NEW JERSEY SOCIETY OF HEALTH-SYSTEM PHARMACISTS

2011

ANNUAL MEETING/EXHIBITION & INSTALLATION DINNER

FRIDAY, APRIL 8, 2011

HILTON EAST BRUNSWICK 3 TOWER CENTER BLVD. EAST BRUNSWICK, NEW JERSEY (732) 828-2000

PLEASE MARK YOUR CALENDAR!

You spoke, and we listened!
Disney’s Approach to Quality Service for Healthcare Professionals program is returning to Princeton, NJ!
Early Bird pricing available—see www.KeysPrinceton.com for details!

Every hospital, clinic, group medical practice, dental practice, or freestanding medical care provider has the opportunity to distinguish themselves through the delivery of quality services.

A one-day local workshop, Disney’s Approach to Quality Service for Healthcare Professionals program will show you the importance of attention to detail in everything Disney does -- from training its Cast Members (employees) to treating every Guest (patient) as a VIP. You will hear the stories and see how Disney best practices can be easily adapted to your healthcare delivery organization.

IMPORTANT: Please use the New Jersey Society of Health-System Pharmacists promotional code SHPMNE to receive $50 OFF PER GUEST when registering. Additional group discounts are available.

TO LEARN MORE AND REGISTER GO TO: www.KeysPrinceton.com
No prerequisite training required.

Click this link for the Membership Form.

Get into the Society Spirit and order your state pin today. State pins can be ordered easily through the NJSHP website.

Celebrate your hard work and dedication in your pharmacy career! Share your accomplishments with NJSHP! Our monthly Newsbriefs is an excellent opportunity to provide education and information about your contributions to the practice of pharmacy. Your story can be an inspiration to others! So don’t be shy. To submit your contribution, please contact Stella Williams at 609-936-2205 or email at swilliam@njha.com. We’d love to hear from you!

Excitement is stirring for the Pharmacy Practice Model Initiative. Check out what ASHP President Lynnae Mahaney had to say about it in her remarks to the House of Delegates on Sunday, June 6. Practice model change and the PPMI were also a key part of ASHP CEO Dr. Henri Manasse’s remarks to the House, ASHP President-elect Diane Ginsburg’s Inaugural address, and Dr. Charles Hepler’s Harvey A.K. Whitney Award Lecture, all of which will also be published in the August 15 issue of the American Journal of Health-System Pharmacy. Dr. Hepler’s lecture will also be posted on the ASHP Foundation Web site in September. You can read more about practice change in the Spring 2010 InterSections, ASHP’s membership magazine. ASHP and the ASHP Foundation are grateful to the many organizations that are generously supporting the PPMI. Keep checking the PPMI web site for updated information.

Two large studies on the use of olmesartan in patients with type 2 diabetes mellitus have revealed higher rates of death from cardiovascular events in participants who received the drug instead of a placebo, FDA said today in announcing its ongoing review of the data. Olmesartan, an angiotensin II-receptor blocker, has been marketed in the United States since 2002 for the treatment of hypertension. FDA emphasized that it has not concluded that olmesartan therapy increases the risk of death. The agency noted that it has not yet reviewed the primary data from the two studies. But, according to FDA's summary of the data, the overall rate of death from myocardial infarction and other cardiovascular causes was more than three times as high in the olmesartan groups as in the placebo groups. The larger of the two studies was known as the Randomized Olmesartan and Diabetes Microalbuminuria Prevention Study, or ROADMAP. According to ClinicalTrials.gov, the Phase III study sought to determine whether olmesartan could delay the first occurrence of microalbuminuria in adults with type 2 diabetes and at least one other cardiovascular risk factor. About five times as many of the olmesartan-treated patients in ROADMAP died of cardiovascular events as did patients who received a placebo, FDA said. The difference in the rates of overall deaths for the two groups was not so large. The other study, also a Phase III study, was known as ORIENT: Olmesartan Reducing Incidence of End Stage Renal Disease in Diabetic Nephropathy Trial. According to FDA, patients died of cardiovascular events 3.4 times as often in the olmesartan group as in the placebo group. The two groups had similar overall rates of death. Most of the patients in the study, FDA said, had three to five cardiovascular risk factors. Both studies were sponsored by companies related to Daiichi Sankyo Inc., which markets olmesartan under the brand name Benicar. Neither study was conducted in the United States. The American Diabetes Association recommends that clinicians include an angiotensin II-receptor blocker or an angiotensin-converting enzyme inhibitor in the medication regimens of patients with diabetes and hypertension. –Cheryl A. Thompson BETHESDA, MD 11 June 2010

