At 6 months after discontinuation of the pharmacist-managed anticoagulation service, the frequency of adverse events increased significantly, resulting in both an increased number of hospitalizations and an increased number of hospital days accrued. This coordinated anticoagulation program using a pharmacist reduced warfarin-related complications.

Numerous case reports have documented an enhanced hypoprothrombinemic effect caused by an interaction between fluoroquinolones (most notably, ciprofloxacin) and warfarin sodium. Conflicting data exist regarding the clinical significance of this interaction. Two patients who had elevated international normalized ratios after receiving concurrent levofloxacin and warfarin sodium are described.

3-Hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors are a frequently prescribed class of drugs that are generally well tolerated by most patients. A rare, yet serious side effect associated with these drugs is rhabdomyolysis. Although all HMG-CoA reductase inhibitors can cause this adverse effect, prevalence may differ among specific agents. Over a 16-month period, in three hospitals, 11 patients experienced cerivastatin-induced rhabdomyolysis, but no cases of rhabdomyolysis associated with any other HMG-CoA reductase inhibitors were reported.

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to 6. More than 375 clinical nurse specialists (CNSs), graduate faculty, nurse administrators, nurse researchers, and graduate students are expected to attend. This year's theme, ''CNS as Internal Consultant: Influencing Local to Global Systems,'' demonstrates the breadth and depth of CNS practice and leadership at multiple levels in organizations and on healthcare.A total of 142 abstracts were submitted for review, and 58 (not including student posters) were selected for either podium or poster presentations. Again, this year, there is a CNS student poster session; student abstracts will appear in a later issue of the journal. The abstracts addressed CNS practice in all 3 practice domains as described in the Spheres of Influence Framework for CNS Practice. Abstracts emphasized patient safety and quality care outcomes, leadership, CNS education, evidence-based practice, and new ways to shape CNS practice. Topics include CNS work activities incorporated into the 3 Spheres of Influence, the role of the CNS in developing clinical inquiry skills among staff nurses, use of simulation technology, strategies to maintain clinical excellence, the role of the CNS in National Database for Nursing Quality Indicators (NDNQI) activities, and many new and thoughtful ideas to support CNS education, practice, and research. Collectively, the abstracts represent the breadth, depth, and richness of the CNS's contribution to the well-being of individuals, families, and communities, as well as contributing to the advancement of the nursing profession.The conference abstracts are published to share new knowledge with those unable to attend the conference. As you read each abstract, appreciate the intellectual talent and clinical scholarship of your CNS colleagues who are advancing the practice of nursing and contributing to the health of society through improved outcomes for patients and healthcare organizations. We Purpose/Objectives: This poster will describe the development of a unique advanced practice role, limb loss clinical nurse specialist (CNS), at Duke University Medical Center.Significance: The numbers of people with amputations are increasing dramatically, with an estimated 1.9 million people in the US living with limb loss, 70-80 % of whom demonstrate comorbid diabetes and peripheral arterial disease. This population spans several medical and surgical services and requires interdisciplinary collaboration. Education, coordination, and support are essential for successful integration into living well, work, sporting, and community activities.Background/Rationale: CNS positions have been created in many specialties to coordinate services; at our large tertiary medical center, it was decided to hire an advanced practice nurse with interest and experience in orthopedics to develop resources and provide support for amputees. Patients' involvement begins preoperatively and continues throughout their treatment trajectory.Description: Creating this position was the first challenge, as no professional peers for benchmarking and no c...