An Elective Course to Train Student Pharmacists to Provide Culturally Sensitive Health Care.

Objective. To design and implement an elective course that prepares student pharmacists to provide culturally sensitive health care by developing their knowledge, self-confidence, and clinical and communication skills for working with patients from various cultural backgrounds during community health screenings. Methods. In this one-credit-hour elective course, second- and third-year pharmacy students were taught about chronic disease states affecting various minorities, approaches to improve their communication with patients from various cultural backgrounds, and proper use of cardiometabolic equipment during health screening events. After a health screening event at the end of the course, knowledge scores, self-confidence, clinical skills, and communication skills were compared between students who took the elective course and those in a control group. A pre-post elective survey was administered to second- and third-year students enrolled in the elective course to assess differences in understanding, self-confidence, clinical skills, and communication skills. Results. The 31 students who completed the elective course performed better on the knowledge quiz questions than did the 31 students in the control group (response rate 100%). Self-confidence, and communication and clinical skills scores were higher among those who completed the elective course than those who did not. There was an increase in knowledge scores for all students enrolled in the course. Second-year students were just as confident in their abilities as third-year students by the end of course. Conclusion. An elective course focused on better preparing students to provide culturally sensitive health awareness through community health screenings improved students' overall knowledge, clinical skills, communication skills, and self-confidence.

Implementation of a cefazolin-based stewardship pathway for methicillin-susceptible Staphylococcus aureus bloodstream infections paired with infectious diseases consultation.

Methicillin-susceptible Staphylococcus aureus (MSSA) infections have been successfully treated both with cefazolin and antistaphylococcal penicillins; cefazolin appears effective in MSSA bloodstream infections (BSIs). Thus, our antimicrobial stewardship programme (ASP) implemented a clinical pathway supporting cefazolin use in MSSA-BSIs and restricting oxacillin use to infectious diseases (ID) consultation due to cefazolin's lower cost and more convenient dosing. This before and after quasi-experimental study was conducted to describe the impact on outcomes and process of care measures associated with implementing this pathway among patients with MSSA-BSI. Definitive treatment with cefazolin increased over the study period from 17.3% to 69.8% post-implementation. Clinical failure (5.8% vs. 2.3%; P = 0.62) and in-hospital mortality (3.8% vs. 0%; P = 0.50) were rare pre- and post-implementation. Median hospital length of stay among survivors was similar between pre- and post-implementation periods (P = 0.31). Duration of bacteraemia [median (IQR) 3 (2-4) days vs. 2 (2-3) days; P = 0.002] and rates of re-infection after culture clearance (9.6% vs. 0%; P = 0.06) were reduced post-implementation. Frequency of source control (P = 0.71) and time to source control (P = 0.52) were similar between study periods. Significant increases in ID consultations (33.3% [3/9] vs. 73.3% [22/30]; P = 0.047) and median (IQR) 24-h daily doses [2 (1-3) g vs. 6 (3-6) g; P < 0.01] were seen for patients treated with cefazolin post-implementation. ASPs may find implementation of a similar pathway to be an effective means of improving the care of patients infected with MSSA.