Investigating inpatient medication administration using the theory of planned behavior.

Purpose: Results of a study to determine behavioral factors that help explain why nurses often do not obtain and administer medications from automated dispensing cabinets (ADCs) "one patient at a time" are reported.

Methods: To investigate nurses' frequent failure to adhere to best-practice standards for ADC use, a 12-item questionnaire developed using information obtained from an elicitation study and a focus group session was e-mailed to 755 nurses at an academic medical center. A model based on constructs of the theory of planned behavior (attitude, subjective norm, and perceived behavioral control) was used to evaluate nurses' intent to follow ADC best practices through univariate and multivariate analyses.

Development of a metrics dashboard for monitoring involvement in the 340B Drug Pricing Program.

Purpose: An electronic tool to support hospital organizations in monitoring and addressing financial and compliance challenges related to participation in the 340B Drug Pricing Program is described.

Summary: In recent years there has been heightened congressional and regulatory scrutiny of the federal 340B program, which provides discounted drug prices on Medicaid-covered drugs to safety net hospitals and other 340B-eligible healthcare organizations, or "covered entities." Historically, the 340B program has lacked a metrics-driven reporting framework to help covered entities capture the value of 340B program involvement, community benefits provided to underserved populations, and costs associated with compliance with 340B eligibility requirements.

Improving patient care through implementation of an antimicrobial stewardship program.

Purpose: The implementation of an antimicrobial stewardship program at a health system is described.

Summary: In 2008, the Center for Antimicrobial Stewardship and Epidemiology (CASE) was formed at St. Luke's Episcopal Hospital (SLEH) to improve the quality of care for patients as it related to antimicrobial therapy.

Effect of bar-code-assisted medication administration on nurses' activities in an intensive care unit: a time-motion study.

Purpose: The effect of bar-code-assisted medication administration (BCMA) on nurses' activities in an intensive care unit was evaluated.

Methods: A prospective, observational, time-motion study was conducted by considering two approaches to medication administration in an intensive care unit: paper-based medication administration (PBMA) and BCMA. The time spent on nursing activities was measured using a prevalidated time-motion observation instrument and categorized based on workflow factors such as direct patient care, indirect patient care, administration, and miscellaneous or other.

Descriptive analysis of workflow variables associated with barcode-based approach to medication administration.

Bedside barcode technology is used during medication administration to ensure patient safety. This study evaluated the workflow variables related to a bedside barcode technology-based medication administration process. A time-and-motion technique was used to assess the observational episodes related to medication administration conducted by registered nurses.

Symposium on roles of and cooperation between academic- and practice-based pharmacy clinicians.

Purpose: The findings of an academic symposium as they relate to the history and role of the academic pharmacy clinician, the strengths and limitations of the academic pharmacy clinician model, and the framework for future synergistic work relations among clinical pharmacy practitioners are summarized.

Summary: On April 23, 2008, a symposium was convened to bring key thought leaders together to discuss the relationship of the academic-based pharmacy clinician and the practice-based pharmacy clinician. Participants included clinical faculty and administrators from two colleges of pharmacy, practice-based clinical pharmacists and pharmacy managers from seven health care institutions, and representatives from the American Association of Colleges of Pharmacy, the American College of Clinical Pharmacy, and the American Society of Health-System Pharmacists.