Addition Of Pharmacist Research Articles

Analysis And Evaluation Of Pharmacist Power Needs With The WISN Method In The Pharmaceutical Installation Of Haji Hospital Surabaya

The success of the hospital in carrying out its functions is influenced by several factors, among which the most dominant is human resources. Human resources are one of the important factors to be able to provide quality and comprehensive services in health services and are the key determinants of the rate and quality of services. The method of calculating needs based on workload (WISN) is an indicator that shows the amount of workforce required for health facilities based on workload, so that the allocation / relocation of labor will be easier and more rational. This research is a descriptive observational research with qualitative data analysis with purposive sampling method, namely the sampling technique by determining certain criteria. The HR category that will be calculated is the pharmacist in the Pharmacy Installation of the Surabaya Haji Hospital and results in a calculation of the total need for pharmacists of 24 people, compared to the current number of pharmacists of 20 pharmacists, the addition of pharmacists is 4 people in the Home Pharmacy Installation Haji Hospital Surabaya. The current number of fulfilled personnel from the calculation results only fulfills 83% of the ideal amount generated by the WISN method. With the obstacles faced such as the large workload of clinical pharmacy services that are carried out every day. To anticipate this, it is necessary to fulfill the need for pharmacists.

Developing Future Clinical Pharmacy Leaders in the Interprofessional Care of Children with Special Health Care Needs and Medical Complexity (CSHCN-CMC) in a Pediatric Pulmonary Center.

The health care needs of children with special health care needs and medical complexity (CSHCN-CMC) are multifaceted and often require the expertise of various disciplines. The medication-related needs of this population can be further complicated with off-label medication use, polypharmacy, and vulnerability to medication errors. Although clinical pharmacists are increasingly becoming a common part of inpatient, pediatric interprofessional patient care teams, their presence remains lacking in the outpatient or ambulatory care realm. Pediatric clinical pharmacists in the ambulatory care setting have the potential to help optimize medication use and safety through collaborative efforts as part of the interprofessional team. Since the late 1960s, Pediatric Pulmonary Centers (PPCs) provide training programs designed to develop interprofessional leaders who will improve the health status of CSHCN-CMC, specifically those with chronic respiratory and sleep-related conditions. The addition of pharmacists not only provides a more comprehensive care model for CSHCN-CMC, it creates an avenue to encourage the career paths of pediatric pharmacists in the ambulatory care setting. Here, we describe the addition of clinical pharmacy as part of an interprofessional patient care team and the development and implementation of a maternal child health (MCH) pharmacy discipline training model designed to mentor future pharmacist leaders in the care of CSHCN-CMC.

The Addition of Pharmacists on a Patient Care Team to Improve Diabetic Patient Outcomes

As diabetes becomes more prevalent throughout the United States, there is an increased demand for healthcare providers and healthcare resources. Pharmacists have started to collaborate with primary care providers, and through this collaboration, pharmacists are able to augment patient care and provide additional resources to diabetic patients. This essay reviews the effect of one clinic that incorporates pharmacist interventions as an addition to established patient care teams, and evaluates the effect that the pharmacist interventions have on patient hemoglobin A1C%. While this essay provides data to show the positive benefits of pharmacist intervention on diabetes patients and A1C% goals, additional data and research are needed to demonstrate how pharmacists are a necessary addition to patient care teams.

Impact of pharmacists as immunizers on influenza vaccination coverage in the community-setting in Nova Scotia, Canada: 2013-2015.

BackgroundAnnual immunization is the most effective way to prevent influenza and its associated complications. However, optimal immunization rates are not being met in Nova Scotia, Canada. Additional providers, such as pharmacists, may improve access and convenience to receive vaccines. Pharmacists began immunizing patients 5 years of age and older within the publicly funded universal influenza vaccination program during the 2013-2014 influenza season. The objective of this study was to evaluate influenza immunization coverage rates before and after pharmacists in Nova Scotia gained authority to immunize as part of the publicly funded universal influenza vaccination program.MethodsInfluenza immunization data was obtained from the Department of Health and Wellness from 2010 to 2015. Data included billing data from physicians and pharmacists, and local public health data. Vaccination coverage was calculated as proportion of vaccinations received in comparison to the total population.ResultsPrior to pharmacists immunizing, overall vaccination coverage for Nova Scotia residents 6 months of age and older was 35.8 % in 2012-2013, increasing to 41.8 % coverage in 2013-2014 the year pharmacists began immunizing. A decrease of 1.9 to 39.9 % was observed in 2014-2015. In patients 65 years of age and older living in the community, coverage has increased from 61.8 % in 2012-2013 to 71.6 % in 2013-2014, and again to 73.3 % in 2014-2015 with the addition of pharmacists immunizing. Prior to pharmacists immunizing the highest coverage noted for this portion of the population was 61.8 %.ConclusionsThe addition of pharmacists as immunizers within a publicly funded universal influenza vaccination program was found to increase overall vaccination coverage in the first year and to maintain higher coverage rates in the second year than those observed before pharmacists began immunizing. Increases in coverage in both years were observed in the elderly. Future research will be required to determine the ongoing impact of the addition of pharmacists as immunizers and other strategies to improve vaccination coverage.

