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1.
Farm. hosp ; 44(1): 26-31, ene.-feb. 2020. tab
Artigo em Espanhol | IBECS | ID: ibc-187489

RESUMO

El desarrollo y la comercialización de medicamentos de terapia celular con células T con receptor de antígeno quimérico (CAR-T) suponen un nuevo reto para la farmacia hospitalaria en España. El objetivo de este artículo es revisar los aspectos clave de estos medicamentos y describir el papel del farmacéutico oncohematológico dentro del equipo clínico multidisciplinar en las diferentes fases del proceso transversal que implica el tratamiento con medicamentos CAR-T, desde la indicación hasta el seguimiento a corto y largo plazo de los pacientes tratados con este tipo de terapias, con una importante mención al manejo de sus principales efectos adversos. La terapia tipo CAR-T ofrece al farmacéutico hospitalario la oportunidad de trabajar en estrecha colaboración con el resto de los profesionales clínicos implicados en el proceso, permitiendo su contribución en el desarrollo de procedimientos, guías de práctica clínica de abordaje global y estableciendo puntos de partida para afrontar tratamientos futuros de complejidad similar e incluso mejorar procesos base anteriormente establecidos


The development and commercialization of cell therapy drugs with chimeric antigen receptor T cells (CAR-T) represent a new challenge for Spain's hospital pharmacy. The aim of this article is to review the key aspects of these medicines and to describe the oncohematological pharmacist's role within the multidisciplinary clinical team. This includes the different phases in the transversal process that involves a therapy with CAR-T medicines, ranging from indication to short and long term follow-up of patients treated with this type of therapy, and emphasizing on the management of its main adverse effects. CAR-T therapy offers the hospital pharmacist the opportunity to work closely with the rest of the clinical professionals involved in the process, allowing their contribution to the development of procedures, clinical practice guidelines of global approach, and establishing starting points when facing future therapies of similar complexity -and even improving previously established basic processes


Assuntos
Humanos , Farmacêuticos/organização & administração , Farmacêuticos/normas , Imunoterapia Adotiva/métodos , Serviço de Farmácia Hospitalar , Imunoterapia Adotiva/normas , Legislação de Dispositivos Médicos/normas , Farmacovigilância
2.
Hosp Pract (1995) ; 48(sup1): 56-62, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31900000

RESUMO

Patients over the age 65 are a quickly expanding segment of the US population and represent a large percentage of patients requiring inpatient care. Older adults are more likely to experience polypharmacy and adverse drug effects. This review explains the risks of polypharmacy and potentially inappropriate medications in the elderly. Specific classes of medications frequently used in older adults in acute care settings are examined, including anticholinergic, sedative hypnotics, and antipsychotic medications. We discuss strategies aimed at addressing polypharmacy in this population including a drug regimen review (which is distinct from medication reconciliation), screening tools, pharmacist-led interventions, and computer-based strategies in the context of current literature and research findings. We provide a summary of general guidelines that may be helpful for geriatricians and hospitalists in improving patient care and clinical outcomes.


Assuntos
Avaliação Geriátrica/métodos , Equipe de Assistência ao Paciente/organização & administração , Polimedicação , Lista de Medicamentos Potencialmente Inapropriados/estatística & dados numéricos , Papel Profissional , Idoso , Idoso de 80 Anos ou mais , Analgésicos Opioides/administração & dosagem , Analgésicos Opioides/efeitos adversos , Antipsicóticos/administração & dosagem , Antipsicóticos/efeitos adversos , Antagonistas Colinérgicos/administração & dosagem , Antagonistas Colinérgicos/efeitos adversos , Humanos , Hipnóticos e Sedativos/administração & dosagem , Hipnóticos e Sedativos/efeitos adversos , Reconciliação de Medicamentos/métodos , Farmacêuticos/organização & administração , Fatores de Risco
3.
J Surg Res ; 246: 482-489, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31635833

RESUMO

The Joint Commission has established medication reconciliation as a National Patient Safety Goal, but it has not been studied much in trauma even though it is integral to safe patient care. This article reviews the existing medication reconciliation strategies and their applicability to the trauma setting. To perform medication reconciliation, hospitals use a variety of strategies including pharmacists or pharmacy technicians, electronic medical record tools, and patient-centered strategies. All of these strategies are limited in trauma. Subpopulations such as injured children, the elderly, and those with brain trauma are particularly challenging and are at risk for suboptimal care from inaccurate medication reconciliation. Further research is necessary to create a safe and efficient system for trauma patients.


