scholarly journals Effects of pharmacist prescribing on patient outcomes in the hospital setting

2021 ◽  
Keyword(s):  
Patient Outcomes ◽  
Hospital Setting ◽  
Pharmacist Prescribing

scholarly journals Effects of pharmacist prescribing on patient outcomes in the hospital setting

2018 ◽  
Vol 16 (9) ◽  
pp. 1823-1873 ◽  
Author(s):  
Eng Whui Poh ◽  
Alexa McArthur ◽  
Matthew Stephenson ◽  
Elizabeth E. Roughead
Keyword(s):  
Patient Outcomes ◽  
Hospital Setting ◽  
Pharmacist Prescribing

scholarly journals 47 Acute Pancreatitis Management Discrepancies Between Different Services in a Single Hospital Setting Affecting Patient Outcomes

2019 ◽  
Vol 114 (1) ◽  
pp. S27-S28
Author(s):  
Nabeeha Mohy-ud-din ◽  
Ivana Deyl ◽  
Shifa Umar ◽  
Heitham Abdul Baki ◽  
Suzanne Morrissey
Keyword(s):  
Acute Pancreatitis ◽  
Patient Outcomes ◽  
Hospital Setting

Antimicrobial Stewardship Programs in Inpatient Hospital Settings: A Systematic Review

2014 ◽  
Vol 35 (10) ◽  
pp. 1209-1228 ◽  
Author(s):  
Brittin Wagner ◽  
Gregory A. Filice ◽  
Dimitri Drekonja ◽  
Nancy Greer ◽  
Roderick MacDonald ◽  
...  
Keyword(s):  
Systematic Review ◽  
Patient Outcomes ◽  
Antimicrobial Stewardship ◽  
English Language ◽  
Guideline Implementation ◽  
Hospital Setting ◽  
The United States ◽  
Prescribing Patterns ◽  
Audit And Feedback ◽  
Cochrane Library

ObjectiveEvaluate the evidence for effects of inpatient antimicrobial stewardship programs (ASPs) on patient, prescribing, and microbial outcomes.DesignSystematic review.MethodsSearch of MEDLINE (2000 through November 2013), Cochrane Library, and reference lists of relevant studies. We included English language studies with patient populations relevant to the United States (ie, infectious conditions and prescriptions required for antimicrobials) that evaluated ASP interventions and reported outcomes of interest. Study characteristics and outcomes data were extracted and reviewed by investigators and trained research personnel.ResultsFew intervention types (eg, audit and feedback, guideline implementation, and decision support) substantially impacted patient outcomes, including mortality, length of stay, readmission, or incidence of Clostridium difficile infection. However, most interventions were not powered adequately to demonstrate impacts on patient outcomes. Most interventions were associated with improved prescribing patterns as measured by decreased antimicrobial use or increased appropriate use. Where reported, ASPs were generally associated with improvements in microbial outcomes, including institutional resistance patterns or resistance in the study population. Few data were provided on harms, sustainability, or key intervention components. Studies were typically of short duration, low in methodological quality, and varied in study design, populations enrolled, hospital setting, ASP intent, intervention composition and implementation, comparison group, and outcomes assessed.ConclusionsNumerous studies suggest that ASPs can improve prescribing and microbial outcomes. Strength of evidence was low, and most studies were not designed adequately to detect improvements in mortality or other patient outcomes, but obvious adverse effects on patient outcomes were not reported.

scholarly journals Is Outpatient Thyroid Surgery for Everyone?

2017 ◽  
Vol 10 ◽  
pp. 117955061772442 ◽  
Author(s):  
Dale Butler ◽  
Sarah Oltmann
Keyword(s):  
Patient Outcomes ◽  
Postoperative Bleeding ◽  
Hospital Setting ◽  
Cost Effective ◽  
High Volume ◽  
Outpatient Setting ◽  
Current Trends ◽  
Surgeon Experience ◽  
Reduced Costs ◽  
Inpatient Basis

Thyroidectomy is a common surgical procedure. Traditionally, surgeons have performed thyroidectomy on an inpatient basis. However, consistent with current trends in surgery, some practices are transitioning thyroidectomy to an outpatient setting. Although concerns for hypocalcemia and postoperative bleeding exist regardless of surgeon experience, multiple studies demonstrate that outpatient thyroidectomy is safe in the hands of high-volume surgeons. Indeed, experienced thyroid surgeons who perform thyroidectomy in an outpatient setting experience excellent patient outcomes and reduced costs. However, outpatient thyroidectomy may not be suitable for all surgeons, hospitals, or patients. When evaluating whether to implement an outpatient thyroid program, a practice should consider a number of important factors including the team performing the procedure, the hospital, and the patient. With the appropriate staff education and experience, hospital setting, and patient selection, practices in a multitude of settings can successfully develop a safe, cost-effective outpatient thyroid program.

scholarly journals Pre-hospital use of intravenous in-line fluid warmers to reduce morbidity and mortality for major trauma patients: A review of the current literature.

