Characterizing the Perceived Need for Advanced Clinical Pharmacy Training in British Columbia.

Background: Currently in Canada there are limited opportunities for advanced clinical pharmacy training after a year 1 residency. Advanced training programs currently in existence are year 2 residencies, clinical Master's degrees, and Fellowships.

Objectives: To characterize the perceived need for advanced clinical pharmacy training in British Columbia and to determine the desired educational competencies to be gained through advanced training.

What Patients Want: A Qualitative Study of Patients' Perspectives on Optimizing the Hospital Discharge Process.

Background: Poor discharge planning can lead to increases in adverse drug events, hospital readmissions, and costs. Prior research has identified the pharmacist as an integral part of the discharge process.

Objectives: To gain patients' perspectives on the discharge process and what they would like pharmacists to do to ensure a successful discharge.

Characterizing Current and Optimal Involvement of Hospital Pharmacists in the Discharge Process: A Survey of Pharmacists in British Columbia.

Background: Transitions of care represent a vulnerable time when patients are at increased risk of medication errors. Medication-related problems constitute one of the main contributors to hospital readmissions. Discharge interventions carried out by pharmacists have been shown to reduce hospital readmissions.

Prioritizing Quality over Quantity: Defining Optimal Pharmacist-to-Patient Ratios to Ensure Comprehensive Direct Patient Care in a Medical or Surgical Unit.

Background: The expanding scope of practice of hospital pharmacists has contributed to improvements in patient care; however, workload remains a barrier to the provision of optimal pharmaceutical care. Established ratios to guide clinical pharmacy staffing on medical and surgical units are lacking in Canada.

Objectives: To determine the pharmacist-to-patient ratio that allows for provision of comprehensive pharmaceutical care to each patient on a medical or surgical unit and to determine which comprehensive care tasks can be delivered in settings where staffing is limited.

Insights into British Columbian Hospital Pharmacists Perspectives on the Discharge Process.

Transitions of care represent a vulnerable time for patients where unintended therapeutic changes are common and inadequate communication of information frequently results in medication errors. Pharmacists have a large impact on the success of patients during these care transitions; however, their role and experiences are largely absent from the literature. The purpose of this study was to gain a greater understanding of British Columbian hospital pharmacists' perceptions of the hospital discharge process and their role in it.

Community pharmacist perceptions of drug-drug interactions.

Background: Drug-drug interactions are preventable medication errors that can lead to serious negative outcomes for patients. Community pharmacists are uniquely positioned with their medication knowledge and role in prescription clinical assessment. However, workplace pressures and limitations related to computer systems can lead to drug-drug interactions being missed.

Discerning Clinician Perceptions of an Established Opioid Stewardship (DISCLOSE) Program.

Background: The Opioid Stewardship Program (OSP) was created to promote safe and rational prescribing of opioids, where the risks associated with providing opioids for patients must be balanced against the risk of patients experiencing uncontrolled pain. The pharmacist-led OSP was established at 2 Fraser Health Authority (FHA) sites, British Columbia, to provide clinical services through patient referrals and screening. The rate of acceptance of OSP pharmacists' recommendations has been high, but there was a need to assess clinicians' perceptions of the program.

Tetralogy of Fallot: A case study and billing and coding perspective using the 2021 updated fee schedule.

The Physician Fee Schedule was updated in 2021 by the Centers for Medicare and Medicaid Services. A case study on Tetralogy of Fallot, the most common cyanotic congenital heart defect, is presented with guidance in billing the office visit to reflect the current guidelines.

Ambulatory Heart Function and Transplant Patients' Perceptions of Drug-Drug Interactions: A Qualitative Study.

Background: Drug-drug interactions (DDIs) can cause adverse drug events, leading to hospitalizations and an increase in the risk of morbidity and mortality. Until now, patients' perceptions of DDIs have represented an understudied area of research.

Objectives: To explore patients' perceptions of DDIs and identify factors important to patients' understanding of their medications.

Evaluating a Pharmacist-Led Opioid Stewardship Initiative at an Urban Teaching Hospital.