Assuntos
Reconciliação de Medicamentos/organização & administração , Segurança do Paciente , Centros de Traumatologia/organização & administração , Ferimentos e Lesões/terapia , Fatores Etários , Idoso , Criança , Registros Eletrônicos de Saúde/organização & administração , Humanos , Assistência Centrada no Paciente/organização & administração , Farmacêuticos/organização & administração , Técnicos em Farmácia/organização & administração , Papel Profissional , Estados Unidos
4.
Perm J ; 232019.
Artigo em Inglês | MEDLINE | ID: mdl-31702984

RESUMO

INTRODUCTION: Despite guidelines for prevention of recurrent renal calculi, routine dietary modification and metabolic evaluation are often not performed. OBJECTIVE: To determine feasibility of a multicenter, pharmacist-staffed program to enroll patients at high risk of recurrent kidney stones and provide dietary instruction, metabolic evaluation, and medical therapy via telemedicine. METHODS: A total of 536 consecutive adult patients were referred from 3 Northern California Kaiser Permanente facilities. We determined the proportion of patients who enrolled, received dietary counseling, and completed metabolic evaluation at 12 months. The program was staffed by a clinical pharmacist and supervised by urologists following a protocol based on the American Urological Association guidelines. Patients were contacted entirely via telemedicine. Cystine or struvite kidney stones, renal tubular acidosis, and primary hyperoxaluria were exclusion criteria. RESULTS: Of the 536 patients, 500 agreed to enrollment. Among patients enrolled for 3 months, 99% self-reported compliance with at least 3 of 5 aspects of dietary advice. A complete metabolic evaluation including 24-hour urine collection was performed in 80% of patients by 12 months. A significant improvement in all urinary parameters occurred in 52 patients with calcium stones who repeated 24-hour urine testing. The 12-month dropout rate was 12.4%. CONCLUSION: A telemedicine-administered, pharmacist-staffed, protocol-driven program can provide dietary advice and obtain compliance with metabolic testing for patients at high risk of recurrent kidney stones. Rates of metabolic testing and dropout compare favorably with previously reported rates. This report represents, to our knowledge, the first telemedicine-administered, pharmacist-staffed, kidney stone prevention program published in the literature.


Assuntos
Prestação Integrada de Cuidados de Saúde/métodos , Cálculos Renais/prevenção & controle , Farmacêuticos , Telemedicina/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Protocolos Clínicos , Prestação Integrada de Cuidados de Saúde/organização & administração , Dieta , Estudos de Viabilidade , Feminino , Humanos , Cálculos Renais/epidemiologia , Masculino , Pessoa de Meia-Idade , Farmacêuticos/organização & administração , Projetos Piloto , Telemedicina/organização & administração , Adulto Jovem
5.
Am J Health Syst Pharm ; 76(1): 34-43, 2019 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-31603982

RESUMO

PURPOSE: The development of an inpatient antimicrobial stewardship program (ASP) in an integrated healthcare system is described. SUMMARY: With increasing national focus on reducing inappropriate antimicrobial use, state and national regulatory mandates require hospitals to develop ASPs. In 2015, BJC HealthCare, a multihospital health system, developed a system-level, multidisciplinary ASP team to assist member hospitals with ASP implementation. A comprehensive gap analysis was performed to assess current stewardship resources, activities and compliance with CDC core elements at each facility. BJC system clinical leads facilitated the development of hospital-specific leadership support statements, identification of hospital pharmacy and medical leaders, and led development of staff and patient educational components. An antimicrobial-use data dashboard was created for reporting and tracking the impact of improvement activities. Hospital-level interventions were individualized based on the needs and resources at each facility. Hospital learnings were shared at bimonthly system ASP meetings to disseminate best practices. The initial gap analysis revealed that BJC hospitals were compliant in a median of 6 ASP elements (range, 4-8) required by regulatory mandates. By leveraging system resources, all hospitals were fully compliant with regulatory requirements by January 2017. CONCLUSION: BJC's ASP model facilitated the development of broad-based stewardship activities, including education modules for patients and providers and clinical decision support, while allowing hospitals to implement activities based on local needs and resource availability.


