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Background: Coronavirus disease 2019 (COVID‐19) is a highly contagious, airborne viral infection that can infect anyone. Those with certain underlying conditions may be at higher risk for infection to develop into a severe disease requiring hospitalization. This report summarizes use of nirmatrelvir‐ritonavir for the treatment of COVID‐19 in high‐risk patients at a single academic medical center through a pharmacist delegation protocol and demonstrates real‐world efficacy and safety of treatment. Methods: This retrospective, single‐center, observational study analyzed all patients who received nirmatrelvir‐ritonavir ordered by a clinical pharmacist for treatment of COVID‐19 infection. The primary outcomes were safety and efficacy of nirmatrelvir‐ritonavir. Safety was evaluated by analyzing drug interaction management and adverse events. Efficacy was evaluated through hospitalization and death within 28 days of nirmatrelvir‐ritonavir use. Results: Sixty patients were eligible for inclusion. No patients were hospitalized or died within 28 days after initiation of nirmatrelvir‐ritonavir. Pharmacists identified 101 drug interactions with 60% considered clinically significant, requiring modification of home medications. Adverse outcomes associated with the use of nirmatrelvir‐ritonavir were reported in 13 patients (21.7%). Conclusions: A comprehensive program to mitigate drug interactions and prescribe nirmatrelvir‐ritonavir ensured timely access to COVID‐19 therapy, which may be associated with the prevention of hospitalization and death. [ABSTRACT FROM AUTHOR]

Background: Although people who smoke cigarettes are overrepresented among hospital inpatients, few are connected with smoking cessation treatment during their hospitalization. Training, accountability for medication use, and monitoring of all patients position pharmacists well to deliver cessation interventions to all hospitalized patients who smoke. Methods: A large Midwestern University hospital implemented a pharmacist-led smoking cessation intervention. A delegation protocol for hospital pharmacy inpatients who smoked cigarettes gave hospital pharmacists the authority to order nicotine replacement therapy (NRT) during hospitalization and upon discharge, and for referral to the Wisconsin Tobacco Quit Line (WTQL) at discharge. Eligible patients received the smoking cessation intervention unless they actively refused (ie, "opt-out"). The program was pilot tested in phases, with pharmacist feedback between phases, and then implemented hospital-wide. Interviews, surveys, and informal mechanisms identified ways to improve implementation and workflows. Results: Feedback from pharmacists led to changes that improved workflow, training and patient education materials, and enhanced adoption and reach. Refining implementation strategies across pilot phases increased the percentage of eligible smokers offered pharmacist-delivered cessation support from 37% to 76%, prescribed NRT from 2% to 44%, and referred to the WTQL from 3% to 32%. Conclusion: Hospitalizations provide an ideal opportunity for patients to make a tobacco quit attempt, and pharmacists can capitalize on this opportunity by integrating smoking cessation treatment into existing inpatient medication reconciliation workflows. Pharmacist-led implementation strategies developed in this study may be applicable in other inpatient settings. [ABSTRACT FROM AUTHOR]

Purpose: To improve patient safety and reduce drug waste through implementation of automated parenteral chemotherapy dose-banding within an electronic health record. Methods: Parenteral chemotherapy dose-rounding practices were transitioned from a manual, pharmacist-driven workflow to an automated process within the electronic health record. Initial medications transitioned included bevacizumab, rituximab, and trastuzumab. Dose-banding tables were built to standardize rounding within a 10% parameter and then subsequently incorporated into the electronic health record after receiving multidisciplinary approval. Following implementation, a retrospective chart review was performed to compare drug and associated cost savings with manual dose-rounding and automated dose-banding. Medication safety improvements were measured by comparing the change in the number of clicks needed for pharmacist verification as well as by evaluation of submissions to our event reporting system. Results: After implementing automated parenteral chemotherapy dose-banding, reported medication errors associated with the parenteral chemotherapy rounding process decreased. The number of event submissions related to incorrect rounding decreased from four submissions in the pre-implementation period to zero in the post-implementation period. Automation saved pharmacists at least 9,297 additional clicks and 11,363 additional keystrokes and also led to notable increases in total drug savings as well as drug cost savings. Conclusion: Overall safety of our parenteral chemotherapy ordering processes within our electronic health record was improved after the implementation of automated dose-banding. By standardizing the administered doses for three chemotherapy agents, we were also able to increase total drug savings and associated drug cost savings. [ABSTRACT FROM AUTHOR]

Using pharmacy residents as covert observers, we evaluated compliance with hand hygiene and contact precautions among 101 unique health care workers on entrance, exit, and inside rooms of patients with known or suspected Clostridium difficile infection. Overall compliance rates with hand hygiene upon entering and exiting patient rooms were 63.4% and 69.3%, respectively. However, there was a lack of hand hygiene inside patient rooms for the observed opportunities., (Copyright © 2014 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.)