Development and implementation of autoverification standardization in the adult and pediatric emergency department.

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Development and implementation of procedures for outpatient naloxone prescribing at a large academic medical center.

Purpose: An interprofessional initiative to operationalize outpatient naloxone prescribing at a large academic medical center is described.

Summary: The initiative was carried out by a work group of clinical pharmacists and pharmacy administrators in collaboration with physicians and nursing staff leaders from multiple practice settings. An opioid overdose risk-assessment guide was developed on the basis of literature review and expert opinion.

Using m-health tools to reduce the misuse of opioid pain relievers.

Background: Emergency department (ED) patients are among the many groups at risk for prescription drug overdose. There is limited research on how best to communicate with ED patients about options for pain management and the risks of opioids. The aim of this study is to pilot test a web-based, patient-centred educational programme that encourages the patient to have an informed discussion about pain medication options with their ED provider.

Implementation of an emergency department-based clinical pharmacist transitions-of-care program.

Purpose: The implementation of an emergency department (ED)-based clinical pharmacist transitions-of-care (TOC) program is described.

Summary: The intervention program consisted of collaboration between ED and ambulatory care pharmacists to provide patient-specific comprehensive medication review and education in the ED setting and to help ensure a coordinated transition to the ambulatory care setting by scheduling an ambulatory pharmacy clinic or home-based visit. Patients who sought care at an adult ED for an exacerbation of asthma, chronic obstructive pulmonary disease (COPD), or congestive heart failure (CHF) were assessed for issues with medication adherence or administration technique, patient-specific concerns regarding medication use, access to medications at discharge, the need for modification of chronic therapy, contraindicated medications, and vaccination status, if applicable.

Management of first-trimester complications in the emergency department.

Purpose: The pharmacologic management and the nonpharmacologic management of first-trimester complications in the emergency department are reviewed.

Summary: The obstetric complications most commonly seen in early pregnancy (less than 20 weeks' gestation) include ectopic pregnancy, threatened and inevitable abortions, and incomplete, complete, and missed abortions. The treatment options for ectopic pregnancy include expectant management, medical management with methotrexate, and surgery.

Strategies for implementing emergency department pharmacy services: results from the 2007 ASHP Patient Care Impact Program.

Purpose: Strategies proposed during a patient care impact program for implementing emergency department (ED) pharmacy services are described.

Summary: In June 2007, the American Society of Health-System Pharmacists developed a patient care impact program entitled "Introducing an Emergency Department Pharmacist into Your Institution" to provide experiential training to practicing pharmacists seeking to establish ED services in their institutions. Under the guidance of four mentors, 19 pharmacists from a variety of practice settings, including community-based hospitals and academic and tertiary-care-based institutions, were selected for participation the six-month program.

No decrease in clindamycin susceptibility despite increased use of clindamycin for pediatric community-associated methicillin-resistant Staphylococcus aureus skin infections.

A previous study at our institution revealed 98% of methicillin-resistant Staphylococcus aureus (MRSA) isolates were susceptible to clindamycin; however, beta-lactams were then the predominant empiric treatment. This follow-up chart review study examined subsequent staphylococcal skin and soft tissue infection treatment and susceptibility patterns over a 2-year period. Of 296 S.