Assuntos
Antibacterianos/uso terapêutico , Gestão de Antimicrobianos/organização & administração , Prestação Integrada de Cuidados de Saúde/organização & administração , Serviço de Farmácia Hospitalar/organização & administração , Desenvolvimento de Programas , Centros Médicos Acadêmicos/organização & administração , Centros Médicos Acadêmicos/estatística & dados numéricos , Gestão de Antimicrobianos/estatística & dados numéricos , Prestação Integrada de Cuidados de Saúde/estatística & dados numéricos , Necessidades e Demandas de Serviços de Saúde/organização & administração , Necessidades e Demandas de Serviços de Saúde/estatística & dados numéricos , Humanos , Illinois , Missouri , Modelos Organizacionais , Equipe de Assistência ao Paciente/organização & administração , Educação de Pacientes como Assunto/organização & administração , Educação de Pacientes como Assunto/estatística & dados numéricos , Farmacêuticos/organização & administração , Serviço de Farmácia Hospitalar/estatística & dados numéricos , Lacunas da Prática Profissional/organização & administração , Lacunas da Prática Profissional/estatística & dados numéricos
6.
Cien Saude Colet ; 24(10): 3717-3726, 2019.
Artigo em Português, Inglês | MEDLINE | ID: mdl-31577002

RESUMO

The objective is to analyze the insertion of the pharmacists work in primary health care in Brazil. The search was performed on BVS, SciELO, Lilacs e Medline databases from 1998 to 2016. From the 157 articles found, excluding the duplicates, theses, dissertations and reviews, after the complete reading the review included 9 articles dealing with the pharmacist's work describing experiences, attributions, potentialities, difficulties and challenges. Results show incipient production and predominance of qualitative studies starting in 2007. The insertion in the team is the central topic of the studies, pointing out the challenges and the difficulties related to the recognition and acceptance of the pharmacists interventions. The potentialities reside in the area of actions directed to the client, the families and the team, as well as in the professional training field as well as in the dissemination of the results of the pharmaceutical actions. The pharmacists' isolation in the primary care prevails, albeit there are perspectives of strengthening the integration in the team that has been stimulated by the recent institutional and regulatory transformations in the national scenario. Beyond the present difficulties and experiences reported, the researchers focus on the potentialities for the professional practice, glancing at the construction of the future.


Assuntos
Assistência Farmacêutica/organização & administração , Farmacêuticos/organização & administração , Atenção Primária à Saúde/organização & administração , Brasil , Humanos , Equipe de Assistência ao Paciente/organização & administração , Papel Profissional
9.
Am J Health Syst Pharm ; 76(19): 1544-1554, 2019 Sep 16.
Artigo em Inglês | MEDLINE | ID: mdl-31532501

RESUMO

PURPOSE: An overview of the pediatric-to-adult healthcare transition (HCT) process, including stakeholders, challenges, and fundamental components that present opportunities for pharmacists and pharmacy technicians, is provided. SUMMARY: Pediatric-to-adult HCT programs should be longitudinal in nature, be patient focused, and be coproduced by patients, caregivers, and care team members. Educational components of HCT programs should include knowledge and skills in disease state management and self-care; safe and effective use of medications, as well as other treatment modalities; and healthcare system navigation, including insurance issues. Interprofessional involvement in HCT is encouraged; however, roles for each discipline involved are not clearly delineated in current guidelines or literature. Possible influencing elements in achieving successful pediatric-to-adult HCT outcomes include those that are related to patient and/or caregiver factors, clinician awareness, availability of resources, and ability to achieve financial sustainability. CONCLUSION: The use of structured pediatric-to-adult HCT programs is currently recommended to optimize patient and health-system outcomes. Given the importance of medication-related knowledge and healthcare system navigation skills to successful care transitions, there are opportunities for pharmacists and pharmacy technicians to contribute to HCT programs.


