Clinical Twisters: Transplant patient develops flu
January 23rd 2006A 55-year-old African-American man, T.F., presents to your ER with headache, fever (102?F), muscle aches, and cough; his symptoms have rapidly worsened since onset (24 hours). T.F. received the inactivated influenza immunization 10 days earlier but is diagnosed with influenza A. T.F. had a renal transplant several years ago. His current medicines include tacrolimus (Prograf, Astellas Pharma), prednisone, mycophenolate mofetil (MMF) (CellCept, Roche), and furosemide 40 mg daily. T.F.'s SrCr51.8. The resident is considering antiviral therapy and asks your opinion. What do you suggest?
Direct thrombin inhibitor urged for PCI patients
January 23rd 2006Percutaneous coronary intervention (PCI) encompasses a variety of procedures, including percutaneous transluminal coronary angioplasty (PTCA), intracoronary stenting, and atheroablative technologies used to diagnose and treat patients with coronary artery syndromes such as heart attacks and angina. In the United States, more than one million PCI procedures are performed annually, and it is estimated that about two million procedures are performed annually worldwide. Patients undergoing PCIs are at risk for developing blood clots in the coronary artery, which can result in a variety of complications including heart attack, emergency surgery, and even death.
Brace for unannounced JCAHO surveys
January 23rd 2006Hospitals and health systems accredited by the Joint Commission on Accreditation of Healthcare Organizations are getting ready for the first truly unannounced, no-appointment-necessary, on-site surveys. Under the new policy, JCAHO surveyors can show up anytime between Jan. 1, 2006, and Dec. 31, 2006. The only warning facilities will get is a 7:00 a.m. e-mail notification on the morning of the survey.
R.Ph.s get set for new MTM, new JCAHO standards
January 9th 2006While there was no "stop-the-presses" news to come out of the 40th ASHP Midyear Clinical Meeting and Exhibition in Las Vegas last month, which drew a record-setting 20,000 registrants, several themes emerged that clearly resonated with attendees.
Pharmacy thrives in all-digital hospital
December 12th 2005When pharmacy director Steve Sievert needs to talk to someone at Baptist Medical Center South (BMCS) in Jacksonville, Fla., he doesn't bother with the telephone. He just tells the Vocera hanging around his neck. The tiny wireless communications device either finds the person somewhere on the hospital campus or routes the request to voice mail.
Diuretics: Still first-line therapy for hypertension
December 12th 2005A revolution in the pharmacologic treatment of hypertension is under way, according to experts reporting at a conference called "The State of the Hypertension Nation," held recently in New York City. Here are some highlights from the conference.
RxHub and Siemens join to offer drug reconciliation
December 12th 2005In a timely marriage of technology and data, RxHub and Siemens Medical Solutions recently signed an agreement to provide outpatient medication records electronically to inpatient clinicians. The move takes place in anticipation of the medication reconciliation patient safety goal set this year by the Joint Commission on Accreditation of Healthcare Organizations for implementation in the nation's hospitals in January 2006.
New IV pump, software combo drives infusion safety
December 12th 2005A new wireless medication management system from Cerner and Hospira may significantly reduce intravenous pump errors. The new system integrates Cerner's bar-code point-of-care (BPOC) system with Hospira's smart pump to ensure that the right patient is getting the right dose of the right drug at the right time by the right route of administration.
Pharmacy thrives in all-digital hospital
December 12th 2005When pharmacy director Steve Sievert needs to talk to someone at Baptist Medical Center South (BMCS) in Jacksonville, Fla., he doesn't bother with the telephone. He just tells the Vocera hanging around his neck. The tiny wireless communications device either finds the person somewhere on the hospital campus or routes the request to voice mail.
Six hospitals win grants to fight nosocomial infections
November 21st 2005In a move to expand efforts to control hospital-acquired infections, the Pennsylvania Health Care Cost Containment Council (PHC4) recently awarded grants totaling $150,000 to six state hospitals. The hospitals will use the money to implement projects to reduce the number of surgical-site infections, Foley catheter-associated urinary tract infections, ventilator-associated pneumonia and central line-associated bloodstream infections, and ventriculostomy and/ or medically resistant staphylococcus infections, said PHC4 officials.
