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Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

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At least 379 records · Page 21Linked to original sources
PubMed1993

Evaluation of i.v. ceftriaxone usage in a community-based hospital.

Ceftriaxone is primarily used for the treatment of gram-negative nosocomial pneumonia and for gram-negative bacteremias. The following study examines whether ceftriaxone, a broad spectrum parenteral cephalosporin antibiotic, was being administered appropriately based on pre-established hospital criteria.

Ceftriaxone↗
PubMed1993

Comparing low-severity hospital admissions in IPA HMOs and indemnity-type programs.

This study compares the proportion of low-severity hospital patients in independent practice association (IPA) HMOs and indemnity-type programs. The length of stay of such low-severity patients is also studied. Admissions of IPA patients under age 65 to ten hospitals are compared with admissions to the same hospital of patients covered by Blue Cross and Blue Shield plans or commercial insurance programs. Admissions to the adult medical service for the eight most frequently occurring DRGs with 5 percent or more patients in the low-severity category are included. A Logit model of the probability of low-severity admission controlling for age, sex, DRG, and hospital shows no significant IPA effect. However, a multiple regression model shows that the IPAs have significantly lower average length of stay for these low-severity patients.

Concurrent Review↗
PubMed1993

Benefits of clinical pharmacy services in a community hospital.

The purpose of this analysis was to itemize the long term cost-avoidance and benefits of the Clinical Pharmacy Program at York Hospital and compare them to the cost of the program. It was assumed that the major actual reduction in drug cost would occur within the first year of clinical activities. Therefore, to determine the long term benefits, the hypothetical cost-avoidance of drug expenditures were calculated for the subsequent years after the clinical programs were instituted. For fiscal year 1991 these significant benefits amounted to an estimated monetary cost-avoidance of $416,000, a reduction in numerous hours in preparations and administration of 39,000 IVs, and numerous non-quantifiable benefits. The cost of the program in fiscal year 1991 for the pharmacist and administrative salaries related to the Pharmacy Clinical Program was approximately $140,000. Thus, the Clinical Pharmacy Program was cost-effective at York Hospital.

Concurrent Review↗
PubMed1991

Drug-usage evaluation and the patient-care pharmacist: a synergistic combination.

The Joint Commission requires a continuous monitoring program to assure quality pharmaceutical care. The only way to achieve compliance with this standard is to enlist the help of the patient-care pharmacists. Equally important to the pharmacy manager is the way a DUE program can benefit the patient-care pharmacists. The key to an effective program is to assist the patient-care pharmacists in taking responsibility for the quality of drug therapy provided to their patients. Through education, encouragement, and recognition, the DUE Coordinator can elevate the practice of the patient-care pharmacists. The outcome is a synergistic program that enriches the practice of the patient-care pharmacists who, in turn, enrich the quality of pharmaceutical care received by their patients.

Concurrent Review↗
PubMed1991

Integration of drug-usage evaluation with a quality assurance program.

"If it ain't broke, don't fix it" is a classic quote that is still heard. Although health professionals strive for continuous improvement in the understanding, prevention, and treatment of pathology, they commonly ignore the system for health care delivery. DUE provides an effective mechanism for continuous examination of the system and improvement of patient outcome as it relates to drug therapy. The movement toward integration of DUE and clinical profiles will bring the Medical Center closer to realizing the ultimate goal of total quality care.

Chicago↗
PubMed1992

An examination of adverse drug event monitoring practices in U.S. hospitals.

Unfortunately, the reasons for respondents' negative attitudes and perceptions toward ADE monitoring are not entirely clear because they generally are not related to time or staff constraints. There was some indication that poor medical record documentation was a contributing factor; however, this problem can be addressed through education of physicians and nurses as to the importance of capturing and reporting ADE data. Other research has demonstrated that substantial effort and diligence are required on the part of all members of the health care team to capture ADEs consistently. Fortunately or unfortunately--depending on the perspective--the motivation and at least the initial energy to establish and maintain an effective ADE monitoring program have to come from the pharmacy department. The greatest fear is that many pharmacists simply will be apathetic to the issue and not devote the time and energy necessary to capture and process ADE information effectively.