Assuntos
Conduta do Tratamento Medicamentoso/organização & administração , Transição para Assistência do Adulto/organização & administração , Adolescente , Fatores Etários , Criança , Humanos , Relações Interprofissionais , Conduta do Tratamento Medicamentoso/normas , Farmacêuticos/organização & administração , Técnicos em Farmácia/organização & administração , Guias de Prática Clínica como Assunto , Papel Profissional , Participação dos Interessados , Transição para Assistência do Adulto/normas , Adulto Jovem
10.
Am J Health Syst Pharm ; 76(19): 1521-1531, 2019 Sep 16.
Artigo em Inglês | MEDLINE | ID: mdl-31532502

RESUMO

PURPOSE: Common bacterial infections in pediatric patients that the hospital pharmacist may encounter are reviewed, and guidance on the safe and effective use of antibiotics to treat those infections is provided. SUMMARY: Pharmacists play a key role in evaluating and creating antibiotic treatment plans for patients with infections. Bacterial infections are a common reason for hospital admission in pediatric patients, and pharmacists working in hospitals may be consulted to provide treatment and monitoring recommendations. It is important for pharmacists to be aware of similarities and differences in adult and pediatric populations with regard to presenting signs and symptoms of bacterial infections, common causative pathogens, and antibiotic selection, dosing, and monitoring. This article reviews current approaches to treatment of common bacterial infections in pediatric patients and also provides general suggestions for antibiotic use. CONCLUSION: Pharmacists have an opportunity to positively impact the care of pediatric patients with bacterial infections. Especially at facilities where pediatric patients are not regularly treated, pharmacists can potentially improve care through provision of recommendations for optimal antibiotic selection, dosing, and monitoring.


Assuntos
Antibacterianos/administração & dosagem , Infecções Bacterianas/tratamento farmacológico , Farmacêuticos/organização & administração , Serviço de Farmácia Hospitalar/organização & administração , Papel Profissional , Adulto , Fatores Etários , Antibacterianos/efeitos adversos , Infecções Bacterianas/diagnóstico , Criança , Relação Dose-Resposta a Droga , Cálculos da Dosagem de Medicamento , Rotulagem de Medicamentos/normas , Monitoramento de Medicamentos/normas , Humanos , Conduta do Tratamento Medicamentoso/organização & administração , Conduta do Tratamento Medicamentoso/normas , Serviço de Farmácia Hospitalar/normas , Guias de Prática Clínica como Assunto , Encaminhamento e Consulta
11.
Am J Health Syst Pharm ; 76(19): 1463-1471, 2019 Sep 16.
Artigo em Inglês | MEDLINE | ID: mdl-31532505

RESUMO

PURPOSE: Pharmacists care for patients of all ages. Pediatric patients are not smaller versions of adults; thus, they provide a unique challenge to pharmacists. Basic components of patient assessment and considerations for medication dosing and administration for pediatric patients are reviewed here. SUMMARY: Each pediatric patient is different, and physiological changes occur as a patient ages. Growth, vital signs, and laboratory tests are common assessments for all patients. However, there are unique factors to consider within the pediatric population, and a pharmacist must understand how to assess and interpret these data for pediatric patients of all ages. Additionally, individualized medication dosing is based on patient factors such as age, weight, or body surface area in this population. Key information about the administration of medications and understanding of dosage formulations for this patient population is an area where pharmacists can make recommendations to prescribers and counsel patients and caregivers in order to improve patient outcomes and increase adherence. CONCLUSION: Patient assessment by the pharmacist is a key step in developing a patient treatment plan. Assessment factors in the pediatric population can differ from those in the adult population. A working knowledge of differences within the pediatric population and understanding how to assess them is essential for providing optimal patient care to this population.


