Children's Opioid Use at Home After Laparoscopic Appendectomy.

Background: To combat the opioid epidemic, prescribers need accurate information about pediatric home opioid requirements to manage acute pain after surgery. Current opioid use estimates come from retrospective surveys; this study used medication adherence technology (eCAP) to track home opioid use.

Purpose: To describe children's pain treatment at home after laparoscopic appendectomy, and to compare self-reported opioid analgesic use to eCAP data and counts of returned pills.

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.

Report on 2020 Safe to Touch Consensus Conference on Hazardous Drug Surface Contamination.

Purpose: The 2020 Safe to Touch Consensus Conference on Hazardous Drug Surface Contamination was convened in order to gather subject matter experts in the field of hazardous drug (HD) handling to develop consensus statements regarding surface contamination monitoring for adoption by stakeholders in the drug supply chain, policy, and healthcare arenas.

Summary: The Safe to Touch conference convened virtually on September 22, 24, and 26, 2020. An expert panel of healthcare providers with experience in HD handling, monitoring, and research; pharmacy and nursing operations; and medication safety led the conference.

Children's Pain at Home After Laparoscopic Appendectomy.

Background: Hospitalized children experience moderate-to-severe pain after laparoscopic appendectomy, but knowledge of children's pain experiences after discharge home is limited. Accurate pain assessments are needed to guide appropriate pain treatment.

Aims: To describe children's pain at home after laparoscopic appendectomy.

A case report of an STEMI mimicker in a patient presenting with haemoptysis and chest pain with metastatic myocardial infiltration and left ventricular mural thrombi.

Background: ST-elevation myocardial infarction (STEMI) requires timely coronary reperfusion but localizing ST-segment elevation (STE) can develop in clinical settings other than STEMI.

Case Summary: We report a case of a 66-year-old man, with a history of diabetes mellitus and arthritis presenting with haemoptysis and chest pain. The electrocardiogram (ECG) at presentation showed marked localizing STE but emergent cardiac catheterization showed no significant coronary artery obstruction and the serial serum cardiac troponin levels were within normal limits.

Comparison of provider satisfaction with specialty pharmacy services in integrated health-system and external practice models: A multisite survey.

Purpose: The purpose of this study is to obtain insight into providers' satisfaction with services offered by health-system integrated specialty pharmacies and to determine whether providers' perceptions of services offered under an integrated model differ from perceptions of external specialty pharmacy services.

Methods: A multi-site, cross-sectional, online survey of specialty clinic healthcare providers at 10 academic health systems with integrated specialty pharmacies was conducted. The questionnaire was developed by members of the Vizient Specialty Pharmacy Outcomes and Benchmarking Workgroup and was pretested at 3 pilot sites prior to dissemination.

Microbial Assessment of Health Care-Associated Pathogens on Various Environmental Sites in Patient Rooms After Terminal Room Disinfection.

We examined the microbial burden on hospital room environmental sites after standard (quaternary ammonium [Quat]) or enhanced disinfection (quat/ultraviolet light [UV-C], bleach, or bleach/UV-C). An enhanced terminal room disinfection reduced the microbial burden of epidemiologically important pathogens on high-touch surfaces in patient rooms, especially sites around the bed, better than standard room disinfection.

Measuring Female Veterans' Prepregnancy Wellness Using Department of Veterans Affairs' Health Record Data.

Objective: To estimate the feasibility of using measures developed by the Clinical Workgroup of the National Preconception Health and Health Care Initiative to assess women's prepregnancy wellness in a large health care system.

Methods: We examined Department of Veterans Affairs' (VA) national administrative data, including inpatient, outpatient, fee-basis, laboratory, pharmacy, and screening data for female veterans aged 18-45 who had at least one pregnancy outcome (ectopic pregnancy, spontaneous abortion, stillbirth, and live birth) during fiscal years 2010-2015 and a VA primary care visit within 1 year before last menstrual period (LMP). LMP was estimated from gestational age at the time of pregnancy outcome, then used as a reference point to assess eight prepregnancy indicators from the Workgroup consensus measures (eg, 3 or 12 months before LMP).

Cost-effectiveness of implementing routine hearing screening using a tablet audiometer for pediatric cystic fibrosis patients receiving high-dose IV aminoglycosides.

Cystic fibrosis (CF) patients who receive high-dose aminoglycosides can acquire inner ear damage and subsequent hearing loss. There is no current standard protocol for assessing ototoxicity in CF centers in the United States. To evaluate the cost-effectiveness of a pharmacist-implemented routine hearing screening for ototoxicity among pediatric patients using a clinically validated tablet audiometer to allow for earlier detection of hearing loss in an exploratory analysis.

A Systematic Review of Randomized Trials Investigating Methods of Postoperative Void Trials Following Benign Gynecologic and Urogynecologic Surgeries.

Objective: To perform a systematic review of randomized controlled trials (RCTs) studying postoperative void trials (VTs) following gynecologic and urogynecologic surgery to investigate (1) the optimal postoperative VT methodology and (2) the optimal time after surgery to perform a VT.

Data Sources: PubMed, Embase, the Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov.

Effectiveness and impact of a structured research approach for health-system pharmacy administration and leadership residents.

