Using Clinical Decision Support Within the Electronic Health Record to Reduce Incorrect Prescribing for Acute Sinusitis.

Purpose: Acute sinusitis has viral etiology in more than 90% of cases, but antibiotics are prescribed for more than 80% of adults in the United States. While applications of computer-assisted guidelines have been found effective in reducing inaccurate prescribing for acute respiratory infections, there is a paucity of research focused specifically on the utilization of electronic best practice alerts (BPA) in improving treatment for acute sinusitis.

Methods: This observational cohort study examined prescribing behavior for sinusitis at a single Federally Qualified Health Center 1 year prior and during the first year of implementation of a BPA in the electronic health record (EHR) reminding providers of the recommended treatment of sinusitis.

Enoxaparin dosing errors in the emergency department.

Background: The study aimed to determine the frequency of enoxaparin dosing errors for patients who had a measured emergency department (ED) weight compared to those who did not have a measured ED weight, and to determine if demographic variables (e.g., weight, height, age, English-speaking, race) impact the likelihood of receiving an inappropriate dose.

Characteristics That Define a Successful Pharmacy Resident as Perceived by Residency Programs.

Purpose: To identify the subjective and objective characteristics that pharmacy residency programs use to define a successful resident and to determine what percentage of their 2009-2010 residency class they felt were successful.

Methods: An electronic survey was sent via e-mail to all residency program directors (RPDs) of postgraduate year 1 (PGY1) and postgraduate year 2 (PGY2) pharmacy residency programs in the United States. A 3-part survey instrument was developed following validation of questions for clarity and reliability using a pilot survey.

Development of an opioid reduction protocol in an emergency department.

Purpose: Results of a study of an opioid-sparing protocol for acute pain management in the emergency department (ED) are reported.

Methods: The ED of a large hospital conducted a project, the "Opioid-Free Shift," to test a multimodal pharmacologic approach to analgesic therapy as an alternative to routine use of opioids. During a specified eight-hour period, all adults arriving at the ED with a complaint of pain were treated according to an opioid-sparing protocol based on principles of channel enzyme receptor-targeted analgesia (CERTA).

Before and After Study of Pharmacists' and Students' Knowledge of Two Novel Antidotes: High-Dose Insulin Euglycemia and Intravenous Fatty Acid Emulsion 20.

Purpose: To assess pharmacists' and students' knowledge of high-dose insulin euglycemia (HIE) and intravenous fatty acid emulsion 20% (IFE) and to see whether it improved after an educational intervention.

Methods: A survey to assess the knowledge about the use of HIE and IFE as antidotes was e-mailed to practicing pharmacists, pharmacy residents, and students prior to and following an educational intervention. Fact sheets on the antidotes were developed in conjunction with the New York City Poison Control Center and were used as the educational intervention in this study.

Feasibility of a pharmacy-based influenza immunization program in an academic emergency department.

Background: From September 2002 to August 2010, 13 patients who were discharged from the emergency department (ED) were immunized against influenza. This correlates with a time when pharmacists were not permitted to vaccinate patients in New York.

Objective: The objectives of this study were to determine the feasibility of a pharmacist-based influenza vaccination program in the ED, assess patients' willingness to be vaccinated by a pharmacist, and identify reasons for declination.

Evaluation and treatment of accidental autoinjection of epinephrine.

Purpose: A case of accidental autoinjection of epinephrine is described.

Summary: A 47-year-old man arrived at the emergency department after accidental injection of epinephrine with an autoinjector into his left thumb. His vital signs were stable at admission.