Background
Expanding the role of pharmacists in the hospital setting has the potential to positively impact the quality of patient care and provide cost savings. Previous studies have shown that integrating pharmacists into rounding teams can enhance patient care through interventions at the point of assessment and prescribing. This study examines these potential benefits at a community hospital that does not have formal hospitalist rounds and in which the pharmacists must make recommendations via written communication.
Objective
The primary objective was to identify the number of interventions and to determine how to optimally utilize a pharmacist for a group of 19 hospitalists. Secondary objectives included estimating pharmacist time invested and cost savings.
Methods
Initially, methods in this study included reviewing patient medication profiles and informally rounding with the hospitalists. Interventions were performed at the time of rounding. After 2 weeks of rounding, methods were altered to improve the efficiency of the pharmacist's time. Patient profiles were reviewed and interventions were performed by written communication.
Results
A total of 386 patients were reviewed, with 117 interventions discovered. Fifty-eight verbal interventions were made during rounds with a 93% acceptance rate. Fifty-nine written interventions were made in the second part of the study with a 76% acceptance rate. The pharmacist spent an average of 10 minutes reviewing each patient profile, which resulted in a savings of $16 per hour of time invested. An actual cost savings of $3,900 was produced by 64 of the interventions, and the potential cost savings of the remaining 53 interventions exceeded $100,000.
Conclusion
Opportunities for pharmacist interventions exist within a hospitalists' team and the potential benefits to patient care, along with the actual and potential cost savings, should justify creating collaborations between pharmacists and hospitalists.
The association between the risk of mortality and cardiovascular implantable electronic device (CIED) infections has been well-established in the literature. As CIED implantations have increased in frequency in the past few decades, the incidence of CIED-related infections has also risen. Given the morbidity, mortality, and health-care costs associated with CIED infections, the prevention of device-related infection is a critical goal. Risk factors for developing CIED infections can be categorized as patient-, procedure-, or device-related. Numerous studies have highlighted different strategies for preventing CIED-related infections, which include patient optimization, device selection, and periprocedural preparation and treatment. Nonetheless, as the comorbidity burden of patients undergoing CIED implantation continues to increase, significant challenges in the successful elimination of CIED-related infections remain. This review provides a comprehensive overview of available evidence-based approaches and strategies to reduce the risk of CIED infections.
Few studies have fully explored the problem of communication barriers in pediatric palliative care, particularly the detrimental effects of poor interaction between staff and families on children's health and well-being. A literature review was undertaken to expand the current body of knowledge about staff to patient communications. Articles meeting the inclusion criteria (N = 15) were systematically read and summarized using a data extraction sheet. A narrative synthesis identified 5 overarching themes as barriers to communication. Improvements in staff education and individualized palliative care plans for children and their families may help to overcome communication barriers.
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