Exploring Pharmacists' Perceptions of Text-Based Artificial Intelligence in Resident and Student Education.

As artificial intelligence (AI) becomes increasingly integrated into various professional fields, understanding its impact on pharmacy education is crucial. This study explores pharmacists' perceptions of AI's role in enhancing educational and professional practices, particularly focusing on the generation of educational content and analytical tasks. The primary objective was to assess pharmacists' concerns and perceived benefits regarding the use of AI in pharmacy education, examining variations across different age groups and years of practice.

Comparing Medication History Capture Rates In-Person Versus Hybrid: A Multisite Pilot Study.

Medication history is the method many organizations use to adhere to The Joint Commission's (TJC) National Patient Safety Goal (NPSG) to communicate accurate patient medication information. Literature is sparse comparing the number of medication histories completed in-person versus virtually. This is a single system, multi-site, retrospective observational study.

Retrospective evaluation of dexmedetomidine dosing in a cohort of neurologically injured obese critically ill patients.

Background: Dexmedetomidine is used in neurocritical care units (NCCUs) due to the light, dose-dependent sedation, and anxiolysis provided. It is unknown how to dose dexmedetomidine in obese patients. The primary objective is to assess the ability to achieve the goal Richmond Agitation Sedation Scale (RASS) measurements in obese patients with a neurological injury who are solely on dexmedetomidine before and after an institutional dosing change from actual body weight (ABW) to adjusted body weight (AdjBW).

Multicenter comparison of antiplatelet treatment strategies for urgent/emergent neuroendovascular stenting.

Background: Emergent neuroendovascular stenting presents challenges for the utilization of antiplatelet agents.

Methods: This was a multicenter, retrospective cohort of patients who underwent emergent neuroendovascular stenting. The primary endpoints were thrombotic and bleeding events in relation to the timing of antiplatelet administration, route of administration, and choice of intravenous (IV) agent and the study investigated practice variability in antiplatelet utilization.

Multicenter Comparison of the Safety and Efficacy of Clopidogrel Versus Ticagrelor for Neuroendovascular Stents.

Background: Dual antiplatelet therapy (DAPT) is commonly employed for neuroendovascular stenting due to the significant risk of thromboembolism. Clopidogrel and aspirin are most often selected as initial DAPTs; however, there is limited literature available to support guidance of DAPT in this setting. The objective of this study was to evaluate safety and efficacy in patients whose final regimen included either DAPT with aspirin and clopidogrel (DAPT-C) or DAPT with aspirin and ticagrelor (DAPT-T).

Characterization of Medication Discrepancies and Interventions Resulting From Pharmacy-Led Medication Reconciliation in the Critical Care Setting.

Medication reconciliation has been shown to reduce medication-related errors in hospitalized patients, but the impact of pharmacy-led medication reconciliation in the intensive care unit (ICU) has not been extensively studied. This was a retrospective chart review of patients with a pharmacy-led medication reconciliation on admission to an ICU between January 1 and March 31, 2018. Pharmacy-led medication reconciliations were completed by pharmacists, pharmacy residents, and pharmacy students.

Evaluation of Dexmedetomidine's Effect on Temperature in Obese Critically Ill Patients.

Previous literature showed an association between hyperthermia and dexmedetomidine (DEX) use for ongoing sedation in non-obese patients. The purpose of this study is to evaluate DEX's effect on temperature in obese critically ill patients. This single center, retrospective, cohort study included patients ≥18 years, admitted to a surgical or medical ICU, received DEX for ≥8 hours as a single continuous infusion sedative, and weighed ≥120% of ideal body weight.

Safety and Efficacy of Urea for Hyponatremia.

Urea is an alternative for treatment of hyponatremia however, its use has not been widely studied. The purpose of this study was to evaluate the safety and efficacy of urea for the treatment of hyponatremia. A retrospective cohort of patients with hyponatremia (serum sodium <135 mEq/L) of any cause who received at least 1 dose of urea during hospitalization and no prior use of urea.

Clinical Advanced Pharmacy Practice Experience Rotations During COVID-19: Evaluation of a Transition to Virtual Learning.

