Improving Medication History at Admission Utilizing Pharmacy Students and Technicians: A Pharmacy-Driven Improvement Initiative.

BACKGROUND: Because of the frequency of medication errors related to care transitions, patient-safety initiatives have recently focused on improving the patient medication list. Pharmacy student and technician participation in the medication-history process has been shown to improve the quality of medication histories. To improve patient care, a pharmacy-driven medication-history service utilizing a unique hybrid team of pharmacy students and technicians was launched at Inova Loudoun Hospital (ILH). OBJECTIVE: The objective of the service was to improve patient safety and therapy by providing the Best Possible Medication History (BPMH) for admitted acute-care patients. METHODS: Data for the medication-history service was collected for six months from July 2015 to January 2016. The service included pharmacy technicians and fourth-year pharmacy students using the BPMH approach to verify patients' allergies, medications, doses, and frequencies, and to ensure optimal documentation in the Electronic Health Record (EHR). Data on types and numbers of discrepancies and interventions were collected during the process. Readmission rates for the study group were calculated and compared to readmission rates for all patients. RESULTS: Out of 4,070 patients interviewed, 77.7% (3,162) had at least one discrepancy in their medication list. Per patient, the average number of medications was 7.47, with an average of 1.8 discrepancies. Pharmacy students identified more discrepancies per patient than pharmacy technicians, 2.3 versus 1.5, respectively. Readmission rates for patients interviewed by the medication-history team was lower than for all patients during the same period, as well as for all patients during the same period in the previous year. CONCLUSION: This pharmacy-driven medication-history service, staffed with pharmacy technicians and students using a structured BPMH approach, increased the accuracy of home-medication lists on patient admission. The service demonstrated a difference in the types of interventions provided by pharmacy students and technicians. Readmission rates were also lower for patients with completed BPMH.

Aid-in-dying practice in Europe and the United States: Legal and ethical perspectives for pharmacy.

This article briefly reviews 'aid-in-dying' options such as euthanasia and physician-assisted suicide in Europe and the US Physician-assisted suicide is now legal in four US States. Current practices, medications used and statistics relating to prescription frequency and death rates from the participating States are briefly discussed. This paper also examines the role of pharmacists in assisted suicides; legal, ethical and professional challenges that they face, and future implications on pharmacist education to enable them to make an educated decision about their involvement in aid-in-dying practices.

Use of Twitter to encourage interaction in a multi-campus pharmacy management course.

OBJECTIVE: To implement and assess the effectiveness of using Twitter to encourage interaction between faculty members, guests, and students in a pharmacy management course taught simultaneously on 2 campuses. DESIGN: Students were required to tweet a minimum of 10 times over several class sessions. The course instructor and guest professionals also participated. ASSESSMENT: More than eighteen hundred tweets were made by students, guests, and the instructor. Students tweeted most frequently with each other and found value in reading each others' tweets. One hundred thirty-one students completed an optional evaluation survey. Seventy-one percent indicated that Twitter was distracting, 69% believed it prevented note taking, and more than 80% indicated that it facilitated class participation and allowed an opportunity to voice opinions. CONCLUSION: Educators who wish to use Twitter in pharmacy courses must balance the potentially positive aspects of the technology, such as increased interaction among students, with potentially negative aspects, such as the interruptive nature of Twitter use and the large volume of tweets generated by a class assignment.

Comparison of two error-detection methods in a mail service pharmacy serving health facilities.

OBJECTIVES: To compare two dispensing error-detection methods in a mail service pharmacy and explore clues to the causes of near errors. DESIGN: Descriptive and exploratory study. SETTING: Mail service pharmacy serving health facilities, April 5-9, 2004. PARTICIPANTS: Technicians, pharmacists at a mail service pharmacy; nurses at health facilities served. INTERVENTION: Blinded, undisguised observation of prescription orders at a mail service pharmacy by a research pharmacist and student pharmacist. MAIN OUTCOME MEASURES: Prescription dispensing errors detected by pharmacist audit compared with errors reported by nurses at the health facilities served. RESULTS: Of the 3,337 prescription orders sampled, 16 (0.48%) contained one or more errors based on the observers' assessment and no errors were reported by nurses for these medications using incident reports. Error types detected by observation were compared with the data from incident reports for the 3 previous years. Extrapolating the findings of the observational study and comparing those data with the incident reports, significant differences were found for total dispensing errors, wrong strength errors, wrong dosage form errors, and wrong label instruction errors. Errors related to wrong drug were not significantly different between the observational and incidentreporting data. In observations of pharmacists at work in the mail-service pharmacy, proximity of look-alike/sound-alike drugs on storage shelves and inadequate lighting were potential causes of near errors. CONCLUSION: Pharmacist assessment of prescription orders detects more dispensing errors than nurse-based incident reports. The study identified clues to the causes of near errors occurring in a mail service pharmacy.