Bupendra Shah

Journal Clubs During Advanced Pharmacy Practice Experiences to Teach Literature-Evaluation Skills

Objective. To determine pharmacy students’ attitudes and academic performance related to journal club during 2 advanced pharmacy practice experiences (APPEs). Design. Fourth-year pharmacy students were required to complete 3 journal club assignments during drug information and internal medicine APPEs. Assessment. A majority (91.3%) of the 105 students who responded to a 21-item survey instrument indicated that journal club assignments during the drug-information APPE were valuable to their understanding of research design and statistics. Students who completed the drug-information APPE before the internal medicine APPE scored higher on their understanding of the strengths and weaknesses and the clinical relevance of studies and had a higher learning slope (p = 0.01) than did students who completed the internal medicine APPE first. Conclusion. Incorporating journal clubs into APPEs is an effective means of teaching literature-evaluation skills to pharmacy students.

Achieving optimal influenza vaccination rates: a survey-based study of healthcare workers in an urban hospital

In the USA, more than 36 000 deaths and 114 000 hospitalisations result from the influenza virus annually. Healthcare workers have been identified as a key source of influenza outbreaks. Despite Centers for Disease Control and Prevention recommendations to vaccinate all healthcare workers, the rate remains low. A survey-based investigation of influenza vaccination rates and related factors was carried out in an urban community teaching medical centre. A total of 570 surveys revealed a 56.5% influenza vaccination rate among participants. Participants who received the vaccine had a significantly higher mean influenza knowledge score compared to those who did not receive the vaccine (P=0.003). Also, a relationship was identified between those who received the vaccine and the perception that the purpose of the vaccine is to prevent patients from being exposed to influenza (P=0.001). Lastly, hospital departments in which managers actively encouraged and facilitated vaccination had higher rates in general.

Perceptions, Barriers, and Knowledge of Inpatient Glycemic Control A Survey of Health Care Workers

Objectives: To assess knowledge and perceptions of health care workers regarding optimal care for patients with hyperglycemia and identify commonly perceived barriers for the development of a hospital-wide education program. Research Design and Methods: A cross-sectional design was utilized to survey health care workers involved in managing hyperglycemia in an urban, community teaching hospital. Each health care worker received a survey specific to their health care role. Results: Approximately 50% of questions about best clinical practices were answered correctly. Correct responses varied across disciplines (n, mean ± standard deviation [SD]), that is, physicians (n = 112, 53% ± 26%), nurses (n = 43, 52% ± 35%), pharmacists (n = 20, 64% ± 23%), dietitians (n = 5, 48% ± 30%), and patient care assistants (n = 12, 38% ± 34%). Most health care workers perceived hyperglycemia treatment to be very important and that sliding scale insulin was commonly used because of convenience but not efficacy. Conclusion: Knowledge regarding hyperglycemia management was suboptimal across a sample of health care workers when compared to clinical best practices. Hyperglycemia management was perceived to be important but convenience seemed to influence the management approach more than efficacy. Knowledge, perceptions, and barriers seem to play an important role in patient care and should be considered when developing education programs prior to implementation of optimized glycemic protocols.

Functions performed by paid pharmacy interns in hospitals in New York

PURPOSE The types of clinical and nonclinical activities performed by paid pharmacy interns in the hospitals in New York state were studied. METHODS In November 2008, a list of hospitals in New York was obtained from the website of the New York State Department of Health. A survey was sent to each hospitals pharmacy director requesting information on hospital characteristics and whether the pharmacy department employed nongraduate pharmacy interns. For those hospitals that employed pharmacy interns, questions were asked about the number of nongraduate pharmacy interns employed, the shifts worked by interns, whether there was a minimum work-hour requirement for interns, the functions routinely performed by interns, and the percentage of interns who remained employed at the hospital upon licensure. RESULTS Of the 184 surveys distributed, 96 responses (52.2%) were received. The majority of hospitals had 400 beds or fewer and were teaching institutions, and 45 employed pharmacy interns. The five functions reported most frequently were answering telephone calls (91%), preparing and distributing medications (82%), compounding nonparenteral medications (69%), compounding parenteral medications (62%), and responding to drug information queries (51%). The mean ± S.D. number of clinical activities performed by interns was 2.1 ± 2.1. The most frequently reported clinical activities were responding to drug information queries (51.1%), performing clinical interventions (33.3%), and completing adverse-drug-reaction reports (31.1%). CONCLUSION Hospital pharmacy departments in New York utilized paid pharmacy interns to perform a variety of functions, including clinical activities. While there appears to be recognition that interns can perform clinical activities, the mean number of such activities was relatively low.

