Study to assess the impact of analytics software on operating room controlled substance management and drug diversion.

PURPOSE: This study investigated the impact of an advanced analytics software solution in the operating room (OR) on tracking and evaluating controlled substance discrepancies. The authors hypothesized that the software would increase identification of these discrepancies and improve the efficiency of the preexisting manual process. METHODS: In this evaluation comparing data from before to after implementation of the software, data were collected using the preexisting manual process for 50 days before implementation, followed by a 25-day period for acclimation to the new software, and ending with a 49-day postimplementation review period. Data collected included the total number of medication discrepancies, time required for discrepancy review and reconciliation by an OR analyst, types of discrepancies, and number of discrepancies leading to provider audits. RESULTS: Before implementation of the analytics software, there were 7,635 OR cases with a total of 674 charting discrepancies (8.83 discrepancies per 100 total OR cases) discovered across 439 OR cases. After implementation, there were 7,454 OR cases with a total of 930 charting discrepancies (12.48 discrepancies per 100 total OR cases; P < 0.0001) discovered across 680 OR cases. While discrepancies increased by 38%, the median review time for the OR analyst per case decreased (P < 0.0001) and the percentage of incidents resolved by the OR analyst increased by 14% while the number of cases requiring additional documentation by the provider decreased by 10%. CONCLUSION: Implementation of advanced analytics software in the OR significantly increased the number of controlled substance charting discrepancies identified compared to the preimplementation review process while increasing the efficiency of the OR analyst.

Creating a Pharmacy Internship: A Toolbox for Success.

OBJECTIVE: To describe available compensated student internships and provide guidance for new program development. METHODS: A search was conducted using PubMed, MEDLINE, and Google with the following search terms: pharmacy, intern, internship, and student. All English language publications were considered for inclusion. Articles describing IPPE or APPE student utilization were excluded. KEY FINDINGS: Pharmacy student internship programs are common in practice, though there are few with published outcome data. Most often, interns serve as pharmacist extenders and participate in activities that center around extension of pharmacy services within the institution. Development of new programs should include partnering with nearby pharmacy programs and state boards of pharmacy to develop a well matched curriculum and allow for interns to practice at the top of their license. Lastly, outcomes should be measured and disseminated for the benefit of the academy. Additional considerations for developing a student internship program and guidance are provided. CONCLUSIONS: Although in existence for decades, minimal published reports showcase institutional outcomes associated with student internships. No data is available to show the downstream effect an internship can have on direct patient care activities.

ACCP Template for Evaluating a Clinical Pharmacist.

ACCP is committed to ensuring that clinical pharmacists possess the competencies necessary to deliver comprehensive medication management in team-based, direct patient care environments. These competencies are divided into six essential domains: direct patient care, pharmacotherapy knowledge, systems-based care and population health, communication, professionalism, and continuing professional development. The 2016 ACCP Clinical Practice Affairs Committee has developed an evaluation tool that includes the assessable tasks of today's clinical pharmacists that fall within each domain. This instrument can be used by institutions, organizations, and others responsible for clinical pharmacist performance evaluation and professional development.

Right pulmonary artery agenesis and coronary-to-bronchial artery aneurysm.

Isolated unilateral pulmonary artery agenesis is a rare congenital anomaly that may be complicated with hemoptysis, recurrent pulmonary infections or pulmonary hypertension. To our knowledge the occurrence of a coronary syndrome associated with a coronary-to-bronchial artery saccular aneurysmal collateralization has never been described before. A 44-year-old female presented a congenital right pulmonary artery agenesis associated with a hypotrophic and multicystic right lung complicated with recurrent bronchitis. This patient had a coronary syndrome for which the coronary artery imaging showed a coronary-to-bronchial artery collateralization with an aneurysm at this level. It gives rise to a coronary syndrome by coronary steal. Two bronchial collaterals arising from a diaphragmatic artery and the subclavian artery were also found on the computed tomography (CT)-scan. This last collateral also showed another saccular aneurysm. We first performed an embolization of those two aneurysms in order to decrease the risk of hemorrhage and coronary steal, before performing a right pneumonectomy. In this case, the surgery was indicated because of the pathological lung and the risk of postembolization ischaemia. The postoperative course was uneventful and the patient was doing well six months later.