Co P P Pr rpo N Se o f rat e pa ile s e ge 23
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The Pharmacist’s News Source
pharmacypracticenews.com
Volumee 37 • Number 8 • August 2010
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McMahon Publishing
this issue $17 billion at stake PCI Antiplatelet Therapy in Up Front ‘Meaningful Use’ IT Provision Gets More Complicated In Brief ACC/AHA panel offers tips in wake of clopidogrel warning Tampa, Fla.—Genetics, comorbidities and other patient-specific factors can impact efficacy and need to be considered when patients with acute coronary syndromes (ACS) are being evaluated for antiplatelet medications, according to a session on thrombosis therapy at the American Society of Health-System Pharmacists (ASHP) 2010 Summer Meeting. Speakers at the session paid particular attention to how these factors could impair response to clopidogrel (Plavix, Sanofi-Aventis). That topic choice proved prescient when, several weeks after the ASHP meeting, a task force warned clinicians to heed the potential causes of impaired response to the commonly used antiplatelet agent.
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see WARNING, page 21
Making Smart-Pump Drug Libraries Smarter Atlanta—It took a multidisciplinary team at Women & Children’s Hospital of Buffalo in New York more than two years to develop and implement a wireless smart pump and customized drug library tailored to the diverse dosing needs of the hospital’s pediatric and high-risk obstetric patient population. When the system went live in 2008 after “no less than four attempted implementations,” according to Kelly A. Michienzi, PharmD, clinical pharmacy coordinator at the 214-bed hospital, it quickly began to pay safety dividends. Within a week, Dr. Michienzi said, the hard-limit safeguards embedded in the pump’s software prevented medication errors such as the administration of an IV immunoglobulin dose at 10 times the safe rate. Other “critical catches” soon followed, she said, including the prevention of insulin, heparin and epinephrine overdoses. In the ensuing months, the system continued to demonstrate safety benefits. “We have had a reduction in preventable errors of 46%—calculated in errors per patient day. We went from 10.4 [errors per patient-day]
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see DRUG LIBRARIES, page 46
Deemed a Game-Changer
New REMS approved to reduce quinine-associated hematologic reactions.
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FDA and NIH launch Web site for reporting safety data.
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Operations & Mgmt
Leadership in Action Ernie Anderson describes the importance of selfconfidence in a leader.
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Reimbursement Part 2 of a series on how a dedicated pharmacist can help resolve payment issues.
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Clinical
IVIG FAQ Exploring the role of immunoglobulins in treatment of complex regional pain syndrome.
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Hem/Onc Pharmacy Second-generation TKIs poised to supplant imatinib for CML.
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Tampa, Fla.— professionals will .— Hospitals and health care p rro ofe fessionals w ill have far greater il flexibility in “meaningful use” elecn meeting the “me ean anin ingf g ul u gf se” requirements ffor se orr ccertified ertifi fied ed eele lectronic health (EHR) technology h record (EH HR) R) technol loggy under a finall rule issue issued byy ed last month b the Centers for Medi Medicare Medicicare & Medic caid Services (CMS). Reacting to more than th haan 2,000 2 00 2, 000 public comments, many ments, m any of an of them criticizing the proposed he p pr roposed rregueeggulations released ased ed in Januaryy ed as being too o rrigid, igid, CMS reduced to 15 th the he number of “core” meane” me eaan ningful use objectives that have to o be satisfied to qualify alify for Medicare and nd Medicaid incentive tive payments in 2011. 11. In addition on to the core measures, thee ag aagency ency tacked on on a “menu set” of 10 otherr objectives from which hospit hospitals and itaalls an it ital nd clinicians ccllin inicians will have to select att least five to fulfill meaningful usee requirements. Others deemed too difficult to achieve by 2011 can be postponed for a year, according to the rule. In announcing the flexible, two-track approach, CMS abandoned its “allor-nothing” test requiring hospitals to meet 23 objectives and physicians to meet 25 in order to be deemed meaningful users.
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Technology
Automation Industry responds to issues surrounding pump recalls.
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Bar Coding Tips on how to select a BCMA system.
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Educational Review
Antimicrobial Efficacy See www.pharmacypracticenews.com
see MEANINGFUL USE, page 48
Clinic Travel a Winning Strategy For Onc Pharmacist/Nurse Team Chicago—A program that brings a pharmacist/nurse team directly to oncology clinic patients for supportive care has achieved major reductions in symptoms such as pain and nausea, according to a study presented at the 2010 annual meeting of the American Society of Clinical Oncology. The Supportive Care Consult Service at the University of North Carolina at Chapel Hill (UNC-CH) consists
of a full-time pharmacist and a nurse. Requests are called in from adult oncology clinics—hematology/oncology, gynecologic oncology, surgical oncology or radiation oncology. The team then goes to the individual clinic where the pharmacist and nurse often conduct the consult together. Once they develop a plan of action, they run their recommendation by
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see ROVING, page 36
New Product APP Pharmaceuticals announces approval and launch of first generic Aztreonam for Injection. See page
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