BackgroundAll Advanced Pharmacy Practice Experience (APPE) pharmacy rotations at a large academic medical center were converted to virtual experiences during the beginning of the coronavirus disease 2019 (COVID-19) pandemic. This study aimed to describe information obtained through pre- and post-rotation surveys, implemented to improve experiences for future students who may be required to complete virtual APPE pharmacy rotations. A single-center, descriptive study was conducted at a 1382-bed academic medical center.

Review of Target-Specific Anticoagulation Reversal Agents.

Bleeding related to direct oral anticoagulants accounts for nearly half of emergency department visits annually and until recently there were no reversal antidotes available. As there continues to be a shift in prescribing practices away from warfarin, it is essential to have these reversal agents readily available for the treatment of life-threatening bleeds associated with these anticoagulants. In addition, for agents that continue to lack a targeted reversal agent (eg, low-molecular-weight heparin, antiplatelets, and new antithrombotics), it is imperative that research continues to evaluate improved reversal strategies.

Effect of desmopressin acetate on acute spontaneous intracranial hemorrhage in patients on antiplatelet therapy.

Purpose: To evaluate the impact of desmopressin acetate (DDAVP) on poor outcomes, hematoma expansion, and adverse events in patients diagnosed with a non-traumatic, antiplatelet-associated intracranial hemorrhage (ICH).

Methods: This was a multicenter, retrospective, propensity-matched cohort study comparing DDAVP to control in patients diagnosed with a non-traumatic ICH previously on antiplatelet therapy. Notable exclusion criteria included admission to trauma service, subarachnoid hemorrhages, confounding coagulopathic factors, and hematoma evacuation.

Machine Learning in Action: Stroke Diagnosis and Outcome Prediction.

The application of machine learning has rapidly evolved in medicine over the past decade. In stroke, commercially available machine learning algorithms have already been incorporated into clinical application for rapid diagnosis. The creation and advancement of deep learning techniques have greatly improved clinical utilization of machine learning tools and new algorithms continue to emerge with improved accuracy in stroke diagnosis and outcome prediction.

PHarmacist Avoidance or Reductions in Medical Costs in CRITically Ill Adults: PHARM-CRIT Study.

Unlabelled: To comprehensively classify interventions performed by ICU clinical pharmacists and quantify cost avoidance generated through their accepted interventions.

Design: A multicenter, prospective, observational study was performed between August 2018 and January 2019.

Setting: Community hospitals and academic medical centers in the United States.

Evaluation of energy intake compared with indirect calorimetry requirements in critically ill patients with acute brain injury.

Background: Nutrition support in critically ill patients with acute brain injury is vitally important because of known hypermetabolism. We aimed to describe energy and protein intake within the first 72 h in a broad neurocritical care population and compare energy intake with the indirect calorimetry (IC) resting energy expenditure (REE) target.

Methods: IC data, daily energy, and protein intake were collected through chart review over the first 7 days of hospital admission.

Supraprophylactic Anti-Factor Xa Levels Are Associated with Major Bleeding in Neurosurgery Patients Receiving Prophylactic Enoxaparin.

Background: Prior studies demonstrated reduced risk for venous thromboembolism (VTE) in neurosurgical patients secondary to prophylaxis with both heparin and low-molecular-weight heparin. The ability to monitor low-molecular-weight heparin by obtaining anti-factor Xa (anti-Xa) serum levels provides an opportunity to evaluate safety and efficacy. The aim of this study was to describe characteristics of patients who have anti-Xa levels outside of the goal range (0.

Pharmacy-Based Nursing Education Utilizing a Social Media Platform.

Social media has changed the way individuals communicate and recently multiple articles have been published highlighting the utilization of social media for education. To our knowledge, cross-discipline education utilizing these platforms has not been evaluated. The purpose of this study was to implement a pharmacist-led, social media-based nursing education program and evaluate the perceived value.

Management of tandem occlusions in patients who receive rtPA.

Background: Tandem occlusions exist in 17-32% of large vessel occlusion (LVO) strokes. A significant concern is bleeding when carotid stenting is performed in tandem with thrombectomy due the administration of antiplatelet agents such as glycoprotein IIb/IIIa inhibitors (GP2b3aI) after receiving rtPA, but data are limited in this setting.

