No abstract

The new practice model allowed better alignment of staff with departmental goals, expanded pharmacy hours and services, more efficient medication distribution, improved employee engagement, and a staff succession plan.

Summary:patients who are neutropenic after receiving conventional dosages of chemotherapy without BMT 7 have shifted from gram-negative to gram-positive bacteria, which currently Antimicrobial prophylaxis against gram-positive bacteremia (GPB) following BMT may prevent infections but account for approximately 60% of all bacteremias in BMT recipients. 1 The systematic use of central venous catheters promote antimicrobial resistance. In a sequential cohort study involving 289 consecutive BMT recipients we has increased the incidence of infections due to coagulasenegative staphylococci, which in many centers have compared three protocols for prevention of GPB (vancomycin prophylaxis, penicillin/cefazolin prophybecome the most common organisms isolated from blood cultures.8 laxis, and no specific GPB prophylaxis) with respect to incidence of GPB, mortality, and vancomycin use. GPB In addition, beginning in the early 1980s viridans-group streptococcal bacteremia, sometimes complicated by septic was associated with increased mortality (27% vs 15%; P = 0.02), but contributed to only five of 52 deaths in shock, emerged as a significant problem among neutropenic patients, including BMT recipients. [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23] In the early 1980s, the study population, and only one of 15 subjects with viridans streptococcal bacteremia developed fatal septic viridans streptococcal bacteremia occurred in 123 (15%) of 832 consecutive BMT recipients at the University of Minshock. Vancomycin prophylaxis reduced the incidence of GPB (11%) compared to penicillin/cefazolin (27%) nesota Hospital and Clinic (UMHC). 5 Ten (8%) of these patients with viridans streptococcal bacteremia developed or no prophylaxis (40%) (all P Ͻ 0.03), but did not significantly reduce mortality. The incidence of fungemia, septic shock, and six died as a consequence of their shock or from subsequent complications. 9 In an effort to decrease gram-negative bacteremia, and infection-associated mortality was unaffected by GPB prophylaxis. Vancoviridans streptococcal and other gram-positive infections, prophylactic vancomycin (vanco) for all patients undermycin use was substantially greater in the vancomycin prophylaxis group. We conclude that in comparison going BMT at UMHC was instituted empirically in 1983.10

Purpose: The heightened involvement of government organizations to improve pain management and mitigate opioid adverse events brings to light the need for an opioid stewardship model. Summary: The US opioid epidemic has resulted in new hospital requirements for pain management by regulatory agencies. Opioid stewardship is a concept in the early development stage of pharmacy practice. There exists a need for a cohesive vision of opioid stewardship and the role of the pharmacist. Over the course of 17 years, the tracks for opioid stewardship in Fairview Health Services were laid through numerous initiatives to mitigate adverse events and improve the quality of pain management. This article will describe a transformation process for establishing the framework for opioid stewardship within Fairview Health Services and role of the pharmacist. Conclusions: The vision for opioid stewardship will ultimately be defined through the actions taken to improve quality care and patient safety. Opioid safety should be expanded to include stewardship of approaches that reduce the risk of diversion, overdose, and medication abuse. Pharmacists currently have a major role monitoring opioid medication in hospitals and this component will increase with new regulatory requirements.