MRSA prevalence among healthcare personnel in contact tracings in hospitals.

Bakgrunn: I norsk helsevesen gjennomføres omfattende tiltak for å hindre spredning av meticillinresistente Staphylococcus aureus (MRSA). Vi ønsket å undersøke hvor mange smitteoppsporinger som gjøres rundt nyoppdagede MRSA-tilfeller hos pasienter og ansatte i sykehus, og hvor ofte smitteoppsporingene fører til ytterligere funn hos helsepersonell.

Materiale Og Metode: I denne retrospektive observasjonsstudien bidro smittevernenhetene ved åtte helseforetak i landets fire helseregioner med opplysninger om MRSA-funn hos helsepersonell etter gjennomførte MRSA-smitteoppsporinger.

A worrying trend in weight-adjusted paediatric antibiotic use in a Norwegian tertiary care hospital.

Aim: The World Health Organization recommends the defined daily dose (DDD) as the standard unit of measurement for antibiotic use, but this is not applicable in children. We aimed to assess paediatric antibiotic use in a Norwegian tertiary care hospital using a novel weight-adjusted method.

Methods: We obtained antibiotic purchase data from the hospital pharmacy and administrative data for all admissions from 2002 to 2009 to the paediatric wards at Oslo University Hospital, Rikshospitalet.

An overview and study of beneficiaries' knowledge, attitudes, and perceptions of the medicare part d benefit.

Purpose: Medicare beneficiaries' knowledge, attitudes, and perceptions (KAP) of the Medicare Part D prescription drug benefit have been under evaluation since the 2006 inception of the Part D benefit.

Objective: This study sought to examine beneficiaries' satisfaction with their Medicare Part D prescription drug plan, knowledge of the coverage gap, attitudes about the relative importance of certain insurance parameters, and overall perceptions of the Part D benefit.

Design: Cross-sectional, descriptive study design.

Hospital- and patient-related factors associated with differences in hospital antibiotic use: analysis of national surveillance results.

Background: Surveillance data of antibiotic use are increasingly being used for benchmarking purposes, but there is a lack of studies dealing with how hospital- and patient-related factors affect antibiotic utilization in hospitals. Our objective was to identify factors that may contribute to differences in antibiotic use.

Methods: Based on pharmacy sales data (2006-2011), use of all antibiotics, all penicillins, and broad-spectrum antibiotics was analysed in 22 Health Enterprises (HEs).

Cost variability of suggested generic treatment alternatives under the Medicare Part D benefit.

Background: The substitution of generic treatment alternatives for brand-name drugs is a strategy that can help lower Medicare beneficiary out-of-pocket costs. Beginning in 2011, Medicare beneficiaries reaching the coverage gap received a 50% discount on the full drug cost of brand-name medications and a 7% discount on generic medications filled during the gap. This discount will increase until 2020, when beneficiaries will be responsible for 25% of total drug costs during the coverage gap.

Assessing Medicare beneficiaries' willingness-to-pay for medication therapy management services.

Objectives: To assess Medicare beneficiaries' willingness-to-pay (WTP) for medication therapy management (MTM) services and determine sociodemographic and clinical characteristics influencing this payment amount.

Design: A cross-sectional, descriptive study design was adopted to elicit Medicare beneficiaries' WTP for MTM.

Setting: Nine outreach events in cities across Central/Northern California during Medicare's 2011 open-enrollment period.

Medicare Part D roulette: potential implications of random assignment and plan restrictions.

Background: Dual-eligible (Medicare/Medicaid) beneficiaries are randomly assigned to a benchmark plan, which provides prescription drug coverage under the Part D benefit without consideration of their prescription drug profile. To date, the potential for beneficiary assignment to a plan with poor formulary coverage has been minimally studied and the resultant financial impact to beneficiaries unknown.

Objective: We sought to determine cost variability and drug use restrictions under each available 2010 California benchmark plan.

Assessing quality of life in an ambulatory medicare population.

