UHSP Collections (University of Health Sciences and Pharmacy)
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Electronic health records in pharmacy skills-based curricula
No full textElectronic health records (EHRs) are integral to contemporary pharmacy practice. The use of EHRs and associated skill development in curricula across pharmacy education is variable. Skills-based courses in the Doctor of Pharmacy curriculum are ideal areas to develop these competencies’ and integrate EHR use and skills with the Pharmacists’ Patient Care Process. Consideration should be given by each school and college of pharmacy for having an EHR curriculum embedded within skills-based courses to prepare students for advanced pharmacy practice experiences as well as professional practice after graduation. A consensus on what skills or competenciesshouldbeconsistentlyincludedinpharmacycurriculashouldbedevelopedacrosspharmacyedu-cation to increase consistency in the delivery of EHR skills education and assessment. Emphasis on EHR skills and incorporation of them into national pharmacy education standards would help further guide development and assessment, as well as ensure new pharmacists are on the cutting edge of patient care and technology
Nosocomial Infection
No full textObjective: The first 70 years of critical care can be considered a period of industrial revolution-like advancement in terms of progressing the understanding and care of critical illness. Unfortunately, like the industrial revolution\u27s impact on the environment, advancing ICU care of increasingly elderly, immunosuppressed, and debilitated individuals has resulted in a greater overall burden and complexity of nosocomial infections within modern ICUs. Given the rapid evolution of nosocomial infections, the authors provide an updated review. Data Sources and Study Selection: We searched PubMed and OVID for peer-reviewed literature dealing with nosocomial infections in the critically ill, as well as the websites of government agencies involved with the reporting and prevention of nosocomial infections. Search terms included nosocomial infection, antibiotic resistance, microbiome, antibiotics, and intensive care. Data Extraction and Data Synthesis: Nosocomial infections in the ICU setting are evolving in multiple domains including etiologic pathogens plus novel or emerging pathogens, prevalence, host risk factors, antimicrobial resistance, interactions of the host microbiome with nosocomial infection occurrence, and understanding of pathogenesis and prevention strategies. Increasing virulence and antimicrobial resistance of nosocomial infections mandate increasing efforts toward their prevention. Conclusions: Nosocomial infections are an important determinant of outcome for patients in the ICU setting. Systematic research aimed at improving the prevention and treatment of nosocomial infections is still needed
Assessment of glycosylated hemoglobin outcomes following an enhanced medication therapy management service via telehealth
No full text(1) Background: Regular contact with a medication therapy management (MTM) pharmacist is shown to improve patients’ understanding of their condition; however, continued demonstration of the value of a pharmacist delivered comprehensive medication review (CMR) using enhanced MTM services via telehealth is needed. The study aimed to describe a pilot program designed to improve type 2 diabetes mellitus (T2DM) management through enhanced condition specific MTM services. (2) Methods: This retrospective study included patients with T2DM aged 40–75 years who received a pharmacist-delivered CMR between January and December 2018. An evaluation of glycosylated hemoglobin (HbA1c) values 3 months pre-and post-CMR was performed. Wilcoxon signed-rank and chi-square tests were used. (3) Results: Of 444 eligible patients, a majority were female (58%) with a median age of 70 years. Median HbA1c values post-CMR were lower than pre-CMR (median 7.1% range 4.5–13.6; median 7.4% range 4.5–13.9, respectively; p = 0.009). There were fewer participants with HbA1c \u3e9% post-CMR (n = 66) than pre-CMR (n = 80; p \u3c 0.001) and more with HbA1C \u3c6.5% post-CMR (n = 151) than pre-CMR (n = 130; p \u3c 0.001). (4) Conclusion: This program evaluation highlighted the value of an enhanced condition specific MTM service via telehealth. Patients had improved HbA1c values three months after receiving a single pharmacist delivered CMR
