical. How are pharmacy services provided in those facilities? And how do health-system pharmacists feel about a Joint Commission on Accreditation of Healthcare Organizations proposal that would require all hospital pharmacies to provide 24/7 service?