Beyond the Bedside: Utilization of an On-Call Pharmacist to Bridge Gaps in Clinical Coverage for Select Critically ill Populations.

The purpose of this report is to describe the activities of critical care and ambulatory care pharmacists in a multidisciplinary transitions-of-care (TOC) service for critically ill patients with pulmonary arterial hypertension (PAH) receiving PAH medications. Initiation of medications for treatment of PAH involves complex medication access steps. In the ambulatory care setting, multidisciplinary teams often have a process for completing these steps to ensure access to PAH medications. Patients with PAH are frequently admitted to an intensive care unit (ICU), and their home PAH medications are continued and/or new medications are initiated in the ICU setting. Inpatient multidisciplinary teams are often unfamiliar with the medication access steps unique to PAH medications. The coordination and completion of medication access steps in the inpatient setting is critical to ensure access to medications at discharge and prevent delays in care. A PAH-specific TOC bundle for patients prescribed a PAH medication who are admitted to the ICU was developed by a multidisciplinary team at an academic teaching hospital. The service involves a critical care pharmacist completing a PAH medication history, assessing for PAH medication access barriers, and referring patients to an ambulatory care pharmacist for postdischarge telephone follow-up. In collaboration with the PAH multidisciplinary team, a standardized workflow to be initiated by the critical care pharmacist was developed to streamline completion of PAH medication access steps. Within 3 days of hospital discharge, the ambulatory care pharmacist calls referred patients to ensure access to PAH medications, provide disease state and medication education, and request that the patient schedule a follow-up office visit to take place within 14 days of discharge. Collaboration by a PAH multidisciplinary team, critical care pharmacist, and ambulatory care pharmacist can improve TOC related to PAH medication access for patients with PAH. The PAH TOC bundle serves as a model that may be transferable to other health centers.

The Cardio-Obstetrics Patient and the Cardiothoracic Anesthesiologist

Task Force 7: Pediatric Cardiology Fellowship Training in Pulmonary Hypertension, Advanced Heart Failure, and Transplantation. SPCTPD/ACC/AAP/AHA.

Discussion Guide for the Hua Article.

Primary graft dysfunction in heart transplantation: How to recognize it, when to institute extracorporeal membrane oxygenation, and outcomes

Protecting the Right Ventricle Network (PRORVNet): Time to Defend the “Forgotten Ventricle”?

Background: Among health care professionals, burnout is of growing concern, affecting both personal well-being and professional performance. Burnout poses significant risks to patient care with diminished work quality and increased staff turnover. Factors contributing to burnout have been identified although specific preventative resources and accessibility data remain limited. Objective: This study aimed to evaluate burnout among emergency medicine and critical care pharmacists, and identify the availability and impact of employer-provided resources on burnout. Methods: This national survey aimed to describe burnout and preventative resource utilization among emergency medicine and critical care pharmacists. Responses were collected from December 20, 2024 to February 14, 2025 from self-identified critical care and emergency medicine pharmacists that accessed the survey from professional listserv posts or email invitations. Demographic information was collected, and burnout was assessed using the Oldenburg Burnout Inventory (range 16-64, with higher scores indicating more burnout). Descriptive statistics, Student's t tests, and analysis of variance (ANOVA) were used with statistical significance defined as P < 0.05. Multivariable linear regression models were used to understand the relationships among variables and burnout. Free text survey responses were reviewed and coded based on themes. Results: Among 346 completed surveys, 72.1% were submitted by female pharmacists, and 50% of respondents practice in emergency medicine. Moderate burnout was observed with a mean score of 39.1 (SD = 7.1). 46.4% of participants indicated using resources at least monthly with clinical support during shifts the most common. All multivariate models demonstrated an association between lack of peer support and burnout. The top resources pharmacists suggested for reducing burnout included improved scheduling, improved staffing ratios, and scheduled nonclinical time. Conclusions: Moderate burnout was observed among critical care and emergency medicine pharmacists with a strong desire for increased leadership support within staffing indicated. In addition, leaders should consider creating formal peer support programs to prevent or address burnout.