2015 ◽  
Vol 12 (2) ◽  
Author(s):  
Nicholas Collins ◽  
Stuart Daly ◽  
Patricia Johnson ◽  
Gavin Smith
Keyword(s):  
Patient Outcomes ◽  
Major Trauma ◽  
Hospital Setting ◽  
Morbidity And Mortality ◽  
Trauma Patients ◽  
Hospital Emergency ◽  
Mortality And Morbidity ◽  
Poor Patient ◽  
Patient Morbidity ◽  
Lethal Triad

IntroductionIn-line fluid warmers are an established treatment for delivering warmed intravenous (IV) fluid in the hospital setting. Recently their potential application within the pre-hospital setting has been highlighted to potentially reduce mortality and morbidity. Currently ambulance paramedics only administer warmed fluid to patients assessed as hypothermic, and this fluid is subject to further cooling on exposure to ambient environmental conditions. This review examined the peer-reviewed literature to determine the available evidence for in-line fluid warmer effectiveness and potential inclusion in pre-hospital emergency care.MethodsA review of the electronic literature, including the Medline and Ebscohost databases was conducted using the terms “intravenous fluid warmers” “hypothermia”, “ trauma”, “ fluid”, “coagulopathy”, “ acidosis”, “hypothermia and trauma patients”, “accidental hypothermia”, “lethal triad” and “trauma care”. Articles were included if they represented a study of in-line fluid warmers within the surgical, general hospital or pre-hospital emergency care settings. Articles not available in English or as full text were excluded.ResultsThe review identified 23 relevant articles for analysis. Of note, up to 40% of trauma patients with signs of hypoperfusion were reported to arrive at hospital in a hypothermic state post-incident. Hypothermia plays a significant role in contributing to the ‘triad of death’- a condition that results in poor patient outcomes and high mortality rates.ConclusionThis review identified that current pre-hospital practice does not prescribe warmed fluid to the normothermic trauma patient. The review also identified that there is a need for in-line fluid warmers in ambulance practice to prevent or limit hypothermia and reduce patient morbidity and mortality associated with trauma.

From theory to practice of electronic handover

2011 ◽  
Vol 35 (3) ◽  
pp. 384 ◽  
Author(s):  
Sara L. Barnes ◽  
Donald A. Campbell ◽  
Keith A. Stockman ◽  
Dirk Wunderlink
Keyword(s):  
Patient Outcomes ◽  
Allied Health ◽  
Clinical Care ◽  
Hospital Setting ◽  
Work Practice ◽  
Tertiary Hospital ◽  
Multidisciplinary Teams ◽  
Post Intervention ◽  
Serious Adverse Events ◽  
Handover Process

Clinical handover is an essential process occurring at many levels of inpatient care. Multiple studies within a hospital setting have identified that a breakdown in the handover process can lead to poor patient outcomes and serious adverse events. The use of electronic handover tools is an intervention identified to decrease errors in clinical care arising from poor handover practice. An electronic handover tool was implemented in a general medical unit in a metropolitan tertiary hospital setting. The program was written by a Medical Professional who also used the tool. The program was evaluated with a pre- and post-intervention survey within the medical, allied health and nursing staff members of the multidisciplinary teams. The use of the Electronic Handover program resulted in improved satisfaction of the handover process within the medical, nursing and allied health professions. This trial demonstrates that an electronic handover program can be successfully integrated into normal medical work practice, resulting in positive outcomes for a multidisciplinary staff team. Further work is required to determine whether patient outcomes are improved as a result.