Corrigendum to “Impact evaluation of a four-year academic-community partnership in provision of medication management and tertiary prevention services for rural patients with diabetes and/or hypertension” preventive medicine reports 17 (2020): 101,038 (Preventive Medicine Reports (2020) 17, (S2211335519302098), (10.1016/j.pmedr.2019.101038))
No full textThe authors regret that Table 2 reports FBG (fasting blood glucose) in units of mmol/L instead of mg/dL. The authors would like to apologise for any inconvenience caused
Pharmacist and physician perception of barriers to collaborative drug therapy management in Missouri
No full textBackground: Collaborative drug therapy management (CDTM) rules were implemented in 2012 in Missouri, but community pharmacists are currently not working with physicians to implement services. Purpose: This study aims to uncover barriers to CDTM adoption by Missouri community pharmacists and outpatient physicians. Methods: A nine question, cross-sectional survey was mailed to a sample of 500 community pharmacists and 500 outpatient physicians in Missouri. Surveys were designed to assess knowledge, attitudes, and beliefs regarding CDTM. Discussion: A total of 103 community pharmacists (21.7%) and 23 outpatient physicians (4.7%) completed the survey. Pharmacists identified concerns about operational barriers such as time (93.2%), and reimbursement for services (80.6%). Physicians indicated concern with clinical risks, including potential disconnect between providers (70%) and inadequate pharmacist training (63.6%). Conclusions: Demonstration of clinical abilities and development of working relationships with physicians is important for the implementation of CDTM. Development of standardized reimbursement models and workflow models should be further evaluated
Remote Work Policy - Staff
No full textRemote work is a work arrangement in which staff in certain positions may receive approval to routinely perform their regular job responsibilities away from their primary business location. Remote work is intended to allow qualifying staff members to continually be productive while promoting work-life balance. Often employees in certain positions and employers find well-developed remote work programs allow for increased productivity overall and increased work satisfaction. These changes occur due to the remote worksite being more free from distractions therefore allowing for certain work to be better accomplished there, while maximizing those irreplaceable interactions and tasks that can only occur when at the worksite.
This policy covers arrangements established for regularly scheduled, sustained periods of time, that represent a portion of the employee’s work week. Working on campus in a collaborative environment is a critical component of almost all positions.
The ability to work remotely is a privilege based on the needs of the job, work group and organization; it may be determined by the employee’s past and present levels of performance; and it is not a right. Not all employees and not all jobs are suited for regular remote work. Typically, remote work relationships will not be established during an employee’s orientation period, when an employee is experiencing performance problems, requires close supervision, or if job requirements can only be accomplished on campus. Remote work arrangements are not intended to create a “second job” with the University or to allow employees to pursue other jobs or business initiatives external to the University.
Department supervisors are responsible for determining the feasibility of any individual remote work arrangement based upon evaluation of the work to be accomplished, benefits to the department, interactions required between the employee who is working remotely and other staff members or customers and the demonstrated skills of the employee. Employees being considered for remote work must have a demonstrated record of acceptable or higher performance, be capable of independent, self-directed work, and be highly self-motivated. A remote work arrangement is developed by the employee and supervisor, but must be approved by both the Office of Human Resources and the President’s Staff representative with oversight of the unit.
