Medication Transitions of Care in Trauma and Acute Care Surgery Patients.

Background: Although the benefits of improved transitions of care regarding medications are widely known, implementation is variable among inpatient settings and populations and requires an interprofessional effort. This article reviews the body of published research on challenges with medication history taking and reconciliation for inpatients requiring treatment of traumatic injuries or surgical intervention.

Review Of Evidence: A comprehensive search of PubMed and MEDLINE databases from inception to February 2021, the reference lists of qualifying articles, and PubMed's "similar article" suggestions were used to identify publications based on the following key terms: patient transfer, transitional care, medication reconciliation, general surgery, and surgical procedures.

Novel use of a sequential standardized oral board exam to assess PGY1 resident progression.

Purpose: A standardized oral board exam was created to longitudinally assess postgraduate year 1 (PGY1) pharmacy residents in key domains.

Summary: We provide a descriptive review of a novel oral board exam administered quarterly to our PGY1 pharmacy residents. Preceptors from our core rotations (internal medicine/infectious diseases, adult critical care, oncology, pediatrics, and administration/health policy and outcomes) developed questions based on situations commonly encountered by PGY1 residents to assess residents' communication; the content of their response, assessment, and plan; and coachability.

Impact of Opioid Restrictions During a Critical Drug Shortage Period: Interrupted Time Series for Institutional Opioid Utilization.

Objectives: This study aimed to evaluate the impact of intravenous opioid product restrictions at an academic medical institution in an urban setting during the time of critical opioid shortages. We assessed the effect of ordering restrictions on inpatient opioid utilization measured by 1) changes in intermittent oral and injectable opioid product administration; 2) changes in total institutional opioid administration; and 3) changes in the utilization of individual restricted opioid agents.

Methods: This study is a single-center retrospective analysis by interrupted time series of institutional opioid utilization from 07/2017 to 06/2018.

Early bronchoalveolar lavage for intubated trauma patients with TBI or chest trauma.

Purpose: To evaluate the efficacy of an early bronchoalveolar lavage (E-BAL) protocol. BAL was performed within 48 h for intubated patients with traumatic brain injury or chest trauma. We hypothesized that E-BAL would decrease antibiotic use and improve outcomes compared to late BAL (L-BAL) triggered by clinical signs of pneumonia.

No difference in mechanical ventilation-free hours in critically ill patients who received intravenous, oral, or enteral phosphate replacement.

Purpose: To determine the impact on duration of mechanical ventilation (MV) and the need for reintubation after changing from intravenous (IV) to oral phosphate formulations, in response to a national shortage of IV phosphate.

Methods: A retrospective study was performed in adult patients who required MV for at least 48 hours.

Results: A total of 136 patients were included, with 68 patients in both the restricted phosphate group and unrestricted phosphate groups.

Early thrombin formation capacity in trauma patients and association with venous thromboembolism.

Unlabelled: Incidence of venous thromboembolism (VTE) in adult trauma patients is high despite mechanical and pharmacologic prophylaxis. We hypothesized that thrombin formation capacity as measured by calibrated automated thrombogram (CAT) is increased early in hospitalization and is associated with the development of VTE.

Methods: We conducted a prospective study in adult, critically ill trauma patients.

Intubated Trauma Patients Receiving Prolonged Antibiotics for Pneumonia despite Negative Cultures: Predictors and Outcomes.

Background: Despite the excellent negative predictive value of sterile respiratory cultures, antibiotics often are continued after negative endotracheal aspirate (ETA) or bronchoalveolar lavage (BAL) for critically ill trauma patients. We hypothesized that persistent elevation of the Clinical Pulmonary Infection Score (CPIS) would predict continued antibiotic therapy after a negative respiratory culture for intubated trauma patients, and that prolonged antibiotics would provide no benefit.

Methods: We performed a four-year retrospective cohort analysis (May 1, 2011-September 30, 2015), including patients from our trauma database with ETA or BAL, excluding patients with any infection other than pneumonia or bacteremia.

Challenges of Administering Pancrelipase in Pancreatitis Patients.

Objective: This study evaluated nutrition status to determine the impact of a novel approach using elemental nutrition compared to pancrelipase administration in patients with pancreatitis.

Methods: This retrospective study included adult patients with pancreatitis who were nil per os (NPO) and received elemental nutrition from August 2008 to 2010 (n = 24) or pancrelipase enzyme supplementation (PES) plus nonelemental enteral nutrition from August 2011 to 2013 (n = 41) at a large academic medical center. The primary outcome is the percentage of diarrhea-free days.

Pharmacologic anticoagulation reversal in the emergency department.

Anticoagulation therapies are 1 of the most commonly encountered therapeutic areas by health care professionals each day. One of the most important adverse effects of anticoagulation therapy is life-threatening hemorrhage, and it may result in visits to the emergency department. Some of the common reversal agents include Vitamin K, protamine sulfate, desmopressin, recombinant Factor VIIa, and prothrombin complex concentrates.

Evaluation of atrial arrhythmias following noncardiac thoracic surgery.

Atrial arrhythmias (AAs) after noncardiac thoracic surgery may be associated with increased mortality, length of stay (LOS), and health care expenditures. A retrospective analysis of adult patients who underwent thoracotomy at our institution from January 2002 to June 2008 was performed. Of 820 patients identified, 112 (14%) developed an AA.

An analysis of telephone interview data collected in 1992 from 820 women who reported problems with their breast implants to the food and drug administration.

How health care providers deal with concerns and feelings of women who have problems with their breast implants affects the women's satisfaction with their breast implants, yet in 1992 little was known about the concerns and feelings of these women. A qualitative analysis of in-depth telephone interviews conducted in 1992 with 820 women from all regions of the United States who reported problems with their breast implants to the Food and Drug Administration and responded to an invitation to be interviewed provided data. Respondents were primarily 40 to 69 years of age at the time of interview, Caucasian, married, and educated beyond high school.