Background: Deaths due to overdose from illicit drugs have risen in Canada, despite various community-led harm reduction programs. There have been limited pharmacist-led inpatient initiatives aimed at reducing opioid harm. The authors' group recently developed and implemented the Medication and Risk Factor Review, Optimize, Refer at Risk Patients, Educate and Plan (MORE) tool, a systematic checklist designed to help pharmacists follow and enhance the safety of in-hospital opioid prescribing.

Comparison of Clinical Importance of Drug Interactions Identified by Hospital Pharmacists and a Local Clinical Decision Support System.

Background: Drug-drug interactions (DDIs) may cause adverse drug events, potentially leading to hospital admission. Clinical decision support systems (CDSSs) can improve decision-making by clinicians as well as drug safety. However, previous research has suggested that pharmacists are concerned about discrepancies between CDSSs and common clinical practice in terms of severity ratings and recommended actions for DDIs.

Designing a Pharmacist Opioid Safety and Intervention Tool.

Background: Despite the recent increase in opioid overdoses across Canada, few pharmacy-led initiatives have been implemented to address issues related to opioid prescribing in the hospital setting.

Objectives: The primary objective of this study was to develop a clinical tool, intended for use by hospital pharmacists and informed by best practices from the literature, that would provide a structured approach to enhancing the safety of opioid prescribing. The secondary objective was to collect pharmacists' opinions about the feasibility and utility of this tool.

Establishing an Open Access Repository for Doctor of Nursing Practice Projects.

The Doctor of Nursing Practice (DNP) faculty at the George Washington University (GW) decided to create a digital DNP Project Repository for our students in 2016 based on the American Association of Colleges of Nursing (AACN) 2015 recommendations to do so. We describe the two-year process during which the DNP faculty and the GW librarians at our Health Sciences Library collaborated to create the DNP project repository. This article contains important information that was learned about digital institutional repositories, the criteria used in deciding to make the GW library's Health Sciences Research Commons the home for the repository, along with questions and concerns that arose during the process.

Hospital Pharmacists' Perceptions and Decision-Making Related to Drug-Drug Interactions.

Background: Pharmacists often overlook drug interaction alerts because of limitations in clinical decision support (CDS) software systems intended to detect evidence-based, clinically significant drug-drug interactions (DDIs). Alert fatigue, which occurs when pharmacists become desensitized to an overload of DDIs, may also contribute.

Objectives: To gain a better understanding of how pharmacists assess common DDIs and the extent to which computerized drug alerts affect their decision-making, as background for initiatives to overcome alert fatigue and improve detection of DDIs.

Learner : preceptor ratios for practice-based learning across health disciplines: a systematic review.

Context: Practice-based learning is a cornerstone of developing clinical and professional competence in health disciplines. Practice-based learning systems have many interacting components, but a key facet is the number of learners per preceptor. Different learner : preceptor ratios may have unique benefits and pose unique challenges for participants.

Identification of risk factors for nephrotoxicity in patients receiving extended-duration, high-trough vancomycin therapy.

Background: In the past, impurities in vancomycin formulations were thought to contribute to nephrotoxicity. In contrast, when current, purer formulations are dosed at conventional trough levels (i.e.

Development and validation of a novel vancomycin dosing nomogram for achieving high-target trough levels at 2 canadian teaching hospitals.

Background: Recent guidelines recommend a vancomycin trough (predose) level between 15 and 20 mg/L in the treatment of invasive gram-positive infections, but most initial dosing nomograms are designed to achieve lower targets (5-15 mg/L). Clinicians need guidance about appropriate initial dosing to achieve the higher target.

Objective: To develop and validate a high-target vancomycin dosing nomogram to achieve trough levels of 15-20 mg/L.

Evaluation of an alcohol withdrawal protocol and a preprinted order set at a tertiary care hospital.

Background: Alcohol withdrawal protocols involving symptom-triggered administration of benzodiazepine have been established to reduce the duration of treatment and the cumulative benzodiazepine dose (relative to usual care). However, the effects of a protocol combining fixed-schedule and symptom-triggered benzodiazepine dosing are less clear.

Objective: To assess the efficacy and safety of a combination fixed-scheduled and symptom-triggered benzodiazepine dosing protocol for alcohol withdrawal, relative to usual care, for medical inpatients at a tertiary care hospital.