Objective: Medicare beneficiaries have unique health-related challenges causing significant impact on quality of life. This study examined the overall health-related quality of life (HRQOL) and differences in HRQOL between subgroups of an ambulatory Medicare beneficiary population.

Methods: Nine outreach events were held during the 2011 Medicare Part D prescription drug open-enrollment period, in which 397 beneficiaries were assisted with Part D plan evaluation and comprehensive medication therapy review.

Antibiotic resistance in hospitals: a ward-specific random effect model in a low antibiotic consumption environment.

Association between previous antibiotic use and emergence of antibiotic resistance has been reported for several microorganisms. The relationship has been extensively studied, and although the causes of antibiotic resistance are multi-factorial, clear evidence of antibiotic use as a major risk factor exists. Most studies are carried out in countries with high consumption of antibiotics and corresponding high levels of antibiotic resistance, and currently, little is known whether and at what level the associations are detectable in a low antibiotic consumption environment.

Impact of an elective course on pharmacy students' attitudes, beliefs, and competency regarding Medicare Part D.

Objective: To determine the impact of an elective course on pharmacy students' perceptions, knowledge, and confidence regarding Medicare Part D, medication therapy management (MTM), and immunizations.

Design: Thirty-three pharmacy students were enrolled in a Medicare Part D elective course that included both classroom instruction and experiential training.

Assessment: Students' self-reported confidence in and knowledge of Part D significantly improved upon course completion.

Reducing post-caesarean surgical wound infection rate: an improvement project in a Norwegian maternity clinic.

Background: During 2006 and 2007 the rate of caesarean section surgical wound infection was 17,4 % in Baerum Hospital.

Objective: The objective was to reduce the incidence to below the Norwegian national level of 8 %.

Design: The intervention (a quality improvement project) was implemented in September 2008.

Use of potentially inappropriate medications in an ambulatory Medicare population.

Objective: To determine the prevalence of potentially inappropriate medication (PIM) use by applying the Beers criteria in an ambulatory population of Medicare beneficiaries, and to identify the most common PIMs/PIM classes taken by this population.

Design: Cross-sectional, observational study.

Setting: Nine community outreach events throughout central and northern California.

Increased antibiotic use in Norwegian hospitals despite a low antibiotic resistance rate.

Objectives: Although antibiotic use and resistance are low in Norway, the situation risks changing for the worse. We investigated trends in antibiotic use and assessed them in relation to antibiotic resistance in Norway.

Methods: We drew on hospital pharmacy sales data to record antibiotic use from 2002 to 2007 in eight hospitals serving 36% of the nation's population.

Potential opportunity cost of neglecting to annually reassess Medicare Part D standalone prescription drug plan offerings: the price of contentment?

Objectives: To determine the (1) potential cost difference (opportunity cost [OC]) to Medicare-eligible beneficiaries enrolled in the lowest-cost standalone prescription drug plan (PDP) in 2007 between the cost of such plan in 2008 and the lowest-cost plan in 2008 and the (2) percentage of PDPs with the lowest estimated annual cost (EAC) in both 2007 and 2008.

Design: Descriptive exploratory study.

Setting: United States during 2007 and 2008.

Local hospital perspective on a nationwide outbreak of Pseudomonas aeruginosa infection in Norway.

Objective: To implement a system for monitoring of rare events based on statistical process control charts.

Design: Statistical process control plotting by g chart of clinical microbiology laboratory data.

Setting: Primary and secondary care Norwegian hospital with a 9-bed intensive care unit.

[An outbreak of methicillin-resistant Staphylococcus aureus infection in a maternity ward].

Background: Staphylococcus aureus is a frequent cause of serious infections. Methicillin-resistant S. aureus (MRSA) are resistant to almost all types of beta-lactam antibiotics and therefore represent a substantial medical problem.

Post-cesarean surgical site infections according to CDC standards: rates and risk factors. A prospective cohort study.

Objectives: The aim of this study was to document the true incidence of post-cesarean surgical site infections (SSI), according to the definition of the US Centers for Disease Control and Prevention (CDC), and to identify independent risk factors for infection.

Design: Prospective population-based cohort study in Norway. Setting.