Assuntos
Conduta do Tratamento Medicamentoso/organização & administração , Assistência Farmacêutica/organização & administração , Farmacêuticos/organização & administração , Fatores Etários , Envelhecimento/fisiologia , Criança , Desenvolvimento Infantil/fisiologia , Relação Dose-Resposta a Droga , Cálculos da Dosagem de Medicamento , Humanos , Encaminhamento e Consulta/organização & administração
12.
Am J Health Syst Pharm ; 76(19): 1481-1491, 2019 Sep 16.
Artigo em Inglês | MEDLINE | ID: mdl-31532506

RESUMO

PURPOSE: Risks and vulnerabilities of the medication-use process in nonpediatric institutions that also serve pediatric patients are reviewed, and guidance on risk mitigation strategies is provided. SUMMARY: There are many risks and vulnerabilities in the medication-use process as it relates to pharmacotherapy for pediatric patients admitted to adult institutions. Mitigation of these risks is critical and should encompass various available resources and strategies. Special emphasis should be placed on use of technology to improve overall safety. Available literature recommends optimization of technology and resource use, institutional support for pediatric pharmacists' involvement in managing pediatric medication use, and provision of early exposure to pediatric patients in pharmacist training programs as additional methods of mitigating risks associated with pediatric medication use in adult institutions. Adult hospitals that provide care for pediatric patients should assess their processes in order to identify hospital-specific interventions to promote pediatric medication safety. CONCLUSION: Pediatric medication safety frameworks in U.S. adult institutions vary widely. Treating pediatric patients involves risks in all areas of the medication-use process. Optimizing technology, utilizing external resources, supporting a pediatric pharmacist, and providing early-career exposure to pediatric patients are methods to mitigate risks in institutions that primarily serve adult patients.


Assuntos
Erros de Medicação/prevenção & controle , Conduta do Tratamento Medicamentoso/organização & administração , Farmacêuticos/organização & administração , Serviço de Farmácia Hospitalar/organização & administração , Gestão da Segurança/normas , Adulto , Fatores Etários , Criança , Sistemas de Informação em Farmácia Clínica/organização & administração , Sistemas de Informação em Farmácia Clínica/normas , Composição de Medicamentos/normas , Cálculos da Dosagem de Medicamento , Educação em Farmácia , Educação Continuada em Farmácia , Humanos , Sistemas de Registro de Ordens Médicas/organização & administração , Sistemas de Registro de Ordens Médicas/normas , Conduta do Tratamento Medicamentoso/normas , Farmacêuticos/normas , Serviço de Farmácia Hospitalar/normas , Guias de Prática Clínica como Assunto , Papel Profissional
13.
Am J Health Syst Pharm ; 76(19): 1492-1510, 2019 Sep 16.
Artigo em Inglês | MEDLINE | ID: mdl-31532507

RESUMO

PURPOSE: Current clinical practice guidelines on management of enteral nutrition (EN) and parenteral nutrition (PN) in pediatric patients are reviewed. SUMMARY: The provision of EN and PN in pediatric patients poses many unique considerations and challenges. Although indications for use of EN and PN are similar in adult and pediatric populations, recommended EN and PN practices differ for pediatric versus adult patients in areas such as selection of EN and PN formulations, timing of EN and PN initiation, advancement of nutrition support, and EN and PN goals. Additionally, provision of EN and PN to pediatric patients poses unique compounding and medication administration challenges. This article provides a review of current EN and PN best practices and special nutrition considerations for neonates, infants, and other pediatric patients. CONCLUSION: The provision of EN and PN to pediatric patients presents many unique challenges. It is important for pharmacists to keep current with pediatric- and neonatal-specific guidelines on nutritional management of various disease states, as well as strategies to address compounding and medication administration challenges, in order to optimize EN and PN outcomes.


