Purpose To describe the development, design, and implementation of a pilot preceptor development bootcamp and feedback related to its feasibility and impact on operational pharmacy preceptors. Summary The University of Texas MD Anderson Cancer Center designed and implemented a pilot preceptor development bootcamp for operational staff pharmacists serving as residency preceptors for longitudinal weekend staffing experiences. A systematic, multipronged approach was taken to identify preceptor development gaps and design a full-day bootcamp curriculum. The resultant curriculum was comprised of content in major functional areas including using the 4 preceptor roles, documenting performance, giving and receiving feedback, and dealing with difficult situations or learners. The impact of the pilot preceptor development bootcamp was assessed using survey methodology and qualitative feedback from debrief discussions. Conclusion Implementation of a pilot preceptor bootcamp program addressing major areas of precepting skill was well received, resulted in positive feedback from operational pharmacy preceptors, and was feasible to implement at a large academic medical center.
For pharmacists, the first years after graduation are spent developing their knowledge base, advancing as a practitioner, and honing their abilities as healthcare providers and drug information experts. New practitioners encounter many challenges during this time, which for many include publishing original research or reviewing manuscripts for colleagues and medical journals. Inexperience navigating the publication process, from submission to receipt of (and response to) peer review commentary, is often cited as a major barrier to timely publication of resident and new practitioner research. Serving as a peer reviewer in turn provides the new practitioner with insight on this process and can be an enlightening experience used to garner confidence in subsequently submitting their own formal manuscripts. A number of publications describing steps for peer review are available, however, many of these articles address more experienced reviewers or critique the peer review process itself. No definitive resource exists for new pharmacy practitioners interested in developing their peer review skills. The information presented in this summative guide should be used in conjunction with practice opportunities to help new practitioners develop proficiency at peer review.
Background: Medication errors are preventable events that lead to inappropriate medication use and potential patient harm. This is especially prevalent within the operating room (OR) where one practitioner is involved in the entire medication-use process. Despite recent implementation of BD Pyxis™ Anesthesia ES, Codonics Safe Label System, and Epic One Step at the University of Kentucky Healthcare (UKHC) to prevent medication errors, errors continue to be reported. Curatolo et al found human error was the most frequent cause of medication error within the OR. Clumsy automation may be an explanation for this, which imposes burdens and promotes work arounds. This study endeavors to assess potential medication errors via chart review to identify risk reduction strategies. Methods: This a single-center retrospective cohort review of patients admitted to a UK HealthCare Main Operating Room, defined OR1A-OR5A and OR7A-OR16A, who were administered medications from 8/1/2021 to 9/30/2021. Results: Over a 2-month period, 145 cases were conducted at UK HealthCare. Of the 145 cases, 98.6% (n = 143) involved a medication error and 93.7% (n = 136) of the errors involved a high-alert medication. The top 5 classes of drugs involved in errors were all high-alert medications. Lastly, 46.6% (n = 67) of cases had documentation that Codonics was utilized. In addition to analyzing medication errors, the financial analysis found that $3154.04 in drug cost was lost in the study period. When extrapolating these results to all BD™ Pyxis Anesthesia Machines at UK HealthCare, $107 237.36 of drug cost is potentially lost per year. Conclusions: These findings add to previous data that have described the increased rate of medication errors when conducting chart review rather than rely on self-reported data. In this study, 98.6% of all cases involved a medication error. In addition, these findings provide additional insight in the increased use of technology within the operating room despite medication errors still occurring. These results can be applied to like institutions to critically evaluate anesthesia workflow to determine risk reduction strategies.
BackgroundDalbavancin (DAL) is a long-acting lipoglycopeptide, which allows for up to 2 weeks of therapy from a single dose. Outside of its FDA-approved indication for the treatment of acute bacterial skin and skin structure infections (ABSSSI), there is a growing interest in the utilization of DAL for other indications, including catheter-related bloodstream infection (CRBSI). The long-acting formulation potentially facilitates patient discharge or admission deferral without the need for daily outpatient parenteral antimicrobial therapy (OPAT). However, there is limited experience reporting DAL utilization in an oncology population. The objective of this study was to report our experience with DAL in an oncology patient population at a National Cancer Institute (NCI) Designated Cancer Center.MethodsWe conducted a retrospective review of all patients receiving DAL therapy in June 2016–June 2017. The primary outcome was a clinical success at 30 days (complete/partial resolution of symptoms without readmission for a same/similar infection), with secondary outcomes including readmission rate, acute kidney injury (AKI) incidence (Acute Kidney Injury Network [AKIN] criteria) and additional antimicrobial use within 30 days.ResultsWe identified 76 unique subjects, with 77 unique infectious episodes, receiving 78 DAL doses. The majority of the subjects were male (57%), the median age was 61 years old, 55% had a solid tumor type and most were treated for ABSSSI (86%). Doses were administered inpatient 76% of the time and most patients received 1500 mg (90%). The most common pathogen isolated was Staphylococcus aureus (19%). Patients frequently received additional methicillin-resistant Staphylococcus aureus active oral antibiotics (39%). Clinical success was reported in 78% of infections. Potential DAL-related AKI was identified in 4 subjects (5%).ConclusionWe reported on the use of DAL in a variety of oncology patients at a major cancer center. Clinical success was often achieved in ABSSSI with a single DAL dose and nephrotoxicity was infrequently encountered. Limitations include the frequent use of additional, potentially active antimicrobials and difficulty in assessment of clinical success and AKI in patients after discharge.Disclosures All authors: No reported disclosures.
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