Includes bibliographical references.

Critical evaluation of pharmacy automation and robotic systems: a call to action -- Sodium Zirconium Cyclosilicate -- Cognitive computing and watson: Implications for hospital pharmacy -- The assessment and management practices pf acute alcohol withdrawal: results of a nationwide survey of critical care pharmacists -- Physical compatibility and chemical stability of injectable and oral ranitidine solutions -- The effect of performance transparency on adherence to barcode scanning during order preparation in an adult inpatient satellite pharmacy -- The effect of pharmacy-driven education on the amount of appropriately administered tetanus vaccines in the emergency department -- Remote antimicrobial stewardship: a solution for meeting the joint commission stewardship standard? -- A survey of opioid medication stewardship practices at academic medical centers.

[Article Title: Critical Evaluation of Pharmacy Automation and Robotic Systems: A Call to Action / Anthony M. Boyd and Bruce W. Chaffee, p. 4-11]

Abstract: Health care is an industry primed for innovation. Health care spending in the United States is approximately 50% more per person than in many other developed nations, with this spending accounting for 17.8% of the gross domestic product (GDP). It has been suggested that the increased use of technology and automation within health care could provide better patient care while reducing total costs. Pharmacy leaders continue to be pressured to minimize costs while providing pharmaceutical care in a safe and effective manner.

https://doi.org/10.1177/0018578718786942

[Article Title: Sodium Zirconium Cyclosilicate / Terri L. Levien and Danial E. Baker, p. 12-19]

Abstract: Each month, subscribers to The Formulary Monograph Service receive 5 to 6 well-documented monographs on drugs that are newly released or are in late phase 3 trials. The monographs are targeted to Pharmacy & Therapeutics Committees. Subscribers also receive monthly 1-page summary monographs on agents that are useful for agendas and pharmacy/nursing in-services. A comprehensive target drug utilization evaluation/medication use evaluation (DUE/MUE) is also provided each month. With a subscription, the monographs are available online to subscribers. Monographs can be customized to meet the needs of a facility. Through the cooperation of The Formulary, Hospital Pharmacy publishes selected reviews in this column.

https://doi.org/10.1177/0018578718817470

[Article Title: Cognitive Computing and Watson: Implications for Hospital Pharmacy / Brent I. Fox, p. 20-21]

Abstract: This installment explores the domain of cognitive computing, using the well-known Watson as an example. The migration of computer manufacturers from a focus on hardware to a focus on services suggests the potential of these tools. Considerations for use of these tools in the health care system are provided.

https://doi.org/10.1177/0018578717715386

[Article Title: The Assessment and Management Practices of Acute Alcohol Withdrawal: Results of a Nationwide Survey of Critical Care Pharmacists / Susanne Dyal and Robert MacLaren, p. 22-31]

Abstract: Alcohol abuse is associated with up to 40% of all intensive care unit (ICU) admissions, and an estimated 0.5% of ICU patients exhibit alcohol withdrawal. Guidelines for the assessment and management of alcohol withdrawal are outdated. Thus, many institutions generate their own protocols to assess and treat alcohol withdrawal syndrome, resulting in many practice variations that could influence patient care and outcomes. Benzodiazepines are frequently used to prevent or treat alcohol withdrawal as their mechanism of action overlaps with alcohol and reestablishes the gamma-aminobutyric acid (GABA)–mediated neurogenic inhibition that occurs when alcohol is no longer present.

https://doi.org/10.1177/0018578718769241

[Article Title: Physical Compatibility and Chemical Stability of Injectable and Oral Ranitidine Solutions / Kelly Fleming and Ronald F. Donnelly, p. 32-36]

Abstract: Ranitidine is a histamine H2-receptor antagonist that acts by antagonizing histamine at gastric H2-receptor sites. Ranitidine inhibits both basal gastric secretion and gastric acid secretion induced by histamine, pentagastrin, and other secretagogues. Ranitidine is used for many different indications including gastroesophageal reflux disease and the prophylaxis of stress ulceration in critically ill patients. Review of the literature found 8 articles that reported the stability of ranitidine hydrochloride injectable solutions in polyvinyl chloride (PVC) bags, polypropylene (PP) syringes, glass vials, and glass ampoules. Six of the studies involved ranitidine hydrochloride injection packaged in PVC bags with concentrations ranging 0.05 to 2 mg/mL in either normal saline (NS), 5% dextrose in water (D5W), 10% dextrose in water, 5% dextrose with 0.45% sodium chloride, or 5% dextrose with lactated Ringer’s.