Pre-hospital use of early warning scores to improve detection and outcomes of sepsis

2021 ◽  
Vol 26 (3) ◽  
pp. 122-129
Author(s):  
Marina Maciver
Keyword(s):  
Patient Outcomes ◽  
Early Warning ◽  
Hospital Setting ◽  
High Sensitivity ◽  
Early Warning Score ◽  
Bibliographic Databases ◽  
Eligibility Criteria ◽  
Early Warning Scores ◽  
Life Threatening ◽  
Hospital Use

Sepsis is a life-threatening complication from infection. The early detection of sepsis pre-hospital is challenging. Early warning scores (EWS) are used in hospitals to identify deteriorating patients. The pre-hospital setting could be a beneficial extension to the use of EWSs. This review aimed to determine whether EWSs can identify patients with sepsis pre-hospital and predict patient outcomes. Bibliographic databases were searched for studies evaluating the pre-hospital use of EWSs. Studies were screened using eligibility criteria. Two studies examined the ability of pre-hospital EWSs to identify patients with critical illness, showing high sensitivity but low specificity. Four studies determined the prognostic effects of the National Early Warning Score (NEWS). The patients identified by NEWS to be high-risk were associated with worse outcomes. This systematic review demonstrated the successful use of EWSs in the pre-hospital setting, in identifying patients most at risk of deterioration and as a useful tool for decision-making.

Hear, hear for ultrasound

2021 ◽  
Vol 10 (9) ◽  
pp. 396-400
Author(s):  
Cormac Convery
Keyword(s):  
Patient Outcomes ◽  
Imaging Modality ◽  
Hospital Setting ◽  
Dermal Filler ◽  
Non Invasive ◽  
Technological Advances ◽  
Educational Programmes ◽  
Vascular Compromise ◽  
Vascular Mapping ◽  
Ultrasound Technology

Ultrasound technology is finally being used outside of the hospital setting. The simple, non-invasive and radiation-free imaging modality is now a reality in the medical aesthetic clinic. Ultrasound has been recognised as a suitable investigation in aesthetic complications since 2008 and recommended in practice since 2013. Technological advances have enabled professionals to deliver imaging in any environment. In treatment planning, delivery and aftercare, patient outcomes can be optimised. Ultrasound imaging allows reliable dermal filler identification, vascular mapping, management of vascular compromise and nodules, real-time rheology and measurement in relation to treatment outcomes. The challenges that remain relate to underpinning availability and enthusiasm with education and support. At the time of writing, there are no such mechanisms or educational programmes.

Antimicrobial Stewardship Programs in Inpatient Hospital Settings: A Systematic Review

2014 ◽  
Vol 35 (10) ◽  
pp. 1209-1228 ◽  
Author(s):  
Brittin Wagner ◽  
Gregory A. Filice ◽  
Dimitri Drekonja ◽  
Nancy Greer ◽  
Roderick MacDonald ◽  
...  
Keyword(s):  
Systematic Review ◽  
Patient Outcomes ◽  
Antimicrobial Stewardship ◽  
English Language ◽  
Guideline Implementation ◽  
Hospital Setting ◽  
The United States ◽  
Prescribing Patterns ◽  
Audit And Feedback ◽  
Cochrane Library

ObjectiveEvaluate the evidence for effects of inpatient antimicrobial stewardship programs (ASPs) on patient, prescribing, and microbial outcomes.DesignSystematic review.MethodsSearch of MEDLINE (2000 through November 2013), Cochrane Library, and reference lists of relevant studies. We included English language studies with patient populations relevant to the United States (ie, infectious conditions and prescriptions required for antimicrobials) that evaluated ASP interventions and reported outcomes of interest. Study characteristics and outcomes data were extracted and reviewed by investigators and trained research personnel.ResultsFew intervention types (eg, audit and feedback, guideline implementation, and decision support) substantially impacted patient outcomes, including mortality, length of stay, readmission, or incidence ofClostridium difficileinfection. However, most interventions were not powered adequately to demonstrate impacts on patient outcomes. Most interventions were associated with improved prescribing patterns as measured by decreased antimicrobial use or increased appropriate use. Where reported, ASPs were generally associated with improvements in microbial outcomes, including institutional resistance patterns or resistance in the study population. Few data were provided on harms, sustainability, or key intervention components. Studies were typically of short duration, low in methodological quality, and varied in study design, populations enrolled, hospital setting, ASP intent, intervention composition and implementation, comparison group, and outcomes assessed.ConclusionsNumerous studies suggest that ASPs can improve prescribing and microbial outcomes. Strength of evidence was low, and most studies were not designed adequately to detect improvements in mortality or other patient outcomes, but obvious adverse effects on patient outcomes were not reported.

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