RESUMO
In 21 antimicrobial stewardship programs in critical-access hospitals in Nebraska and Iowa that self-reported nonadherence to a CDC Core Element or Elements, in-depth program assessment and feedback revealed that accountability and education most needed improvement. Recommendations included providing physician and pharmacist training, tracking interventions, and providing education. Program barriers included lack of time and/or personnel and antimicrobial stewardship and/or infectious diseases expertise.
Assuntos
Doenças Transmissíveis , Humanos , Estados Unidos , Iowa , Nebraska , Hospitais , Centers for Disease Control and Prevention, U.S.RESUMO
Objective: To evaluate the impact of extended-release (ER) intramuscular naltrexone on readmission rates for hospitalized patients with alcohol use disorder (AUD).Methods: This was a single-center, retrospective before and after study. Adult patients with AUD who received ER naltrexone prior to discharge between June 29, 2020, and November 30, 2020, were included in the study. The primary outcome measure was alcohol-related readmission 90 days after ER naltrexone administration. Secondary outcomes were the number of emergency department visits, length of hospital stay, and time between hospital admissions. Patients served as their own controls before and after ER naltrexone administration, and data were collected from the electronic medical records. Comparative analysis was performed using descriptive statistics and paired Student t test.Results: 58 patients received ER naltrexone during the study period, with a mean (SD) pre and post 90-day admission rate of 0.60 (1.14) and 0.71 (1.27), respectively, P = .56. Number of emergency department visits before and after the intervention were 0.5 (1.06) and 0.48 (1.40), respectively, P = .93. Length of hospital stay decreased after naltrexone administration (2.92 [1.95] vs 1.18 [1.78] days, P < .005).Conclusion: There was no major difference in the number of hospitalizations or emergency department visits, but there was a decreased length of hospital stay in patients who received ER naltrexone prior to hospital discharge for the treatment of AUD.
Assuntos
Alcoolismo , Naltrexona , Adulto , Humanos , Naltrexona/uso terapêutico , Alcoolismo/tratamento farmacológico , Projetos Piloto , Readmissão do Paciente , Estudos Retrospectivos , HospitaisRESUMO
PURPOSE: Results of a study to determine whether reducing pharmacy phone call workload through implementation of a pharmacy services call center (PSCC) led to decreased employee workload, improved efficiency, and increased pharmacist availability for patient care are reported. METHODS: A pre-post study was conducted using the NASA Task Load Index (NASA-TLX) instrument. Pharmacists, pharmacy technicians at 7 academic health center community pharmacies, and PSCC staff provided NASA-TLX data over 5 days during 3 data collection periods before and after PSCC implementation. Perceived workload was measured as an overall workload score (OWS) and mean scores for 6 NASA-TLX workload dimensions (mental demand, physical demand, temporal demand, performance, effort, and frustration). RESULTS: Relative to pre-PSCC values, mean postimplementation OWS scores significantly decreased in all 7 pharmacies (from 33.3 to 29.1 overall, p < 0.001) but especially in small pharmacies (from 31.7 to 27.6, p < 0.001). Scores for the physical demand and frustration dimensions were low in both the PSCC and in the 7 pharmacies, while scores for the performance dimension remained high (range, 6.8-8.3). In general, scores for all other measured NASA-TLX dimensions decreased after PSCC implementation, more so at smaller pharmacies. The PSCC staff mean OWS score increased over time (from 26.8 to 28.6, p < 0.0001) but remained near the overall pharmacy average of 29.1. CONCLUSION: Use of the NASA TLX allowed for a direct subjective measurement of workload as perceived by pharmacy and PSCC employees before and after PSCC implementation. Long-term effects of the PSCC on workload should be assessed.