Effect of emergency medicine pharmacists on medication-error reporting in an emergency department

The effect of an emergency medicine (EM) clinical pharmacist on medication-error reporting in an emergency department (ED) was studied. The medication-error reports for patients seen at a university's ED between September 1, 2005, and February 28, 2009, were retrospectively reviewed. Errors reported before the addition of an EM pharmacist (from September 1, 2005, through February 28, 2006) were compared with those reported after the addition of two EM pharmacists (from September 1, 2008, through February 28, 2009). The severity of errors and the provider who reported the errors were characterized. A total of 402 medication errors were reported over the two time periods. Pharmacy personnel captured significantly more errors than did other health care personnel (94.5% versus 5.7%, p < 0.001). The addition of two EM pharmacists resulted in 14.8 times as many medication-error reports as were made when no EM pharmacist was in the ED. More errors that actually occurred were captured with two pharmacists providing care (95.7% versus 4.3%, p < 0.001). A majority of the errors documented were ordering errors (79.8%). Of these, 73.7% were captured after the addition of two EM pharmacists. Performance (40.0%) and knowledge (27.9%) deficits were the most common contributing factors to medication errors. During the study period after the addition of two EM pharmacists in the ED, 371 medication-error reports were completed, compared with 31 reports during the study period before the addition of the pharmacists. Pharmacy personnel reported the majority of medication errors during both study periods.

The changing nature of prescribing: pharmacists as prescribers and challenges to medical dominance

This paper investigates the potential threat to medical dominance posed by the addition of pharmacists as prescribers in the UK. It explores the role of prescribing as an indicator of professional power, the legitimacy and status of new pharmacist prescribers and the forces influencing professional jurisdictional claims over the task of prescribing. It draws upon 23 interviews with pharmacist supplementary prescribers. Data suggest that the legitimacy of pharmacists as prescribers, as experienced in the workplace, has been aided by: (1) blurred definitions of prescribing; (2) the emphasis on new prescribers' competence urging pharmacist prescribers to limit their areas of clinical practice; and (3) a team approach to patient management. Competence, self-limitation on practice and the benefits of team working as part of the ideology of patient safety were thus an important influence on pharmacists' jurisdictional claim over prescribing. While pharmacists have successfully negotiated a role for themselves as prescribers, medicine has retained its high status, relative to other health professionals and with patients; it controls the knowledge base relevant for prescribing practice and has managed to develop an 'overseer' role over the process of prescribing. Prescribing, as an indicator of medicine's autonomy of control over their work and professional status, has changed. Yet the extent to which new prescribers have been able to threaten the professional dominance of medicine is debatable.

Impact of the Clinical Pharmacist on Readmission in Patients with Acute Coronary Syndrome

Previous studies have reported a positive impact of pharmacists on care of patients with chronic illnesses. The impact of the clinical pharmacist on hospital readmission in patients with acute coronary syndromes (ACS) has yet to be evaluated, as of this writing. To evaluate the impact of the clinical pharmacist as a direct patient-care team member on cardiac-related readmission in patients admitted to the general cardiology unit with ACS. A prospective, nonrandomized observational study compared patients who received standard practice care with patients admitted to a service with a clinical pharmacist to provide care at the bedside. Patients admitted to and discharged from the general cardiology unit for ACS were included. The primary endpoint of the study was cardiac-related readmission at 30 days following hospital discharge. Secondary endpoints included length of stay and medication utilization. Interventions provided by the clinical pharmacist in the study group were documented. Cardiac readmission at 30 days was similar between the groups (p = 0.59). In the subset of patients with unstable angina, readmission in the study group was significantly lower than in the control group (1.3% vs 9.1%; p = 0.04). Patients in both groups were similarly managed using drug therapy and invasive coronary interventions. The medical staff's rate of acceptance of recommendations provided by the pharmacist was 94.4%. The most common interventions were medication education and identification of indicated therapy. The addition of pharmacists did not decrease readmission in patients with ACS. The finding of significant reduction in readmission in the subset of patients with unstable angina should be considered "hypothesis generating" for future randomized studies to confirm the results.

Guiding heart failure care by invasive hemodynamic measurements: Possible or useful?

The quest to discover effective methodologies to monitor the course of disease and response to therapeutic agents in patients with chronic heart failure continues. The relentless progression of underlying left ventricular dysfunction and periodic, severe symptomatic decompensation often requiring hospitalization remain essential features of the heart failure syndrome despite significant therapeutic advances. Clinical trials of specific therapeutic agents have shown efficacy in large groups of patients. But outcome, even with the most effective agents, is recognized to be heterogeneous for largely unexplained reasons. The idea that treatment of individual patients with heart failure could be guided by serial measurements of surrogate end points for mortality and morbidity remains attractive to clinicians. Several assumptions underlie the concept that sequential physiologic measurements such as hemodynamics can be used to guide therapy: (1) measurements indicative of clinical response during heart failure can be ascertained, albeit with varying degrees of difficulty; (2) serial determinations of these measurements, such as left ventricular dysfunction, neurohormonal activation, and central hemodynamics, will predict clinical responses to general measures and pharmacologic therapy; (3) these measurements are not sufficiently risky, expensive, or cumbersome to preclude their being obtained as a part of routine clinical practice; (4) these measurements are sufficiently reproducible to provide the basis for making therapeutic changes in individual patients; (5) continuous measurements rather than serial snapshots of, for example, hemodynamics are likely best; (6) adjustment of currently available treatment strategies will favorably effect the measures that are monitored; (7) the frequency of therapeutic adjustments and subsequent follow-up study prompted by serial measurements is feasible for most patients; and (8) monitoring physiologic aspects of the disease process will provide more benefit than expending similar resources on changes in the process of delivery of care, ie, measurements of right heart hemodynamics with medication adjustment versus patient management via a heart failure program. Magalski et al in this issue of Journal of Cardiac Failure describe one strategy for monitoring the course of chronic heart failure that begins early work to address some of these issues.