PurposeTo elucidate considerations that infectious diseases (ID) and critical care (CC) pharmacists have regarding beta‐lactam antibiotics in critically ill adult patients in order to identify areas for practice improvement and future research.Materials and MethodsA 17‐item survey was distributed to ID and CC pharmacists. Responses were characterized using frequency and descriptive statistics. Categorical variables were compared using χ2 or Fisher's exact test, as appropriate.ResultsNinety‐five of 834 ID pharmacists (11.4%) and 221 of 1436 CC pharmacists (15.4%) participated. Compared with ID pharmacists, more CC pharmacists would administer renally‐excreted beta‐lactams in critically ill patients with reduced renal function without dosage adjustment for 24 hours (17% vs 34%, P = 0.002). Most respondents believed therapeutic drug monitoring would be somewhat/very important in all surveyed scenarios. ID pharmacists more frequently believed antimicrobial stewardship teams should conduct prospective audits for definitive beta‐lactam therapy (98% vs 86%, P = 0.001), develop protocols for beta‐lactam use (95% vs 85%, P = 0.019), recommend beta‐lactam dosing (98% vs 85%, P &lt; 0.001), and recommend empirical beta‐lactam selection (95% vs 81%, P = 0.001) compared with CC pharmacists.ConclusionBeta‐lactam dosing and monitoring recommendations in critically ill adults were frequently similar between pharmacy specialties. Research should be conducted in areas where opinions differ between specialties.

The growth and promulgation of Advanced Practice Providers (APPs) across the entire spectrum of healthcare delivery has been profound, and APPs are increasingly common members of emergency department (ED) care teams. Emergency APP workforce growth is outpacing that of emergency physicians with little to suggest that this trend will subside. The evolution of the deployment of APPs in emergency care has been dramatic; initially, emergency APPs were deployed to lower acuity patients or environments-minor injury and illness and in conjunction with an emergency physician-hence the now antiquated description of APPs as "physician extenders."

Pulmonary arterial hypertension (PAH) is a rare disease caused by high pressure in the blood vessels leading from the heart to the lung. PAH affects many parts of a patient's life, which means that patients should be managed by a clinical team of different specialists, including doctors, advance practice providers, nurses, social workers, and therapists. This article is co-authored by a patient living with PAH and an acute care nurse practitioner specializing in the management of patients with pulmonary hypertension. In the first section of this commentary, the patient describes her experience of living with PAH. The specialist nurse practitioner then discusses the management of PAH, to provide a clinician perspective in the context of the patient's experiences.

Since the last World Symposium on Pulmonary Hypertension in 2008, we have witnessed numerous and exciting developments in chronic thromboembolic pulmonary hypertension (CTEPH). Emerging clinical data and advances in technology have led to reinforcing and updated guidance on diagnostic approaches to pulmonary hypertension, guidelines that we hope will lead to better recognition and more timely diagnosis of CTEPH. We have new data on treatment practices across international boundaries as well as long-term outcomes for CTEPH patients treated with or without pulmonary endarterectomy. Furthermore, we have expanded data on alternative treatment options for select CTEPH patients, including data from multiple clinical trials of medical therapy, including 1 recent pivotal trial, and compelling case series of percutaneous pulmonary angioplasty. Lastly, we have garnered more experience, and on a larger international scale, with pulmonary endarterectomy, which is the treatment of choice for operable CTEPH. This report overviews and highlights these important interval developments as deliberated among our task force of CTEPH experts and presented at the 2013 World Symposium on Pulmonary Hypertension in Nice, France.

NP-112: Onboarding advanced practice providers to myeloma clinical teams

Evidence-Based Review and Discussion Points

Over 7 decades after Isaac Starr declared that “ weakness of the right side of the heart … seems less important … in the dynamics of congestive failure, [1][1]” the right ventricle (RV) has finally been afforded its due respect in many disease states. However, the definition and assessment

Program Evaluation of a Community-based Pediatric Inpatient Advanced Practice Provider (APP) Nocturnist Program.