Six hospitals win grants to fight nosocomial infections
November 21st 2005In a move to expand efforts to control hospital-acquired infections, the Pennsylvania Health Care Cost Containment Council (PHC4) recently awarded grants totaling $150,000 to six state hospitals. The hospitals will use the money to implement projects to reduce the number of surgical-site infections, Foley catheter-associated urinary tract infections, ventilator-associated pneumonia and central line-associated bloodstream infections, and ventriculostomy and/ or medically resistant staphylococcus infections, said PHC4 officials.
Office of Pharmacy Affairs gains access to 340B data
November 21st 2005The government agency responsible for overseeing the 340B Drug Discount Program again has the power to access data on the drug prices charged to healthcare providers who serve underprivileged communities, following an intervention by Senator Chuck Grassley (R, Iowa).
Is use of these agents justified? Here are tips
November 21st 2005Having trouble rationalizing the use of popular but off-label critical care agents? A special session at the American College of Clinical Pharmacy's annual meeting explored evidence for the use of vasopressin, Factor VIIa, intravenous proton pump inhibitors, and dexmedetomidine (Precedex, Abbott Laboratories).
Federal bill would promote apology after medical errors
November 21st 2005Supporters of the notion that apologies are better than malpractice lawsuits got a boost in late September. Sens. Hillary Rodham Clinton (D, N.Y.) and Barack Obama (D, Ill.) introduced the National Medical Error Disclosure and Compensation (MEDiC) Act to encourage hospitals to apologize after medical errors and negotiate fair compensation.
Hospital safety project aims to save thousands of lives
November 21st 2005A new project in mid-Atlantic region hospitals puts the spotlight on reconciling medications for intensive care unit (ICU) and operating room patients. As part of a nationwide "100,000 Lives and Beyond" Collaborative, pharmacists who care for patients in Delaware, Maryland, Northern Virginia, and Washington, D.C., hospitals beginning in January 2006 will have the opportunity to formalize processes for getting a complete and accurate list of each patient's current home medications, including name, dosage, frequency, and route and comparing them to the physician's admission, transfer, and/or discharge orders.
Virginia health system wins award for new safety rules
November 21st 2005At Sentara Healthcare in Norfolk, Va., an aggressive program borrowed from the nuclear energy industry recently won the health system a prestigious patient safety award. Called "Culture of Safety," the program focuses on what its practitioners call behavior-based expectations (BBEs), or "Red Rules," emphasizing communication and accountability.
ICU patients at greater risk for adverse events
November 21st 2005The fast-paced complex environment of a hospital critical care unit presents significant patient safety challenges for healthcare practitioners. High-risk decisions are often made with incomplete patient data, and, because patients require high-intensity care, if something goes wrong, they have a higher risk of getting hurt.
New protocol says meds can help treat addiction
November 21st 2005Saying it's an exciting time for the use of medications to treat opioid addiction, the federal Substance Abuse & Mental Health Services Administration (SAMHSA) has released a protocol giving details of the clinical pharmacology, screening, treatment matching, and other aspects of recommended use.
Reducing RSV risk in preemies: Here's how
November 21st 2005According to the National Center for Health Statistics, premature births are at a record high. Combine that fact with the reality of the crowded living conditions in the wake of recent hurricanes and we may have a recipe for respiratory syncytial virus (RSV) disaster this coming season.
Clinical Twisters: Attaining pain relief for PHN
November 21st 2005A 70-year-old man, P.A., is seen in your ER with burning, stabbing, shooting pain on his lower back. He has recently had shingles; the emergency physician diagnoses his current discomfort as postherpetic neuralgia (PHN). The physician is debating what to prescribe and asks your opinion. You note from the patient's history that P.A. also takes donepezil (Aricept, Eisai) 10 mg, digoxin .125 mg, and benazapril 20 mg daily. What do you recommend?