Purpose: The purpose of this study was to evaluate the impact of the implementation of pharmacist-guided, unit-specific dornase alfa utilization guidelines for patients without cystic fibrosis in an academic medical institution. The study reviewed the prescribing patterns in the institution’s pediatric intensive care unit (PICU) and pediatric cardiac intensive care unit (PCICU) before and after the implementation of these guidelines. The primary objective of this study was to determine the effects of the guidelines on the number of dornase alfa doses prescribed in critically ill pediatric patients without cystic fibrosis. We also evaluated the pharmacoeconomic effect of the guidelines and the impact on clinical outcomes in these critically ill patients. Methods: This study was a single-center, retrospective evaluation of the implementation of pharmacist-guided, unit-specific dornase alfa guidelines. The guidelines were piloted on November 1, 2015. Pre-guideline implementation data were collected from February 1, 2015 to October 31, 2015. Post-guideline implementation data were collected from December 1, 2016 to August 31, 2016. We included patients admitted to the PICU and PCICU who had received at least 1 dose of dornase alfa and did not have a medical history or suspicion of cystic fibrosis. Results: During the pre-guideline data collection period, 1067 doses of dornase alfa were administered, and following guideline implementation, 239 doses were administered. The average total admission length of stay for patients admitted to the PICU or PCICU before guideline implementation and after implementation was 16.22 and 13.14 days, respectively ( P = .042). Conclusions: The implementation of pharmacist-guided, unit-specific dornase alfa guidelines within the PICU and PCICU resulted in a 77.6% reduction in the use of dornase alfa among these units. The implementation of these guidelines led to a cost reduction of approximately US $87 707.76 over a 9-month period for the health system. During the study, the length of stay for patients admitted to the PICU and PCICU did not increase, indicating that the reduction in use of dornase alfa did not negatively affect the overall hospital length of stay for patients.

Purpose To describe current pharmacy education organizational structures and perceptions in medical institutions in order to inform education management practices and prompt greater discussion about strategies to optimize workforce development and patient care. Methods Two surveys were created and distributed to collect information from key personnel involved in educational management at medical institutions across the nation. The education management survey was distributed to residency program directors and requested participants to define their current organizational structure around and resources for education. The education perceptions survey was distributed to health‐system pharmacy personnel and requested participants to describe their perceptions and needs about current education programs and management strategies used in their respective institution. Results Sixty participants from primarily large academic medical institutions (88%) completed the education management survey (37% response rate). Only 27 (45%) institutions were reported to have an individual responsible for education program oversight and 20 (33%) institutions have an education committee. Participants identified that a significant gap remains in resources available for preceptor development, technician continuing education, and conducting research in health‐system pharmacy. The education perceptions survey was completed by 107 participants from 31 institutions; most participants felt their institutional education structure was “above average” (33%) or “average” (45%). Conclusion The findings from this study suggest education management in a sample of institutions is variable and in need of greater attention. Institutions are encouraged to commit to refining pharmacy education management models to support lifelong learning practices that are integral for organizational success and advancing the profession.