Impact of a pharmacy technician on an interprofessional antithrombotic stewardship program at an academic medical center.

PURPOSE: The need for monitoring and standardization of anticoagulation management has garnered the attention of national organizations, driving the implementation of antithrombotic stewardship programs (ASPs). Established ASPs have highlighted interdisciplinary collaboration between physicians, nurses, and pharmacists and demonstrated financial benefits and positive patient care outcomes. While pharmacy technicians are key members of the pharmacy profession, they are rarely utilized to expand clinical programs. The aim of this report is to describe the impact of adding a pharmacy technician to an ASP at an academic medical center. SUMMARY: The departments of pharmacy and quality at West Virginia University Hospitals (WVUH) developed a business plan and financially justified an ASP. The ASP was implemented in January 2022 and consisted of 2 full-time clinical pharmacist specialists, 1 full-time clinical pharmacy technician, 2 full-time clinical nurse specialists, and 1 part-time physician medical director. The clinical pharmacy technician's primary role was to review patients' sequential compression device (SCD) compliance and newly started oral anticoagulants prior to discharge. The clinical nurse specialists educated patients newly started on oral anticoagulants within 24 hours of discharge and triaged any postdischarge medication access issues. The medical director provided high-level program oversight and acted as a clinical consultant on complex patient cases. In the first 6 months after the program's implementation, the clinical pharmacy technician made 174 recommendations to the clinical pharmacist specialists regarding discharge transitions of care and assessed SCD compliance in 246 patients. Of the 246 patients assessed, 217 patients (88%) were deemed to be noncompliant. CONCLUSION: The pharmacy department at WVUH successfully justified and implemented an interprofessional ASP at an academic medical center, which is the first ASP to date to incorporate a clinical pharmacy technician.

Is feeding the new play? Examination of the maternal language and prosody used during infant feeding.

The current study examined maternal language and prosody production during feeding (milk vs. solid foods) and playing with their infant compared to an adult-directed speech (ADS) baseline in 12 healthy full-term infants (6-13 months old). We recorded maternal language during 10 min of spontaneous speech across the four conditions. We further recorded maternal connected speech containing specific word targets, elicited through picture description, to attain prosodic measures. Results showed that mothers used significantly fewer verbs and more utterances per minute in the baseline condition compared to play or solid feeding conditions. Type token ratio was significantly higher during milk compared to play or solid feeding conditions and baseline was significantly higher than play. Vowel duration and peak fundamental frequency were significantly higher during play compared to ADS baseline. These findings suggest that maternal language and prosody changed across conditions, with feeding offering more lexical diversity than play. The most robust infant directed speech was observed during play and followed by the solid feeding condition, whereas it was not observed during the milk and ADS conditions. Identifying opportunities for maternal linguistic input is key to advancing infant development. These findings suggest that mealtime may provide such an opportunity for speech and language input.

Best Practices in Bridging Education: Multiple Case Study Evaluation of Postsecondary Bridging Programs for Internationally Educated Health Professionals.

AIMS: Bridging education for internationally trained professionals has grown in popularity, but little is known about promising practices for bridging education in allied health professions. This paper addresses this gap by examining the expected outcomes of effective bridging programs, the key features that contribute to their effectiveness, challenges faced by bridging programs, and the appropriate role of regulatory colleges, government, employers, and professional associations in bridging education. METHODS: We conducted a mixed-methods multiple case study analysis of seven bridging programs in Ontario, Canada, in five allied health professions: medical laboratory technology, medical radiation technology, diagnostic medical sonography, respiratory therapy, and physical therapy. RESULTS: Effective bridging programs are accessible and flexible in content and format. The key challenges include developing curricula tailored to participants' needs, identifying appropriate format for program delivery, obtaining clinical placements for participants, and achieving financial sustainability. Government, professional, and educational stakeholders should play a central role in bridging education planning and delivery. CONCLUSION: The success of a bridging program relies on two key components-program design and infrastructure. Partnerships with government, professional, and educational stakeholders facilitate the development of good bridging programs.

Chasing zero: our journey to preventing surgical site infection.

After an increase in methicillin-resistant Staphylococcus aureus infections was discovered at a health care facility in Arizona, a multidisciplinary team convened to investigate the underlying problem and work toward eliminating surgical site infections. The team investigated environmental factors, held inservice sessions to reinforce sterile technique, and made important changes to the facility culture in efforts to eliminate surgical site infections. The team's efforts were put into practice on October 30, 2008, and only one surgical site infection was identified in the following seven months.

Biologic therapy and screening for tuberculosis in a new service.

Plaque psoriasis is a common skin condition that can greatly affect quality of life. Biologic therapy is an effective treatment, but it poses risks to patients, particularly concerning latent infections such as tuberculosis (TB), which may be reactivated. Medical practitioners therefore need to screen patients before commencing a biologic therapy. There are a number of screening tools for TB infection, which vary in efficacy depending on the patient being screened, and some tests can give a false-negative result for TB infection. It is important to screen for TB and to take a good clinical and lifestyle history before commencing biologic treatment. This article discusses the above in the context of setting up a dedicated clinic to monitor patients on biologic therapy for plaque psoriasis.