https://doi.org/10.1177/0018578718763085

[Article Title: The Effect of Performance Transparency on Adherence to Barcode Scanning During Order Preparation in an Adult Inpatient Satellite Pharmacy / David Merola, John D. Hill, Stephanie Olumba, Rosemary Duncan, Virna Almuete, and Kenneth M. Shermock, p. 37-44]

Abstract: Preventable medication errors remain a prominent problem among health care institutions that often lead to negative outcomes and excessive health care costs. It has been estimated that inpatients experience, on average, 1 or more medication errors during each day of hospital admission, and as many as 1 in 3 adverse outcomes occurring in hospitalized patients has been attributed to adverse drug events. The Institute of Medicine’s 1999 report, “To Err Is Human,” cited the inpatient medication use process as an area of health care delivery from which many preventable mistakes arise. Each phase of drug distribution—ordering, transcribing, selection, preparation, dispensing, administration, and monitoring—poses a risk for inaccuracies to occur that may ultimately result in patient harm. Efforts to promote exactitude throughout these processes have prompted the implementation of barcode scanning technology across health systems nationwide.

https://doi.org/10.1177/0018578718764272

[Article Title: The Effect of Pharmacy-Driven Education on the Amount of Appropriately Administered Tetanus Vaccines in the Emergency Department / Meghan Fletcher, Shannon Rankin, and Preeyaporn Sarangarm, p. 45-50]

Abstract: Incidence of tetanus in the United States has been declining at a constant rate since the beginning of case documentation in 1940; however, there were still a reported 233 cases of tetanus between 2001 and March 2008, with an average of 29 cases per year. Tetanus vaccination was reported for only 39.5% of these patients. Postexposure prophylaxis of tetanus upon presentation in an emergency department (ED) for wounds could have possibly prevented these cases. Emergency department providers have varying knowledge regarding the most current tetanus immunization guidelines as well as the differences between available vaccination products. The Centers for Disease Control and Prevention (CDC) and Advisory Committee on Immunization Practices (ACIP) currently recommend routine booster vaccination with tetanus and diphtheria (Td) every 10 years for immunity against tetanus. However, if a patient obtains a wound that is anything beyond “minor and uncontaminated,” they should receive another Td if it has been ≥5 years since their last vaccination.

https://doi.org/10.1177/0018578718769239

[Article Title: Remote Antimicrobial Stewardship: A Solution for Meeting The Joint Commission Stewardship Standard? / C. K. Howell, Jesse Jacob, and Steve Mok, p. 51-56]

Abstract: With increasing rates of resistance, hospital-acquired infections, and a shift from pay for service to value-based services, there has been increasing awareness that the use of antimicrobial agents needs to be evaluated and optimized. In 2007, the Infectious Diseases Society of America (IDSA) and the Society for Healthcare Epidemiology of America (SHEA) recognized that antimicrobial stewardship (AS) could be a self-supporting tool to address these growing concerns. This led to the publication of guidelines for developing antimicrobial stewardship programs (ASP). Since then, there have been numerous attempts to determine the optimal structure of an ASP with various results. Multiple national organizations have also recognized the need for ASP and have developed a tool or guidelines for ASP including the White House, The National Quality Forum, the Centers for Disease Control and Prevention, IDSA, and SHEA.

https://doi.org/10.1177/0018578718769240

[Article Title: A Survey of Opioid Medication Stewardship Practices at Academic Medical Centers / Pamela Phelps, Thomas S. Achey, Katherine D. Mieure, Lourdes Cuellar, Heidemarie MacMaster, Robert Pecho, and Virginia Ghafoor, p. 57-62]

Abstract: It is widely recognized there is an opioid abuse epidemic in America. Drug overdose deaths are the leading cause of injury death in the United States. Since 1999, the rate of overdose deaths involving opioids has nearly quadrupled. More than 650 000 opioid prescriptions are dispensed in the US daily and it is estimated the opioid epidemic costs 55 billion dollars per year in health and social costs. Fighting this epidemic is a national priority for the US Department of Health and Human Services. This priority is highlighted by the Centers for Disease Control and Prevention’s publication in March 2016 of guidelines for prescribing opioids for chronic pain outside of active cancer treatment, palliative care, and end-of-life treatment. One of the principle strategies to combat the epidemic is the improvement in widespread prescribing practices for opioids. Health care providers, including pharmacists, across the nation will be asked to exhibit leadership in curbing opioid prescribing for common conditions.

https://doi.org/10.1177/0018578718779005