Adverse Drug Reaction Reporting Systems↗
PubMed1993

Hospital mainframe computer documentation of pharmacist interventions.

The hospital mainframe computer pharmacist intervention documentation system described has successfully facilitated the recording, communication, analysis, and reporting of interventions at our hospital. It has proven to be time efficient, accessible, and user-friendly from the standpoint of both the pharmacist and administrator. The advantages of this system greatly outweigh manual documentation and justify the initial time investment in its design and development. In the future, it is hoped that the system can have even broader impact. Intervention/recommendations documented can be made accessible to medical and nursing staff, and as such further increase interdepartmental communication. As pharmacists embrace the pharmaceutical care mandate, documenting interventions in patient care will continue to grow in importance. Complete documentation is essential if pharmacists are to assume responsibility for patient outcomes. With time being an ever-increasing premium, and with economic and human resources dwindling, an efficient and effective means of recording and tracking pharmacist interventions will become imperative for survival in the fiscally challenged health care arena. Documentation of pharmacist intervention using a hospital mainframe computer at UIH has proven both efficient and effective.

Chicago↗
PubMed1993

Interventions: a quality assessment tool for the pharmacy department and the medical staff.

The intervention tracking system at Texas Children's Hospital has evolved from a simple log to a pocket book of check-off forms requiring minimal writing. Information gathered from the intervention data has progressed from merely notification that a call was made to tracking numbers and types of interventions to including the pharmacists in the information loop. Pharmacists are assured that the time spent documenting interventions provides data for medical staff QI, pharmacy QI, and feedback to themselves as well. No documentation is wasted; no separate data collection is required. Intervention categories with medical staff-approved indicators are treated as a concurrent DUE. Depending on the rate of acceptance of pharmacists' recommendations, physicians, pharmacists, or both are targeted for education. Analysis of the acceptance rate may also indicate the need for systems changes more profoundly affecting one or the other of the groups.

Child↗
PubMed1993

Applying total quality management to a pharmacist intervention program.

Intervention documentation continues to be a valuable tool for both documenting pharmacist impact on patient care and justifying new clinical pharmacy services. Utilizing TQM principles to improve documentation has yielded many long-term benefits. Not only has intervention documentation been streamlined, but pharmacists at the staff level were an integral part of the changes that were made and the improvements to come. Their familiarity with the pitfalls of the former system provided solutions to the problems that might have been overlooked without their input.

Academic Medical Centers↗
PubMed1994

Patient controlled analgesia: evaluation of pain management and patient outcome.

A study was conducted to evaluate patient response to patient controlled analgesia (PCA) devices. All patients were interviewed for this concurrent study. A survey was also taken with the nursing staff for their assessments regarding PCA therapy and comparison of outcomes between morphine and meperidine use. Our goal was to see what improvements could be made in pain management and patient therapy wherever possible.

Analgesia, Patient-Controlled↗
PubMed1994

Target drug monitoring: a cost-effective service provided by staff pharmacists.

A concurrent drug use evaluation program that improves patient care while meeting JCAHO requirements was designed and implemented. Integration of staff pharmacists into the program has been an important component. The net annual savings of the program for H2 antagonists and cephalosporins was $16,756. The net annual cost of the program if all drugs were studied throughout each quarter would be $1,336. The program essentially pays for itself, meets medication use standards for JCAHO, and may save significant healthcare costs if potential drug misadventures are avoided.

Concurrent Review↗
PubMed1994

Mental health's contribution to the financial performance of a utilization management program.

Analysis of a national utilization management program covering approximately 3.4 million individuals from 1989 through June 1993 indicates that while only 6% of all hospitalizations were for a primary psychiatric or substance abuse diagnosis, over 44% of the program savings are accounted for by concurrent mental health utilization management. The cost of performing mental health utilization management is significantly greater than the cost of providing medical, surgical, and maternity management, but returns on investments are significantly greater for psychiatric and substance abuse than for these other diagnostic areas. Implications for health care reform inclusion of full mental health benefits are discussed.

Concurrent Review↗