Pharmacists Levels of Emotionality and Career Success Correlates An Exploratory Study

Objective: The objectives of this study were to (1) examine the relationships between Emotional Thinking Scale (ETS) scores and demographic variables such as income, years worked as a pharmacist, and hours worked per week and (2) determine the distribution of ETS scores among this sample of pharmacists. These objectives are significant to explore because they may provide important data regarding effective and ineffective pharmacist work-related behaviors that affect career and life success. Method: A convenience sample of practicing pharmacists was selected. Participants completed the 8-item ETS and a demographic survey. The ETS predicts how an individual’s thoughts might influence his or her emotions and behaviors. Researchers analyzed participant’s ETS scores with his or her demographic responses. Data were analyzed using SPSS statistical software. Results: One hundred twenty-five pharmacists completed the survey. Twenty-one percent of the sample scored between slightly high and very extremely high on the ETS. “often being incapacitated by strong feelings” correlated negatively with annual income r = −.309 (P = .008); “relying on feelings to deal with complex situations” correlated negatively with annual income r = −.253 (P = .026), with the “number of years practicing pharmacy” r = −.317 (P = .007), and “number of hours worked each week” r = −.317 (P = .007); and “focusing on details thus losing the big picture” was correlated negatively with annual income r = .215 (P = .05). These findings are consistent with the previous ETS research. Conclusion: The variables of interest in this study were negatively but significantly related. Emotional thinking scores decreased with pharmacy practice experience and may be counterproductive for career goals. Entry-level pharmacy education and continuing education programs may help develop self-awareness to this issue.

A Quantitative Professionalism Policy in a Community Pharmacy Introductory Pharmacy Practice Experience

Objective. To determine whether implementing a quantitative professionalism policy would lead to improved behaviors in an introductory pharmacy practice experience (IPPE) and to evaluate students’ attitudes about professionalism expectations in the IPPE. Design. A policy using quantitative parameters for assessing unprofessional behaviors was developed and implemented in the community pharmacy IPPE after discrepancies were identified in the way professional expectations were assessed. Assessment. The quantitative professionalism policy reduced the number of assignments submitted post deadline (p<0.05). There was no change in students’ attitudes towards professional behaviors after the implementation of the policy. Conclusion. The quantitative professionalism policy was effective in changing some of the students’ professional behaviors in an IPPE.

Reasons Why Herbal Users Do or Do Not Tell Their Physicians about Their Use: A Survey of Adult Ohio Residents

Background: Several studies have reported lack of patient–physician communication regarding herbal use. However, reasons for this lack of communication are not well understood. Objective: To determine, explore, and identify reasons for lack of patient–physician communication about herbal use. Methods: Using a cross-sectional design, a systematic sample of 1,000 adult Ohio residents was surveyed through a 29 item questionnaire. Survey items were adapted from earlier instruments evaluating complementary and alternative use. Descriptive and univariate statistics were run using SPSS version 10.0. Results: Of 210 usable responses, almost half (47.6%) of the participants reported that they were either currently using herbal products or had used them in the past, with 1 in 16 using herbal products daily. Forty-eight percent of these respondents indicated that they had never had a discussion with their physician about using herbal medicines. A similar percentage (45%) of individuals using herbal agents had not told their physicians about any of the products they used. The top 3 reasons for informing physicians of herbal use were that the physician needs to be aware of all of the products used, the physician may know whether herbals work, and the physician understands the interactions of herbals with prescribed drugs. The main reason that patients did not supply the information was that the physician did not ask them about it. Conclusions: Many patients do not inform their physicians about their use of herbal products unless asked. Physicians and other healthcare providers should therefore integrate inquiry about herbal product use as part of medication history.

Evaluation of Early Versus Late Postdischarge Medication Reconciliation on Readmission Rates and Emergency Department Visits

Background: The current literature speculates ideal postdischarge follow-up focusing on transitions from hospital to home can range anywhere between 48 hours and 2 weeks. However, there is a lack of evidence regarding the optimal timing of follow-up visit to prevent readmissions. Objective: The purpose of this study is to evaluate the impact of early (<48 hours) versus late (48 hours-14 days) postdischarge medication reconciliation on readmissions and emergency department (ED) use. Methods: In this retrospective study, data for patients who had a clinic visit with a primary care provider (PCP), clinical pharmacist, or both for postdischarge medication reconciliation were reviewed. Primary outcome included hospital use rate at 30 days. Secondary outcomes included hospital use rate at 90 days and hospital use rate with a postdischarge PCP follow-up visit, clinical pharmacist, or both at 30 days. Results: One hundred sixty patients were included in the analysis: 31 early group patients and 129 late group patients. There was no significant difference on hospital use at 30 days in patients who received early or late groups (32.3% vs 21.8%, P = .947). There was also no significant difference on hospital use at 90 days in patients in early versus late group (51.6% vs 50.3%, P = .842). The type of provider (PCP vs pharmacists) conducting postdischarge medication reconciliation did not show significance on hospital use at 30 days (19.9% vs 21.4%, P = .731). Conclusion: Results from this study suggest patients can be seen up to 14 days postdischarge for medication reconciliation with no significant difference on hospital use.