Evaluating the effects of a mindfulness mobile application on student pharmacists' stress, burnout, and mindfulness.

PURPOSE: Pharmacists report high levels of burnout. Mindfulness approaches have been demonstrated to have positive results in the general population and in other healthcare professions. However, limited studies have been performed evaluating mindfulness approaches in student pharmacists. The aim of this study was to evaluate the effectiveness of daily use of a mindfulness mobile application in improving student pharmacists' perceived stress, burnout, and mindfulness. METHODS: This study was a randomized, longitudinal, waitlist-controlled trial. The intervention group was asked to meditate using the mindfulness application Headspace daily for at least 6 weeks. The waitlist control group was asked to abstain from using the application for the entire study. Stress, burnout, and mindfulness were assessed using validated survey instruments at baseline, 6 weeks, and 10 weeks. A secondary outcome was to assess the persistence of application use after the intervention period. RESULTS: Fifty-six participants completed the study. The intervention group reported significantly lower scores on stress and burnout at 6 weeks compared to the control group. The intervention group also reported significantly higher scores on mindfulness. The differences in stress, burnout, and mindfulness persisted at follow-up. The mean percentage of students in the intervention group who used the application each day was 90% over the intervention period and 62% over the follow-up period. CONCLUSION: A mindfulness mobile application significantly improved student pharmacists' stress, burnout, and mindfulness with daily use. Most participants continued to use the application for 4 weeks after the end of the intervention. Positive effects on stress and mindfulness persisted even with decreased use.

Evaluating Fidelity to Comprehensive Medication Management in Pharmacy Education Courses Teaching the Patient Care Process.

Objective. To evaluate fidelity to the comprehensive medication management (CMM) framework in a patient care skills course by using CMM essential functions to analyze the domains of content and competency.Methods. A mixed methods approach was used to compare the curriculum of the Pharmacist's Patient Care Process II skills course to the nationally developed CMM framework. The content of the course curriculum was mapped to the CMM framework and the percentage of omissions and deficiencies were calculated. Student competency was analyzed using pharmacy students' assessment scores.Results. Of the 102 class hours in the PPCP II course, 41.5 hours (40.7%) were spent teaching CMM content. Deficiencies in and omissions of content from the CMM framework were calculated at 14.3%, indicating an overall alignment with the CMM framework of 71.4%. For the competency domain, the percentage of students initially achieving competence ranged from 76.6% to 98.7% on formative assessments in 2018-2019 and 2019-2020, combined academic years. For the summative assessment, 87.5% in 2018-2019 and 69.2% in 2019-2020 achieved competency on their first attempt, with levels rising significantly to 98.8% and 98.7%, respectively, after remediation. Overall, 98.7% of students achieved competency in CMM-related course curriculum.Conclusion. About 70% of the CMM framework for the core domain of content can be covered in approximately 40 hours of direct curricular time, and the majority of students can achieve competency. The omissions of and deficiencies in CMM content identified in this study highlight opportunities for course improvement. Remediation of students with deficient skills resulted in a significant improvement in the percentage of students achieving competence in CMM.

Chemotherapy order second check and error discovery rates by pharmacists and technicians.

BACKGROUND: The American Society of Health-System Pharmacists suggests that pharmacy practice models allow pharmacists to be readily available as organizational leaders. This project aimed to identify potential process improvements to increase pharmacist availability to perform more clinical activities. OBJECTIVE: We evaluated the effectiveness of pharmacy technicians performing chemotherapy second checks at an outpatient infusion clinic. PRACTICE DESCRIPTION: Intermountain Medical Center is a Level 1 Trauma Center. The infusion clinic treats a variety of oncology indications, with solid organ tumors being most prevalent. At Intermountain Healthcare, a second pharmacist reverifies all chemotherapy orders for accuracy of drug, dose, preparation, and administration instructions. PRACTICE INNOVATION: Pharmacy technicians are in a unique position to assist with chemotherapy second checks because they are already knowledgeable in compounding and reviewing chemotherapy. This would be particularly useful in rural settings where staffing is sparse. EVALUATION METHODS: This was a single-center prospective analysis of chemotherapy second-check processes at an outpatient infusion clinic. Once chemotherapy orders were sent to the infusion clinic, first and second checks were completed to verify the correct patient, medication(s), dose calculations, diluents, administration rates, volumes, and other instructions. The chemotherapy first checks were completed by a pharmacist. The second checks were completed by a second pharmacist and a chemotherapy-trained certified pharmacy technician. The second checks by the pharmacist and technician were compared to determine if they were in agreement regarding error identification. Any disagreements found between the 2 second checks or between the first check and either of the second checks were discussed before compounding. We evaluated whether a chemotherapy-trained pharmacy technician could identify the same errors as a pharmacist. RESULTS: The Cohen kappa test was used to determine rater agreement between the pharmacist and technician second checks. The kappa value measure of inter-rater reliability between pharmacist and chemotherapy-trained pharmacy technician was excellent (kappa = 0.88, P < 0.001). They agreed 96.8% of the time, with technicians correctly identifying more errors. CONCLUSION: This project illustrates that chemotherapy-trained pharmacy technicians may be capable of performing chemotherapy second checks as accurately as pharmacists.