Assessing the impact of an electronic chemotherapy order verification checklist on pharmacist reported errors in oncology infusion centers of a health-system.

Purpose: Chemotherapies are medications with narrow therapeutic indices and potential for severe adverse events that account for at least 1 to 3% of medication errors in all adult and pediatric oncology patients. The use of an electronic chemotherapy order verification (ECOV) checklist can standardize the steps of chemotherapy verification by pharmacists, which can potentially increase medication error detection at the point of dispensing. This study evaluated the implementation of a standardized chemotherapy order verification checklist on pharmacist error reporting, particularly good-catches or near-misses type errors.

The RANA Model Revisited: How a Primary Nursing Model for Professional Psychiatric Nursing Practice Has Withstood the Test of Time.

Objective: This article revisits the responsible, accountable nurse with authority (RANA) model and its continued application to psychiatric-mental health nursing care nearly 30 years after its development. It will ascertain key elements of the model that remain in use today, while identifying parts of the model that have transformed over the years.

Methods: This article will also explore the theoretical underpinnings of the model, including Peplau's interpersonal relations theory.

Reply to Maase et al. Comment on "Jones et al. Application of a Novel Algorithm for Expanding Newborn Screening for Inherited Metabolic Disorders across Europe. 2022, , 20".

The commentary provided by Maase et al. [..

A New Approach to Objectively Evaluate Inherited Metabolic Diseases for Inclusion on Newborn Screening Programmes.

Newborn screening (NBS) programmes are essential in the diagnosis of inherited metabolic diseases (IMDs) and for access to disease modifying treatment. Most European countries follow the World Health Organisation (WHO) criteria to determine which disorders are appropriate for screening at birth; however, these criteria are interpreted and implemented by individual countries differently, creating disparities. Advances in research and diagnostics, together with the promise of new treatments, offer new possibilities to accelerate the expansion of evidence-based screening programmes.

Application of a Novel Algorithm for Expanding Newborn Screening for Inherited Metabolic Disorders across Europe.

Inherited metabolic disorders (IMDs) are mostly rare, have overlapping symptoms, and can be devastating and progressive. However, in many disorders, early intervention can improve long-term outcomes, and newborn screening (NBS) programmes can reduce caregiver stress in the journey to diagnosis and allow patients to receive early, and potentially pre-symptomatic, treatment. Across Europe there are vast discrepancies in the number of IMDs that are screened for and there is an imminent opportunity to accelerate the expansion of evidence-based screening programmes and reduce the disparities in screening programmes across Europe.

Horseshoe Fistulae in the Age of LIFT.

Background: Horseshoe fistula is a challenging benign anorectal condition to treat. The aim of this study was to assess the utilization and success of different definitive fistula repair techniques in the treatment of horseshoe fistula.

Methods: This was a retrospective case series which included all patients who were treated for horseshoe fistula from 2006 to 2019 at a single, tertiary care center and whom had at least one follow-up visit.

What Can an Aging Pouch Tell Us? Outcomes of Ileoanal Pouches Over 20 Years Old.

Background: Little is known about the long-term functional outcomes of restorative proctocolectomy.

Objective: The aim of this study was to examine ileoanal pouch outcomes 20 and 30 years postoperatively.

Design: This is a retrospective case series.

Optimization of the medication-use process for fentanyl patches at a small community hospital.

Purpose: To describe a community hospital pharmacy department's novel approach to addressing safe use of fentanyl patches in acute and subacute care patients.

Summary: Beginning in 2017, improvement opportunities were identified within the medication-use process for fentanyl patches at Cleveland Clinic Euclid Hospital. Prescribing was addressed through development of a procedure requiring an opioid status verification by a pharmacist for all fentanyl patch orders.

Expecting the Expected: Planning Considerations for Cleanroom Construction.

With a recent emphasis on sterile compounding regulatory requirements, a newly constructed space or renovations to an existing space may need to be considered in any pharmacy where sterile compounding occurs. Pharmacy leaders from two facilities within a health system outline their experience with important aspects of cleanroom renovation learned through the process. Identifying how to maintain sterile compounding operations during construction is required to continue patient-care services.

Descriptive Report of Individual State Responses to Personal Protective Equipment Shortages for Pharmacy Practice During the Covid-10 Pandemic.

The objective of this study was to describe the response by state boards of pharmacy pertaining to personal protective equipment shortages during the early phase of the COVID-19 pandemic. All webpages of state boards of pharmacy were independently reviewed for written guidance pertaining to personal protective equipment conservation strategies in sterile compounding and deviations from United States Pharmacopeia General Chapter <797> standards; each guidance was then reviewed for referenced sources. Of 52 state pharmacy regulatory bodies, 38 (73.

What Are the Cost Drivers for the Major Bowel Bundled Payment Care Improvement Initiative?

Background: The Bundled Payments for Care Improvement initiative links payments for service beneficiaries during an episode of care (limited to 90 days from index surgery discharge).

Objective: The purpose of this study was to identify drivers of costs/payments for the major bowel Bundled Payments for Care Improvement initiative.