Assuntos
Desenvolvimento Infantil/fisiologia , Nutrição Enteral/normas , Necessidades Nutricionais/fisiologia , Nutrição Parenteral/normas , Serviço de Farmácia Hospitalar/organização & administração , Adulto , Fatores Etários , Criança , Pré-Escolar , Composição de Medicamentos/normas , Humanos , Lactente , Recém-Nascido , Recém-Nascido Prematuro/fisiologia , Farmacêuticos/organização & administração , Serviço de Farmácia Hospitalar/normas , Guias de Prática Clínica como Assunto
18.
Farm. comunitarios (Internet) ; 11(3): 22-41, sept. 2019.
Artigo em Espanhol | IBECS | ID: ibc-186881

RESUMO

La prestación de servicios profesionales farmacéuticos asistenciales (SPFA) al paciente des-de la farmacia comunitaria ha de realizarse observando una serie de garantías sanitarias y legales previas que aseguren los derechos del paciente. Toda actuación en el ámbito de la salud de un paciente necesita su consentimiento libre y voluntario una vez que haya recibido la in-formación adecuada. Esta información que, como regla general, se proporcionará verbalmente (salvo en los casos de procedimientos invasivos, que son los que entrañan riesgos más graves), ha de ser veraz e incluir como mínimo la finalidad y la naturaleza de cada intervención, sus riesgos y sus consecuencias, y se debe comunicar al paciente de forma comprensible y adaptada a sus necesidades, de forma que le ayude a tomar decisiones de acuerdo con su propia y libre voluntad. De este modo, para que el paciente consienta que se le preste un SPFA ha de recibir previamente una información específica sobre dicho servicio. Aunque esta información se po-dría proporcionar solo verbalmente, al ser los SPFA servicios novedosos con los que el paciente no está familiarizado, es recomendable proporcionarla también por escrito ya que esta vía per-mite garantizar que se comunica de forma uniforme, comprensible, evitando equivocaciones y olvidos, y además el paciente tendrá más tiempo para estudiarla en su casa. Este artículo analiza la información mínima que se debe proporcionar a los pacientes y usuarios en la prestación de los SPFA. Además, muestra como ejemplo tanto la información que se proporciona al paciente en cinco de los SPFA que gestiona la aplicación SEFAC e_XPERT®, como un modelo de consen-timiento informado válido para dichos servicios y que incluye el resto de información necesaria que también se debe comunicar previamente al paciente


The provision of professional pharmaceutical care services (SPFA) to the patient from the community pharmacy must be carried out by observing a series of previous health and legal guarantees that ensure the rights of the patient. Any action in the area of a patient’s health requires his or her free and voluntary consent once he or she had received the appropriate information. This information will, as a general rule, be provided orally (except in the case of invasive procedures, which are the ones with the most serious risks), must be truthful and include at least the purpose and nature of each intervention, its risks and its consequences, and must be communicated to the patient in a way that is understandable and adapted to his or her needs, in a way that helps you make decisions according to your own free will. Thus, in order for the patient to consent to the provision of an SPFA, he must first receive specific information about that service. Although this information could be provided only verbally, as SPFAs are novel services with which the patient is not familiar, it’s advisable to provide it also in writing, as this way ensures that it communicates uniformly, comprehensively, avoiding mistakes and forgetfulness, and also that the patient will have more time to study it at home. This article discusses the minimum information to be provided to patients and users in the provision of SPFA. In addition, it shows, as an example, the information provided to the patient in five of the SPFA that manage the SEFAC e_XPERT®application, as well as an informed consent model which includes all other necessary information which must also be communicated to patient


Assuntos
Humanos , Assistência Farmacêutica/organização & administração , Farmácias , Serviços de Informação sobre Medicamentos , Informação de Saúde ao Consumidor , Tomada de Decisões , Autonomia Pessoal , Legislação de Medicamentos , Farmacêuticos/legislação & jurisprudência , Farmacêuticos/organização & administração
19.
Am J Health Syst Pharm ; 76(16): 1238-1247, 2019 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-31369113