Purpose: Required competency areas, goals, and objectives for both postgraduate year 1 (PGY1) pharmacy residencies and postgraduate year 2 (PGY2) health-system pharmacy administration and leadership (HSPAL) residencies indicate the importance of research in the residency program by specifying it as a required part of the training process. Research is critical in the field of health-system pharmacy administration, which is built upon the principles of evaluation and assessment, ensuring that all activities implemented in an organization are evaluated through data collection and assessment to determine their impact. Additionally, the research structure provides residents the opportunity to share research broadly, and it also provides the platform for other institutions to implement successful ideas of interest to them.

Efficacy of a Bioresorbable Matrix in Healing Complex Chronic Wounds: An Open-Label Prospective Pilot Study.

Objective: The goal of this prospective clinical study was to assess the effectiveness of a novel bioresorbable polymeric matrix impregnated with ionic and metallic silver as a primary wound contact dressing in healing stagnant or deteriorating chronic wounds.

Materials And Methods: Thirty-two patients with a total of 35 chronic wounds undergoing treatment at the Wound Healing and Hyperbaric Center at Mission Hospital were recruited under a protocol approved by the institutional review board. The wounds included venous stasis ulcers, diabetic foot ulcers, postoperative surgical wounds, burn wounds, and chronic, nonpressure lower extremity ulcers.

Impact of a Nurse Care Coordinator Supporting a Clinical Pharmacist Practitioner in Further Managing HCV-Infected Patients.

Patients undergoing chronic hepatitis C treatment require monitoring to ensure that treatment is both safe and effective. However, many of these patients are lost to follow-up. The aim of this study was to investigate the impact of implementing a Nurse Care Coordinator's role in a pharmacy-based collaborative team to enhance the care of hepatitis C-infected patients.

Does XR injectable naltrexone prevent relapse as effectively as daily sublingual buprenorphine-naloxone?

YES. MONTHLY EXTENDED-RELEASE INJECTABLE NALTREXONE (XR-NTX) TREATS OPIOID USE DISORDER AS EFFECTIVELY AS DAILY SUBLINGUAL BUPRENORPHINE-NALOXONE (BUP-NX) WITHOUT CAUSING ANY INCREASE IN SERIOUS ADVERSE EVENTS OR FATAL OVERDOSES. (STRENGTH OF RECOMMENDATION: A, 2 GOOD-QUALITY RCTS).

Perioperative Bacterial Contamination From Patients on Contact Precaution in Operating Room Environment.

We investigated the microbial burden on the operating room environment when patients on contact precautions for a multidrug-resistant pathogen received surgery. Our study demonstrated that the perioperative environment was contaminated with aerobic bacteria and methicillin-resistant (MRSA) after surgery, and that MRSA persisted environmentally even after cleaning and disinfection, highlighting the need for meticulous cleaning and disinfection in the perioperative environment.

Loss of daptomycin susceptibility in clinical infection coincided with variants in .

Daptomycin (DAP) is key in treating multidrug-resistant infections. Diminished susceptibility to DAP is emerging among strains although mechanisms for non-susceptibility (NS) remain poorly understood. We report a case of persistent bacteremia in which loss of DAP susceptibility arose during prolonged treatment.

Suture thickness and transvaginal cervical cerclage outcomes.

Background: Cervical cerclage placement has been shown to benefit women who have cervical insufficiency, however, the best type of suture to use for transvaginal cerclage placement is unknown.

Objective: To evaluate the association between transvaginal cerclage suture thickness and pregnancy outcomes.

Study Design: Retrospective cohort study of women with a singleton, non-anomalous gestation who underwent history-, ultrasound- or physical exam-indicated transvaginal cerclage at a single tertiary care center (2013-2016).

Impact of embedded medication assistance program specialists on medication access in outpatient oncology clinics.

Introduction: Medication prior authorizations (PA) required by insurance payers can be time-consuming to complete and may lead to delays in treatment for cancer patients. The primary objective of this study is to assess the impact of Medication Assistance Program (MAP) specialists embedded in adult hematology and oncology clinics on the PA and financial assistance process.

Methods: This was a retrospective chart review study performed at a large academic medical center that examined medication referrals completed by MAP specialists in four hematology and oncology clinics.

Adverse Childhood Experiences as Predictors of Perceived Health: Assessing the ACE Pyramid Model Using Multiple-Mediation.

Background: Adverse Childhood Experiences (ACEs) have been shown to contribute to a litany of mental and physical health problems, including several chronic diseases and death, via a model known as the ACE pyramid. Many of the results of ACEs in the ACE pyramid are known contributors to poor perceived health, which has significant health implications. Despite these results, a possible link between ACEs and perceived health has not been examined to date.

A Systematic Review of Patient-Reported Outcomes in Primary Biliary Cholangitis and Primary Sclerosing Cholangitis.

Primary biliary cholangitis (PBC) and primary sclerosing cholangitis (PSC) are associated with decreased health-related quality of life and debilitating symptoms. These experiences can be defined as patient-reported outcome (PRO) concepts and measured using PRO instruments. We identified all PRO concepts and instruments used in the PBC and PSC literature.

Human-Centered Design for a Women's Health Screening Tool: Participant Experiences.

Objectives: Screening is a priority in primary care and women's health, and increasingly used for intimate partner violence. Integrating such routine screening into primary care screening may be challenging for clinicians. Human-centered design (HCD) is a participatory process emphasizing stakeholder input and is used increasingly in health care.