Remote work arrangements must comply with federal, state and local laws, as well as University policies that apply to employees at University of Health Sciences and Pharmacy in St. Louis (UHSP). This includes, but is not limited to, the Fair Labor Standards Act (FLSA) and the Occupational Safety and Health Act (OSHA). Therefore, remote work arrangements do not change salaries, benefits, job responsibilities, leave policies or other basic terms or legal requirements associated with employment
Associations between stress, anxiety, depression, and emotional intelligence among osteopathic medical students
No full textContext: Stress, anxiety, and depression affect medical student populations at rates disproportionate to those of general student populations. Emotional intelligence (EI) has been suggested as a protective factor in association with psychological distress. Objective: To explore the relationships between EI and stress, anxiety, and depression among a sample of US osteopathic medical students. Methods: From February to March 2020, a convenience sample of medical students enrolled at an osteopathic medical school in the southeastern region of the United States were invited to complete a voluntary and anonymous 54-item online questionnaire that included sociodemo-graphic items as well as validated and reliable scales assessing perceived stress, anxiety, depression, and EI. Univariate statistics were calculated to describe the partic-ipant characteristics and the study variables of interest. Pearson’s product-moment correlations were used to examine relationships between EI and study variables. Three multiple regression models were fitted to examine the relationship between EI and stress, anxiety, and depres-sion, adjusting for sociodemographic factors exhibiting significant bivariate relationships with outcome variables. Dichotomous variables were created that were indicative of positive screens for potential depressive disorder or anxiety disorder. Independent-sample t-tests were used to determine the presence of a statistically significant difference in EI scores between positive screeners for depression and anxiety and their respective counterparts; an alpha level of 0.05 was set apriorito indicate statistical significance. Results: In all, 268 medical students participated in this study, for a response rate of approximately 27%. Impor-tantly, EI exhibited significant negative correlations with stress, anxiety, and depression (r=−0.384, p\u3c0.001; r=−0.308, p\u3c0.001; r=−0.286, p\u3c0.001), respectively). Thus, high levels of stress, anxiety, and depression were observed in the sample. Significant relationships remained following covariate adjustment. Established cutoffs for anxiety and depression were used to classify positive and negative screens for these morbidities. Using these classi-fications, individuals screening positive for potential anxiety and depression exhibited significantly lower levels of EI than their counterparts showing subclinical symp-toms (t=5.14, p\u3c0.001 and t=3.58, p\u3c0.001, respectively). Conclusion: Our findings support the notion that higher levels of EI may potentially lead to increased well-being, limit psychological distress, improve patient care, and facilitate an ability to thrive in the medical field. We encourage continued study on the efficacy of EI training through intervention, measurement of EI in both academic and clinical settings as an indicator of those at risk for programmatic dropout or psychological distress, and consideration of EI training as an adjunct to the educa-tional program curriculum
Adolescent birth rates and rural⇓urban differences by levels of deprivation and health professional shortage areas in the United States, 2017–2018
No full textObjectives. To examine the differences in adolescent birth rates by deprivation and Health Professional Shortage Areas (HPSAs) in rural and urban counties of the United States in 2017 and 2018. Methods. We analyzed available data on birth rates for females aged 15 to 19 years in the United States using the restricted-use natality files from the National Center for Health Statistics, American Community Survey 5-year population estimates, and the Area Health Resources Files. Results. Rural counties had an additional 7.8 births per 1000 females aged 15 to 19 years (b = 7.84; 95% confidence interval [CI] = 7.13, 8.55) compared with urban counties. Counties with the highest deprivation had an additional 23.1 births per 1000 females aged 15 to 19 years (b = 23.12; 95% CI = 22.30, 23.93), compared with less deprived counties. Rural counties with whole shortage designation had an additional 8.3 births per 1000 females aged 15 to 19 years (b = 8.27; 95% CI = 6.86, 9.67) compared with their urban counterparts. Conclusions. Rural communities across deprivation and HPSA categories showed disproportionately high adolescent birth rates. Future research should examine the extent to which contraceptive access differs among deprived and HPSA-designated rural communities and the impact of policies that may create barriers for rural communities
#LetsUnlitterUK: A demonstration and evaluation of the Behavior Change Wheel methodology
No full textThe Behavior Change Wheel is the most comprehensive and practically useful methodology available for developing behavior change interventions. The current article demonstrates how it can be applied to optimize pro-environmental behaviors and, in so doing, give interventionists access to a rigorous set of theories and techniques for systematically developing pro-environmental interventions. Section 1 describes the development of an intervention to increase people\u27s intentions to post anti-littering messages on social media. Study 2 describes the development and evaluation of an intervention to increase people\u27s actual anti-littering posts. Both evaluations are randomized controlled trials that compare the effectiveness of the developed intervention with interventions less informed by the Wheel. We found interventions completely informed by the Wheel to be more effective than interventions less (or not at all) informed by the Wheel. The discussion explores how the Behavior Change Wheel methodology can be used to design future pro-environment interventions