Characterizing the role and associated stakeholder perceptions of a novel pharmacy experiential education facilitator role within the inpatient practice setting.

INTRODUCTION: To address practicum challenges commonly reported in inpatient pharmacy practice settings, a novel experiential education facilitator (EEF) role was created and implemented to provide on-the-ground support for students and practice educators (PEs). This article characterizes the daily activities of the EEF and associated perceptions of their role by students and PEs. METHODS: In this prospective, descriptive study, EEFs, students, and PEs involved with inpatient advanced pharmacy practice experiences (APPEs) participated. Day-to-day activities were captured by EEFs through completion of logs, and student and PE perceptions of the EEF role were collected through surveys. RESULTS: Seven EEFs, 14 students, and 20 PEs participated. During the practicum, EEFs frequently organized student activities, provided education to PEs, assisted with student evaluations, and provided logistical support. Orienting students to the site and providing teaching sessions took the greatest amount of time. These activities were perceived to be beneficial by students and PEs, and 12 of 14 (86%) students stated that they felt more confident in their clinical skills after working with their EEF. The majority of students and PEs did not experience challenges with the EEF role. The main challenge identified by both groups was inaccessibility to the EEF due to illness, vacation, or competing clinical responsibilities. CONCLUSIONS: EEFs within inpatient practice settings are valued for their involvement in providing on-site support for students and PEs. Orientating students to the site, facilitating teaching sessions, and supporting student evaluation were perceived as beneficial and addressed some of the key needs identified by inpatient stakeholders.

Evaluation of a symptom-triggered protocol approach to the management of alcohol withdrawal syndrome in older adults.

OBJECTIVES: To evaluate whether implementation of symptom-triggered administration of a benzodiazepine protocol reduces the severity (total cumulative dose), duration, and complications of alcohol withdrawal syndrome (AWS). DESIGN: Retrospective health record review. SETTING: Tertiary care center in Vancouver, Canada. PARTICIPANTS: Individuals aged 70 and older admitted to the Acute Care for Elders and Acute Medicine Unit wards with diagnostic codes for AWS from 2008 to 2012. MEASUREMENTS: Median duration and cumulative dose of benzodiazepine treatment, number of severe AWS complications, severe benzodiazepine-associated adverse effects, and need for adjunct therapy. RESULTS: Thirty-three participants in the preprotocol group and 30 in the protocol-implemented group met the inclusion criteria. Median duration of benzodiazepine treatment decreased from 96 hours (interquartile range (IQR) 72-120 hours) in the preprotocol period to 48 hours (IQR 0-108 hours; P=.04), and median cumulative benzodiazepine dose administered decreased from 9 mg (IQR 5-19.8 mg) to 3 mg (IQR 0-10 mg; P=.001). Statistically significantly lower incidence of severe AWS complications (P=.007) and adjunct therapy use (P=.02) was seen in the protocol-implemented group. CONCLUSION: A symptom-triggered protocol for dosing of benzodiazepine therapy in the management of AWS in individuals aged 70 and older significantly reduced the total duration of benzodiazepine use, cumulative benzodiazepine dose, and use of adjunctive medications in the treatment of AWS.