RESUMO

PURPOSE: The purpose of this study was to identify and describe strategies that have successfully achieved collaboration among physicians and pharmacists providing comprehensive medication management (CMM) to support development of CMM services. METHODS: A 2-phase, mixed-methods approach was employed to identify successful strategies for building pharmacist-physician relationships in primary care clinic settings. Phase I used a qualitative approach to identify strategies deemed successful in building relationships with physicians. An advisory group of pharmacists with experience building CMM practices assisted in the development of minimum criteria characterizing pharmacists as having strong collaborative relationships. Semi-structured interviews were conducted with 10 interviewees meeting established criteria. Researchers coded interview transcripts and identified the resulting strategies. Phase II employed a survey instrument to determine how frequently identified strategies are used and evaluate the relative level of perceived impact of each strategy, which was distributed to a national audience of pharmacists practicing in ambulatory care settings. Responses from pharmacists meeting prespecified criteria were included in the analysis. RESULTS: Thirty-three strategies were identified and grouped into 8 themes. In phase II, 104 survey respondents met defined criteria and were eligible to endorse use of identified strategies and rate their relative influence. CONCLUSIONS: Thirty-three strategies were identified and grouped into 8 themes to aid pharmacists practicing CMM in developing stronger collaborative relationships with physician colleagues. A national sampling found many of these strategies were employed by a majority of pharmacists, who had found them to be influential in creating collaborative relationships.


Assuntos
Assistência Ambulatorial/organização & administração , Relações Interprofissionais , Farmacêuticos/organização & administração , Médicos/organização & administração , Atenção Primária à Saúde/organização & administração , Assistência Ambulatorial/estatística & dados numéricos , Atitude do Pessoal de Saúde , Comportamento Cooperativo , Humanos , Farmacêuticos/psicologia , Farmacêuticos/estatística & dados numéricos , Médicos/psicologia , Atenção Primária à Saúde/estatística & dados numéricos , Pesquisa Qualitativa , Inquéritos e Questionários , Estados Unidos
20.
Am J Health Syst Pharm ; 76(16): 1226-1230, 2019 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-31369114

RESUMO

PURPOSE: A national survey performed in 2007 found that only 23% of American College of Surgeons (ACS) trauma centers involved pharmacists in trauma resuscitation. This study describes interval change in use, perceptions, and responsibilities from 2007 to 2017. METHODS: Of the 419 trauma centers identified from the ACS website, contact information was available for 335. In March 2017, a survey assessing hospital demographics, pharmacist coverage and services, and perception of pharmacist value and use was emailed to the identified trauma representatives. Data were analyzed using descriptive statistics and chi-square analysis, as appropriate. RESULTS: The response rate was 33% (110/335). Pharmacist involvement with trauma resuscitation increased significantly from 23% in 2007 to 70% (p < 0.001) and in 71% of trauma centers was provided by pharmacists practicing within the emergency department. Pharmacist involvement was greatest in the Midwest (p < 0.01), but with similar distribution with regards to ACS designation, institution type, and patient volume. Common bedside responsibilities include calculating dosages (96%), preparing medications (89%), and providing medication information (79%), while trauma program/administrative responsibilities (45%) include trauma team education, pharmacy operations, medication safety, quality improvement data collection, research, review of quality assurance cases, ACS accreditation preparation, and others. The primary reason for not considering pharmacist involvement was unfamiliarity with these roles/benefits. CONCLUSION: Pharmacists are an increasingly important component of the trauma team, as evidenced by growth over the last decade. In addition to clinical benefit at the bedside, pharmacists can support the regular activities of a trauma program in many meaningful ways.


Assuntos
Equipe de Assistência ao Paciente/organização & administração , Farmacêuticos/organização & administração , Papel Profissional , Ressuscitação , Ferimentos e Lesões/terapia , Adulto , Criança , Estudos Transversais , Serviço Hospitalar de Emergência/organização & administração , Serviço Hospitalar de Emergência/estatística & dados numéricos , Seguimentos , Humanos , Masculino , Equipe de Assistência ao Paciente/estatística & dados numéricos , Serviço de Farmácia Hospitalar/organização & administração , Serviço de Farmácia Hospitalar/estatística & dados numéricos , Inquéritos e Questionários/estatística & dados numéricos , Centros de Traumatologia/organização & administração , Centros de Traumatologia/estatística & dados numéricos , Estados Unidos
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