Design: Discharges from the Medicare Standard Analytic Files of hospitals participating in the major bowel bundle of the Bundled Payments for Care Improvement initiative were analyzed.

How to Get Ahead: Early-Career Colorectal Surgeons Reflect on Their First Few Years in Practice.

Objective: To identify strategies and barriers to career progression in early-career colorectal surgeons.

Design: Qualitative research study performed via semi-structured interviews with early-career, board-certified colon, and rectal surgeons. Responses were analyzed, coded, and categorized to understand strategies towards career progression, perceived barriers to career progression, beliefs about case mix, and referral patterns.

What influences conversion to open surgery during laparoscopic colorectal resection?

Introduction: We analyzed the risk of morbidity and mortality in laparoscopic (Lap) conversion for colorectal surgery across a group of subspecialist surgeons with expertise in minimally invasive techniques.

Methods: We reviewed prospective data patients who underwent abdominopelvic procedures from 7/1/2007 to 12/31/2016 at a tertiary care facility. We identified procedures that were converted from Lap to open (Lap converted).

Evaluation of gravimetric-based technology-assisted workflow for nonhazardous sterile product preparation.

Purpose: The impact of a gravimetric-based technology-assisted workflow (TAWF) system on the nonhazardous compounded sterile product (CSP) error capture rate, production times, and pharmacy staff perceptions of compounding methods was evaluated.

Methods: For 2 weeks prior to TAWF implementation, staff used a punch clock to document production times with a volumetric method. Preimplementation error data were captured in a previous study; TAWF software captured error and time data in the postimplementation period.

What Is the Long-Term Follow-Up of Nonoperatively Treated Patients with Appendicitis?

In this study, we determine outcomes after nonoperative treatment of appendicitis. First, we abstracted data for patients discharged with a diagnosis of appendicitis from a tertiary care facility from August 1, 2007, through June 30, 2017. For patients treated nonoperatively, we collected additional medical treatment for appendicitis, future surgical treatment, and date of last follow-up.

Should They Stay or Should They Go? The Utility of C-Reactive Protein in Predicting Readmission and Anastomotic Leak After Colorectal Resection.

Background: Hospital readmission and anastomotic leak following colorectal resection have a negative impact on patients, surgeons, and the health care system. Novel markers of patients unlikely to experience these complications are of value in avoiding readmission.

Objective: This study aimed to determine the predictive value of C-reactive protein for readmission and anastomotic leak within 30 days following colorectal resection.

What do Young Colorectal Surgeons Value From Their CRS Residency Training?

Objective: Colorectal surgery (CRS) training has seen many changes over the years. This study sought to identify aspects of CRS residency curriculum that were most valued by recent graduates and what changes could be made to improve training.

Design: Semistructured interviews were performed with board-certified colorectal surgeons 2 to 7years removed from their CRS residency.

Evaluation of a gravimetric-based technology-assisted workflow system on hazardous sterile product preparation.

Purpose: The impact of a gravimetric-based technology-assisted workflow (TAWF) system on hazardous compounded sterile product (CSP) production time, staff perception of safety, and job satisfaction was evaluated.

Methods: For 2 weeks before implementation of a gravimetric-based TAWF, staff utilized an automated punch clock to document the time to prepare and check CSPs compounded volumetrically. Simultaneously, an anonymous, online survey was e-mailed to staff to evaluate their perceptions regarding the safety of volumetric preparation and satisfaction with their role preparing CSPs.

What Is the Relationship between Operative Time and Adverse Events after Colon and Rectal Surgery?

We propose that prolonged colorectal surgery operative times are associated with increased 30-day adverse events. We identified a cohort from the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) from January 2005 through December 2012. Patients who underwent colectomy with primary anastomosis were selected using CPT codes.

A pharmacy-led () chapter 800 compliance collaborative at an academic medical center.

Purpose: One academic medical center's efforts to move toward compliance with requirements of () chapter 800 through a multidepartmental collaborative initiative are described.

Summary: Requirements of general chapter 800 (enforceable as of December 2019) address the handling of hazardous drugs (HDs) throughout the entire operational and clinical cycle, from receiving to compounding, administration, and waste disposal. Due to the variety of pharmacy operational areas in which HDs are encountered at University of North Carolina Medical Center (UNCMC), multiple pharmacy managers oversee the safe handling of HDs.

What factors are associated with increased risk for prolonged postoperative opioid usage after colorectal surgery?

Background: Opioid-related deaths have increased substantially over the last 10 years placing clinician's prescription practices under intense scrutiny. Given the substantial risk of opioid dependency after colorectal surgery, we sought to analyze risk of postoperative prolonged opioid use after colorectal resections.

Methods: Between 2008 and 2014, patients undergoing abdominopelvic procedure with intestinal resection at a tertiary care facility were retrospectively identified.

Financial Effect of a Drug Distribution Model Change on a Health System.

Drug manufacturers change distribution models based on patient safety and product integrity needs. These model changes can limit health-system access to medications, and the financial impact on health systems can be significant. The primary aim of this study was to determine the health-system financial impact of a manufacturer's change from open to limited distribution for bevacizumab (Avastin), rituximab (Rituxan), and trastuzumab (Herceptin).