ABSTRACT
OBJECTIVE: To challenge the standard of practice by evaluating the identification of medication discrepancies found depending on type of access to an electronic health record (EHR). In other words, is there a difference in the number of discrepancies between a pharmacist with only access to the postacute long-term care (PALTC) EHR (ie, single-access pharmacist [SAP]) compared with a pharmacist with access to both the PALTC and hospital EHRs (ie, dual-access pharmacist DAP) In October 2018, the Improving Medicare PostAcute Care Transformation (IMPACT) Act mandated admission drug review (DRR) upon admission to a postacute, long-term care (PALTC) facility.
SUMMARY:This was a prospective study investigating the occurrence of medication therapy problems (MTP) identified by two different DRR processes; SAP versus DAP. Data were collected in a community hospital and a stand-alone PALTC facility. It was found that the DAP identified more safety-related medication needs and medication omissions than an SAP. There was a significant association between the type of access and whether a MTP (ie, yes or no) was discovered, the type of medication-related need, and MTP category.
CONCLUSION: These results strongly suggest that current standard of practice should change to require access to both hospital and PALTC EHR systems for a pharmacist completing the medication reconciliation. Until the gap in EHR interoperability is closed, the potential breakdown in communication associated with SAP places patients transitioning from hospital to PALTC facilities at increased risk for medication problems and accompanying adverse medication events.
Subject(s)
Electronic Health Records , Pharmaceutical Preparations , Humans , Medicare , Medication Reconciliation , Prospective Studies , United StatesABSTRACT
The main purpose of this study was to examine the relationship between socioeconomic status (SES), ACT test scores, and the National Council Licensure Examination-Registered Nurse (NCLEX-RN) through a mediated logistic regression model. ACT is often considered one of the strongest predictors of success on the NCLEX-RN. Data from nursing students (N = 1,176) at a large, Midwestern university were analyzed. The goal was to determine if the predictive power of ACT on the NCLEX-RN stems from the influence of SES on ACT. A significant indirect effect through the causal chain of Pell Grant eligibility (i.e., SES)âACTâNCLEX-RN was found.
Subject(s)
Education, Nursing, Baccalaureate , Licensure, Nursing , Social Class , Students, Nursing , Educational Measurement , Humans , Logistic ModelsABSTRACT
BACKGROUND AND PURPOSE: Literature addressing victim-bully dynamics suggests that subtle bullying is prevalent in health care, both in practice and educational settings. The complex dynamics of workplace bullying complicate its assessment. The purpose was to investigate the factor structure of the Pain Catastrophizing Scale (PCS) for modeling victim responses to subtle workplace bullying. METHODS: Nursing faculty members from multiple Midwestern universities (N = 116) completed the PCS online. RESULTS: The 3-factor PCS structure (i.e., Rumination, Helplessness, Magnification) developed to describe victim response to chronic physical pain was useful in describing victim response to the chronic psychological pain of bullying via confirmatory factor analysis (CFA). CONCLUSIONS: With minor modifications, the PCS represented the construct of victim response to bullying's psychological pain.
