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Biomedical subjects

David B Brushwood

Publications and source records attributed to David B Brushwood.

18 recordsLinked to original sources
PubMed2004

A pharmacist model of perceived responsibility for drug therapy outcomes.

Pharmacists in community and ambulatory care settings are in a unique position to reduce drug-related morbidity and to optimize patient outcomes by identifying, resolving, and preventing drug therapy problems. This particular approach to pharmacy practice expands traditional pharmacist responsibilities of dispensing pharmaceuticals and providing drug information to optimizing patients' drug therapy outcomes. However, pharmacists in general, and community pharmacists in particular, have yet to incorporate this expanded professional role into daily practice. The objective of this study was to examine the validity of a pharmacist model of perceived responsibility for drug therapy outcomes based on the triangle model of responsibility. A survey instrument was tested among community and ambulatory care pharmacists in Florida, USA. The survey instrument contained the following pharmacist-related constructs from the model: clarity of standards, personal control, professional duty, and perceived responsibility for drug therapy outcomes. The model was examined by testing hypothesized relationships between the model constructs and pharmacists' reports of providing pharmaceutical care. The survey response rate was 40.9% (525/1283). All of the study measures exhibited Cronbach alpha values greater than .70. A measurement model was tested using confirmatory factor analysis. The chi2/df ratio (3.02), CFI (.95), and residual (.051) indicated a good fit of the item data to the constructs. According to path analysis, clarity of standards, personal control, and professional duty were significantly related to perceived responsibility for drug therapy outcomes, which in turn, was significantly related to pharmaceutical care provision. Perceived responsibility for drug therapy outcomes acted as a mediator of the effects of clarity of standards, personal control, and professional duty on pharmaceutical care provision. These findings have implications for pharmacy practice and research.

Adult↗
PubMed1990

Deception.

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Altruism↗
PubMedDate not supplied

Time savings associated with dispensing unit-of-use packages.

OBJECTIVES: To determine how much time can be saved with the use of unit-of-use packaging in a community pharmacy, the distribution of work between the pharmacist and the pharmacy technician when unit-of-use packaging is used, and the number of errors that occur when either unit-of-use or bulk packaging is used in dispensing prescriptions. DESIGN: A simulation comparing count-and-pour dispensing with unit-of-use package dispensing. SETTING: An independent community pharmacy. PARTICIPANTS: Two teams, each composed of one pharmacist and one pharmacy technician. INTERVENTION: Each team prepared 50 typical prescription orders, once using unit-of-use packaging and once by transferring medication from a bulk container. MAIN OUTCOME MEASURES: Time needed to dispense 50 prescriptions, dispensing activities performed by technicians and pharmacists, and number of dispensing errors. RESULTS: The time saved with unit-of-use packaging compared with count-and-pour dispensing was 46.5 minutes per 100 prescriptions, which represents an average time savings of more than 27 seconds per prescrition. In the bulk package dispensing simulation, the pharmacists assisted in retrieving and counting medication for 26% of the prescriptions. This percentage dropped to 4% when unit-of-use packaging was used because the technicians dispensed prescriptions at a rate that occupied the pharmacist with verifying the prescription orders and dispensed products. Each team committed two counting errors when executing the bulk package trial and no errors when using unit-of-use packaging. CONCLUSION: Unit-of-use packaging can reduce the time needed for and increase the efficiency of pharmacists' dispensing activities. Unit-of-use packaging may also reduce the number of counting errors.

Drug Packaging↗
PubMedDate not supplied

Media coverage of controlled substance diversion through theft or loss.

OBJECTIVES: To determine the frequency of media reports of controlled substance diversion. DESIGN: Quantitative search of news articles from LexisNexis Academic, using search strings related to four different types of controlled substance diversion. SETTING: Not applicable. PATIENTS OR PARTICIPANTS: Not applicable. MAIN OUTCOME MEASURES: Number of media reports about diversion of controlled substances at the prescriber or dispenser levels, through pharmacy robberies or thefts, and through hijackings or robberies of shipments. RESULTS: Media reports of controlled substance diversion indicate that theft and loss are important problems and that inappropriate prescribing and dispensing are substantial problems as well. Leaks of controlled substances from the closed system of distribution seem to be increasing as rapidly through theft and loss as through inappropriate prescribing and dispensing. During the five biennia between 1993 and 2002, these percentage increases in media reports were observed for the different types of diversion: 200% for prescribers; 350% for dispensers; 133% for pharmacy robberies and thefts; and 1,800% for thefts from shipping channels. CONCLUSION: A balanced approach to the prevention of controlled substance diversion, aimed at reducing illicit acquisition of drugs from theft and loss as well as from prescribing and dispensing, may produce the greatest success without adversely affecting the quality of patient care.

Drug Prescriptions↗