Reprint of: Impact of an HIV pre-exposure prophylaxis dashboard on veteran PrEP enrollment.

Background: Pre-exposure prophylaxis (PrEP) is highly effective at reducing the risk of human immunodeficiency virus (HIV) acquisition in at-risk individuals; however, it is largely underutilized. The Veterans Health Administration has created an HIV PrEP dashboard to identify at-risk veterans in attempt to increase PrEP enrollment.

Objective: This study aimed to determine whether the use of an HIV PrEP dashboard would prove effective at increasing PrEP enrollment at a single facility.

Case Report: Cefepime Induced Neurotoxicity Following a Change in Infusion Time.

Cefepime is an antibiotic associated with cefepime induced neurotoxicity (CIN), particularly in those with reduced renal function, or in cases of inappropriate medication dosing. This report describes a case of CIN associated with a change in infusion duration from 180 to30 minutes, which to the best of our knowledge has not been previously reported in the literature. A 73-year old male was treated with extended infusion cefepime over 180 minutes while hospitalized with recurrent pneumonia.

Impact of an HIV pre-exposure prophylaxis dashboard on veteran PrEP enrollment.

Background: Pre-exposure prophylaxis (PrEP) is highly effective at reducing the risk of human immunodeficiency virus (HIV) acquisition in at-risk individuals; however, it is largely underutilized. The Veterans Health Administration has created an HIV PrEP dashboard to identify at-risk veterans in attempt to increase PrEP enrollment.

Objective: This study aimed to determine whether the use of an HIV PrEP dashboard would prove effective at increasing PrEP enrollment at a single facility.

Lack of correlation between standardized antimicrobial administration ratios (SAARs) and healthcare-facility-onset infection rates in Veterans Affairs medical facilities.

We detected no correlation between standardized antimicrobial administration ratios (SAARs) and healthcare facility-onset infection (HO-CDI) rates in 102 acute-care Veterans Affairs medical centers over 16 months. SAARs may be useful for investigating trends in local antimicrobial use, but no ratio threshold demarcated HO-CDI risk.

Incorporation of Clinical Staff Pharmacists in the Emergency Department Sepsis Response at a Single Institution.

Background: Sepsis is a medical emergency in which timely, appropriate antibiotic therapy improves patient outcomes. While the addition of emergency department (ED) pharmacists has been found to optimize timely antimicrobial therapy in patients with sepsis, the role of clinical staff pharmacists (CSPs) in the sepsis response has not been studied.

Methods: We implemented a process of incorporating CSPs in sepsis antimicrobial management in the ED.

Comparing Anti-Factor Xa and Activated Partial Thromboplastin Levels for Monitoring Unfractionated Heparin.

Lab tests such as activated partial thromboplastin time (aPTT) or anti-factor Xa (anti-Xa) levels are typically used to monitor intravenous unfractionated heparin (IV heparin), with recent evidence suggesting that anti-Xa levels may provide a more accurate measure of anticoagulation. The Lexington Veterans Affairs Health Care System transitioned from using aPTT to anti-Xa levels in January 2017. This study was conducted to evaluate the efficacy and safety of this change.

Outcomes From a Pharmacist - led Proton Pump Inhibitor Stewardship Program at a Single Institution.

Proton pump inhibitors (PPIs) are effective medications for acid-related disorders; however, they are also overused and may be associated with several adverse effects. A PPI stewardship program was implemented at one institution to combat the overuse of PPIs. The purpose of this study is to evaluate the effectiveness of an inpatient PPI stewardship program in reducing PPI use, both during hospitalization and upon discharge.

Implementation of a proton pump inhibitor stewardship program.

Purpose: The development and implementation of a proton pump inhibitor (PPI) stewardship program at a single institution are described.

Summary: Due to the overuse of PPIs and the increasing awareness of the adverse drug events associated with long-term PPI therapy, the pharmacy and internal medicine services of a medical center implemented a PPI stewardship program. All patients admitted to the internal medicine service were evaluated by the PPI stewardship team to determine if they had an appropriate indication for PPI continuation in the hospital as well as after discharge.

Outcomes After Implementation of an Alcohol Withdrawal Protocol at a Single Institution.

There are varying dosing strategies for the administration of benzodiazepines in the setting of alcohol withdrawal. In October 2014, a symptom-based alcohol withdrawal protocol (AWP) using the Clinical Institute Withdrawal Assessment of Alcohol, Revised (CIWA-Ar) scale was implemented at one institution. To evaluate the safety and efficacy of the AWP.

Comparison of Outcomes: Nurse-Driven vs. Physician-Driven Weight-Based Intravenous Heparin Protocol.

The transition from a physician-driven heparin protocol to a nurse- driven heparin protocol at one institution resulted in shorter times to therapeutic activated partial thromboplastin time (aPTT), increased time within goal aPTT range, and an increased percent- age of patients who ultimately achieved a therapeutic aPTT.