Methods: A mutlicenter, retrospective chart review was conducted at two comprehensive stroke centers to assess the safety and efficacy of using GP2b3aI to facilitate carotid stent placement simultaneously with endovascular thrombectomy in patients who have received rtPA.

Evaluation of Dexmedetomidine Dosing in Obese Critically Ill Patients.

Background: Dexmedetomidine is a highly selective α-adrenoreceptor agonist that produces dose-dependent sedation, anxiolysis, and analgesia without respiratory depression. Due to these ideal sedative properties, there has been increased interest in utilizing dexmedetomidine as a first-line sedative for critically ill patients requiring light sedation.

Objective: To evaluate the ability to achieve goal intensive care unit (ICU) sedation before and after an institutional change of dosing from actual (ABW) to adjusted (AdjBW) body weight in obese patients on dexmedetomidine.

Use of Continuous Glucose Monitor in Critically Ill COVID-19 Patients Requiring Insulin Infusion: An Observational Study.

Context: The coronavirus disease 2019 (COVID-19) pandemic has created a need for remote blood glucose (BG) monitoring in the intensive care unit (ICU).

Objective: To evaluate feasibility and patient safety of a hybrid monitoring strategy of point-of-care (POC) BG plus continuous glucose monitor (CGM) in the ICU.

Design: Retrospective analysis.

PHarmacist Avoidance or Reductions in Medical Costs in Patients Presenting the EMergency Department: PHARM-EM Study.

Unlabelled: To comprehensively classify interventions performed by emergency medicine clinical pharmacists and quantify cost avoidance generated through their accepted interventions.

Design: A multicenter, prospective, observational study was performed between August 2018 and January 2019.

Setting: Community and academic hospitals in the United States.

Facilitators and Barriers to Nursing Implementation of Continuous Glucose Monitoring (CGM) in Critically Ill Patients With COVID-19.

Objective: We describe our implementation of a continuous glucose monitoring (CGM) guideline to support intravenous insulin administration and reduce point of care (POC) glucose monitoring frequency in the coronavirus disease 2019 medical intensive care unit (MICU) and evaluate nurses' experience with implementation of CGM and hybrid POC + CGM protocol using the Promoting Action on Research in Health Services framework.

Methods: A multidisciplinary team created a guideline providing criteria for establishing initial sensor-meter agreement within each individual patient followed by hybrid use of CGM and POC. POC measures were obtained hourly during initial validation, then every 6 hours.

Stress-Related Gastrointestinal Bleeding in Patients with Aneurysmal Subarachnoid Hemorrhage: A Multicenter Retrospective Observational Study.

Background/objective: Stress-related mucosal bleeding (SRMB) occurs in approximately 2-4% of critically ill patients. Patients with aneurysmal subarachnoid hemorrhage (aSAH) have a (diffuse) space-occupying lesion, are critically ill, often require mechanical ventilation, and frequently receive anticoagulation or antiplatelet therapy after aneurysm embolization, all of which may be risk factors for SRMB. However, no studies have evaluated SRMB in patients with aSAH.

Indirect Calorimetry Measurements Compared With Guideline Weight-Based Energy Calculations in Critically Ill Stroke Patients.

Background: Perturbations in resting energy expenditure (REE) among critically ill stroke patients are ill defined, and guidelines recommend weight-based dosing when indirect calorimetry (IC) is not feasible to estimate daily energy requirements. We aimed to determine whether guideline-recommended weight-based dosing provides adequate energy requirements compared with guidelines recommended IC target.

Methods: IC data was collected on stroke patients admitted to a neurocritical care unit.

Lorazepam timing for acute convulsive seizure control (LoTASC).

Introduction: Guidelines specify early administration of benzodiazepines (BZD) for the management of convulsive status epilepticus. The distinction between acute convulsive seizure and status epilepticus can be misconstrued resulting in BZD administration prior to a patient meeting criteria of status epilepticus. Early BZD administration may theoretically lead to systemic vital instability.