Pharmacy Student Research Projects

Omnicell Medication Optimization in the Emergency department at Northwest Medical Center

Mon, 01 Jan 2024 00:00:00 GMT

Omnicell Medication Optimization in the Emergency department at Northwest Medical Center Jones, Songhee; Tran, Trang; Vuong, Tu Specific Aims: To identify medications needing adjustment or removal from the Omnicell, and to assess if the adjustment made a difference in restocks. Methods: This project collected baseline usage data during a 60-day timeframe in Emergency Department (ED) Omnicell machines. Changes were made to the Periodic Automated Replacement (PAR) and Reorder (R/O) amount in the ED East and West Omnicell machines based on max used day, restocks, and number of stockouts. After implementation, a 45-day timeframe was used to assess the effects. Chi Square was used to compare the number of restocking events before and after interventions at ED West and East Omnicell machines with p<0.05 for significant results. Results: Of the 414 medications in the ED West Omnicell, 29 (7%) medications were adjusted. Of the 489 medications in the ED East Omnicell, 28 (5.3%) medications were adjusted. The average number of restocks per period changed from 10.86 times to 7.17 times in the ED West, and changed from 9.86 times to 5.57 times in ED East. The changes gave a significant reduction in the average number of restocks in the ED West with p=0.011, and ED East with p=0.0002. The number of stockouts did not change. Conclusions: Adjustments to PAR and R/O amounts in the Emergency Department Omnicell machines led to a significant reduction in the average number of restocks for pharmacy technicians. Since stock outs were not reduced, nursing time and patient safety were also not improved. Class of 2024 Abstract and Poster

Analysis of Adverse Events Occurring in Ordered KIDs List Medications Administered to Pediatric Patients at Diamond Children’s Hospital at Banner University Medical Center

Mon, 01 Jan 2024 00:00:00 GMT

Analysis of Adverse Events Occurring in Ordered KIDs List Medications Administered to Pediatric Patients at Diamond Children’s Hospital at Banner University Medical Center Evangelista, Ed; Hise, Jarrod; Mardi, Nazanin; Rosales, David; Unarker, Aakash Specific Aims: This study aims to examine prescribing practices and potential side effects linked to KIDs list medications at Diamond Children’s Hospital, Banner University Medical Center Tucson in 2022. Methods: The study utilized a descriptive, retrospective analysis. A chart review was conducted to identify patients who received KIDs list medications. The chart review focused on identifying adverse effects, evaluating alerts generated during prescribing and dispensing, and monitoring for adverse reactions occurring within 48 hours of medication administration. KIDs list medications prescribed to patients in the cautionary age range were considered inappropriately prescribed. Results: The study found that 9.86% of KIDs list medications administered to children at Banner Diamond Children’s Medical Center were inappropriately prescribed. In the group inappropriately prescribed these medications, 1.01% experienced an adverse reaction, none of which was severe. Out of 198 patients who were inappropriately administered KIDs list medications, only 29 of these patients were administered a medication where avoidance was recommended. Additionally, a total of 95 alerts were generated during the verification process. The majority of these alerts were related to duplicate therapy (27) and were linked to weight-based dosing alerts (34). Conclusion: This study provides a foundational understanding of prescribing practices related to KIDs List medications. However, there remains a need for ongoing evaluation and improvement in pediatric medication safety protocols. In the future, it would be beneficial to duplicate this study across multiple in-patient sites over an extended period of time. Addressing these challenges may lead to safety optimizations that will improve outcomes in pediatric populations. Class of 2024 Abstract

Naloxone: A Pain to Co-Prescribe? Evaluating naloxone co-prescribing practices for patients at an increased risk of opioid overdose at a federally qualified health center

Mon, 01 Jan 2024 00:00:00 GMT

Naloxone: A Pain to Co-Prescribe? Evaluating naloxone co-prescribing practices for patients at an increased risk of opioid overdose at a federally qualified health center Ellis, Danielle; Fleury, Molly; McDermott, Logan; Welch, Haley Specific Aims: Describe the population at high risk for opioid overdose that are receiving naloxone orders with concurrent prescriptions with a morphine milliequivalent (MME) ≥ 50, concurrent prescriptions for benzodiazepines or opioid use disorder, and/or a history of opioid overdose. Methods: This is a descriptive, observational, retrospective, cross-sectional study from October 2022 using data extracted from El Rio charts. To be eligible for this study, patients must have been treated at El Rio Clinic during October 2022, and meet certain Centers for Disease Control and Prevention (CDC) criteria for being at high risk for opioid overdose. A sample size of 773 was provided for data analysis. A total of 77 patients were excluded due to a lack of combined MME available, leaving a total of 696 patients analyzed. Results: Of the sample size analyzed (n=696), there were 367 naloxone orders prescribed. For MME >50, 238 patients were analyzed and 159 were prescribed concurrent naloxone (66.8%). For patients with medications used for opioid use disorder (OUD) and/or substance use disorder (SUD), 186 patients were analyzed and 130 were prescribed concurrent naloxone (69.9%). For patients with an OUD/SUD diagnosis, 239 patients were analyzed and 148 had concurrent naloxone (61.9%). For patients with concurrent benzodiazepines and opioids, 143 patients were analyzed and 65 had concurrent naloxone (45.4%). For patients with orders for benzodiazepines, muscle relaxants, and opioids, 75 patients were analyzed and 38 had concurrent naloxone (50.6%). Conclusions: There were 881 total opportunities to provide naloxone that met CDC recommendations. On average, 2 out of every 5 patients could have received naloxone that did not. Patients with OUD/SUD history or relevant medications were most commonly co-prescribed naloxone. The most overlooked group were those on opioids and benzodiazepines concurrently. Class of 2024 Abstract and Poster

Evaluating the efficacy of an addiction consult service

Mon, 01 Jan 2024 00:00:00 GMT

Evaluating the efficacy of an addiction consult service Walters, Tori; Herrick, Brianna Specific Aims: To explore whether an addiction consult service improves 30-day emergency department readmission rates. Methods: Chart review was performed on 278 patients to collect demographic data on age, substance used, recommended treatment, and discharge. Data was de-identified and stored electronically to perform analysis. Descriptive analysis was done using Excel. Results: The two most common substances used were opioids and alcohol at rates of 59% and 21% respectively. 91 patients were recommended to start buprenorphine, 81 were recommended methadone, and 86 were given resources. 66% of patients were discharged without difficulty and 13% of patients left against medical advice. In patients who met with the addiction consult service, 30-day emergency department readmissions decreased by 59%. Conclusions: This project demonstrated that an addiction consult service can have a positive impact on 30-day emergency department readmissions and is an important intervention that should be implemented in more healthcare systems. Class of 2024 Abstract and Poster