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DISCLAIMER: In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time. PURPOSE: To describe the implementation of a pharmacy technician career ladder and internal technician training program at UF Health Shands Hospital in Gainesville, Florida. SUMMARY: As the systems for providing care and receiving reimbursement become more complex, the ability to deliver comprehensive care in the most efficient and effective manner is critical. In order to maximize impact, pharmacists must practice at the top of their license. Recruitment and retention practices that support an optimized pharmacy technician workforce and continued expansion of technician roles are vital to advancement of pharmacy practice. This report describes the efforts to improve technician recruitment, professional development, and retention through the implementation of a technician career ladder and internal training program. The programs contributed to a reduction in technician rolling 12-month turnover rates from 26.72% in July 2015 to 13.1% in March 2023 (a reduction of 51%). Overtime hours as a percentage of total hours worked were reduced from 11.02% in July 2015 to 4.54% in March 2023 (a reduction of 59%). Improvements were noted in pharmacy technician job satisfaction, as evidenced by key employee engagement indicators including responses to the posed statement "Overall, I am a satisfied employee," with a mean score of 3.32 (on a scale of 0-5) in 2015 as compared to 4.2 in 2019 (a 21% increase). CONCLUSION: Implementation of a pharmacy technician career ladder and technician training program creates a sustainable and effective recruitment and retention pathway that may favorably impact technician job satisfaction, turnover, and career development opportunities.
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PURPOSE: The intent of this study was to evaluate the safety and efficacy of an intravenous (IV) potassium (K) dosing algorithm for hypokalemic critically ill trauma patients. METHODS: Adult patients, admitted to the trauma intensive care unit from June 2010 to October 2012 and who received IV K therapy according to a standardized dosing algorithm, were retrospectively evaluated. Patients who received IV K during resuscitation or following initiation of nutrition therapy, IV fluids containing >20 mEq/L of potassium, or medications known to alter K homeostasis or those with an arterial pH change >0.1, diarrhea, hypomagnesemia, renal impairment, or morbid obesity were excluded. RESULTS: In total, 715 patients were reviewed to obtain 100 evaluable patients. Serum K for patients with mild depletion (serum K, 3.5-3.9 mEq/L, n = 74) remained unchanged at 0.0 ± 0.3 mEq/L ( P = ns) following 46 ± 8 mEq. Serum K increased by 0.4 ± 0.3 mEq/L ( P = .001) following 78 ± 18 mEq during moderate depletion (serum K, 3-3.4 mEq/L). None of the patients experienced hyperkalemia (serum K, >5.2 mEq/L) postinfusion. The presence of traumatic brain injury (TBI) blunted the response to IV K for mild K depletion as only 26% had an increase in serum K compared with 55% of patients without TBI ( P = .025). CONCLUSIONS: The Nutrition Support Service-guided IV K dosing algorithm was safe for patients with mild and moderate hypokalemia and efficacious for those with moderate hypokalemia. Further study in patients with severe hypokalemia (serum K, <3 mEq/L) is warranted.
