Death education in selected health professions.

Health professionals have a high probability of working with populations experiencing death and other types of loss. Surveys of medical, nursing, pharmacy, dental, and social work schools in the United States to determine their offerings in thanatology revealed that the majority (with the exception of dentistry) offer some education on death and dying. Because most of the offerings are limited to one or two lectures, a high percentage of students are graduating with limited formal exposure in this area. However, offerings have come a long way since the early 1970s.

Using self-evaluation to maintain competence.

This limited study examined differences in pharmacists' competencies through self-assessment. By using self-assessment with specified objectives, pharmacists can target areas for CE programs. Pharmacists can then improve and maintain their competencies in these specific areas. A future study could focus on discovering the reasons some pharmacists do not feel comfortable in giving advice/information to other healthcare professionals.

Study of antipsychotic drug use in long-term care facilities.

We chose to conduct this study because neuroleptic use has not been well defined in nursing homes. To our knowledge, it represents the only attempt at implementing the AIMS procedure in a group of nursing homes. We have provided evidence for what appears to be reasonably typical use of antipsychotic medication in skilled and intermediate care facilities. Senility and dementia were the most common diagnoses noted for neuroleptic recipients. Inservice education had little, if any, impact on antipsychotic drug use. Efforts to reduce the incidence of inappropriate use of neuroleptics should be aimed at physicians. We do feel that nursing and administrative staff are now more aware than previously of the dangers of indiscriminate use of these drugs. We feel that, because of our efforts, nursing staffs are better able to detect the presence of TD in their geriatric residents. If our sample of patients is representative of the entire population of institutionalized elderly, the overall rate of neuroleptic-induced TD may be lower than once thought. Similarly, the use of regularly scheduled neuroleptics in this population may be lower.

Family physicians' attitudes toward death and the terminally-ill patient.

Family physicians often experience a continuing relationship with the terminally-ill patient. Like other physicians, they may experience difficulty in these relationships. We surveyed 441 family physicians practicing in South Carolina to determine their personal attitudes toward death, and their feelings and reactions toward terminally-ill patients and their families. Physicians aged 50 years and older had a significantly more positive attitude toward death than did physicians aged 25-34 years (p less than .05). In addition, more positive attitudes were present in physicians who had a strong religious orientation (p less than .002) or had received some death education instruction in medical school (p less than .002). The study suggests that the basic concepts of death and dying should be included in medical school curricula. In addition, a medical education series offering practitioners an opportunity to express their feelings about this topic might also be beneficial.

Death education in U.S. professional colleges: medical, nursing, and pharmacy.

Physicians, nurses, and pharmacists often practice in death environments. A questionnaire was mailed to 126 medical schools, 396 baccalaureate nursing schools and 72 pharmacy colleges to determine the extent of death education offerings in their curricula. A response rate of better than 80 percent was received. The majority of professional programs had some emphasis on thanatology which was initiated within the past decade.

Death education: a survey of U.S. colleges and schools of pharmacy.

This survey was conducted to assess the present state of death education available to pharmacy students at both the BS and PharmD degree levels. Eighty-five percent of the colleges and schools of pharmacy located in the United States provided information concerning: (i) attitudes toward teaching death education; (ii) present offerings; (iii) academic background of instructors and departments responsible for death education programs; and (iv) course information. It was determined that 38 colleges of pharmacy offered some form of death education in their curricula during 1985. However, only 12 schools offered a full semester course, and many schools offered death education as an elective through a discipline other than pharmacy. As a result, a majority of graduates are still leaving pharmacy schools without any instruction in death education. The implications of these and other findings are discussed.

Pharmacists' and physicians' responses to the South Carolina Product Selection Act of 1978.

The "Drug Product Selection act of 1978" became effective in South Carolina on January 1, 1979. All written prescription forms must be printed with two signature lines. Under the line at the left, "DISPENSE AS WRITTEN" must be printed. Under the line at the right, "SUBSTITUTION PERMITTED" must be printed. In addition, the pharmacist must receive the patient's consent before substitution can occur. This study investigated the impact of the Act on physicians' prescribing habits and pharmacists' responses to drug product selection initially and 3 months after enactment. The data were analyzed according to the drugs prescribed, permitted substitutions, physicians' specialties, use of correct prescription blank, drug category, date, and drug actually dispensed. Physicians permitted substitution for 27.19 percent of all prescriptions written. There were 499 prescriptions out of 1,835 authorizing substitutions. A total of 127 of these drugs were for single-source items, as 162 were written for generic items. In the remaining 210 prescriptions for brand name items, pharmacists selected another brand only 24 percent of the time.

Particulate contamination and stability of three additives in 0.9% sodium chloride injection in plastic and glass large-volume containers.

The effect of particulate matter and stability of three parenteral drugs upon addition to glass and flexible polyvinyl chloride containers of 0.9% sodium chloride injection was studied. Aminophylline, lidocaine hydrochloric and metaraminol bitartrate were added to the solution in therapeutic quantities using techniques normally practiced by the hospital pharmacist. Statistical comparisons of the amount of particulate matter present were made for each solution consisting of drug added to plastic and glass bottles, drug filtered through a 0.22-mum filter and then added to the solution in plastic bags, controls for bags and bottles, and solutions with adjusted pH values to simulate the pH attained after addition of the drug to the solution. A correlation appeared to exist between the quantity of particulate matter and the amount of unfiltered drug solution added to the large-volume parenteral containers. Differences in storage and handling had an influence on the initial quantity of particles found in the plastic bags, no significant change in concentration of the drugs occurred during the 24-hour test period.