Diane B. Ginsburg, M.S., RPh., FASHP, was installed this week as president of the American Society of Health-System Pharmacists (ASHP) during the 62nd session of the Society’s House of Delegates in Tampa, Fla. Ginsburg, is clinical professor and assistant dean for student affairs at The University of Texas at Austin College of Pharmacy. She has served the Society as a member of the Board of Directors, chair of the Council on Educational Affairs, co-chair of the Foundation Development Committee, and a Texas delegate to the House of Delegates. She is also a past president of the Texas Society of Health-System Pharmacists (TSHP) and a recipient of TSHP’s Pharmacist of the Year award. Ms. Ginsburg is editor-in-chief of ASHP’s PharmPrep and co-editor of ASHP’s Preceptor Handbook for Pharmacists.

Philip J. Schneider; B.S.; Pharm.D., was elected by the ASHP House of Delegates to a three-year term as Treasurer of the Society. Schneider is director of pharmacy at the Olathe Medical Center in, Olathe, Kan. He has served ASHP in a variety of capacities including as a member of the Board of Directors (2004-2007), chair of the Council on Organizational Affairs; member, Committee on Nominations, and ASHP delegate for approximately 8 years. He is a past Treasurer and Presidential officer of the Kansas Society of Health-System Pharmacists. He was the recipient of KSHP’s Harold Godwin lecture award for outstanding achievement in hospital pharmacy (1994) and the Kansas Health-System Pharmacist of the Year (1997).

Also taking office during the Society’s annual business meeting was Gerald Meyer, MBA, Pharm.D., FASHP, who was reelected to a one-year term as Chair of the ASHP House of Delegates. Christene M. Jolowsky, M.S., R.Ph. and Michael D. Sanborn, M.S., R.Ph, FASHP, were installed as members of the ASHP Board of Directors.

The skill-set required of hospital pharmacists continues to change rapidly, and many schools of pharmacy are working to adapt their programs in order to ensure their graduates are prepared for those changes. One such institution is the St. Louis College of Pharmacy. Founded in 1864, St. Louis is the oldest college of pharmacy west of the Mississippi River. The college, which recently graduated its latest class of nearly 180 students, is revamping its curriculum to take into account changes in the healthcare industry. It also has plans to reduce the number of traditional lecture classes, focusing instead on individual studies, workshops, and public service projects that emphasize teamwork, problem-solving, and communications skills. These updates reflect the new opportunities for clinical pharmacists as they become accepted members of a patient's healthcare team. Despite these changes, the expectations of students in the program remain as rigorous as ever. Admissions standards include high grade-point averages, letters of recommendation, and strong test scores. Freshman tuition runs $20,600, plus room and board, but 99 percent of students receive financial aid. The majority of the 1,250 students are from the St. Louis metropolitan area or Southern Illinois, but it also welcomes attendees from 25 other states, and its graduates are working around the nation and around the world. This year, 15 percent of graduates- a higher number than in previous years- will begin two-year clinical residency programs at hospitals and other healthcare facilities. When asked to comment on the changing programs at St. Louis, pharmacy practice professor Terry Seaton said, "Medication safety [remains] a very high priority for this college. We are preparing our students to select drugs in a particular situation, to modify them as necessary, and to monitor them for both efficacy and for safety."

The American Society of Health-System Pharmacists (ASHP) has released the eighth edition of its Assuring Continuous Compliance With Joint Commission Standards: A Pharmacy Guide. The book, written by John P. Uselton, B.S. Patricia C. Kienle, M.B.A., FASHP, and Lee B. Murdaugh, Ph.D., updates chapters on the Joint Commission's survey process, as well as medication-related National Patient Safety Goals, and Medication Management standards. It also features a new chapter on the National Integrated Accreditation for Health Care Organizations surveys of Det Norske Veritas Healthcare. Additionally, it includes the new Joint Commission number system and most current updates, revised examples of forms and documents, updated checklists, and an expanded index.

The Pharmacy Technician Certification Board (PTCB) has announced that the U.S. Department of Veterans Affairs (VA) will now require PTCB certifications for all pharmacy technicians employed at a grade GS-6 and above. This decision follows formal recommendations made by the House Committee on Veterans Affairs and mirrors similar certification standards in the private sector. When asked to comment on the new requirements, Michael Valentino, R.Ph., MHSA, VA Chief Consultant, Pharmacy Benefits Management, said, "The VA chose to adopt pharmacy technician certification for a number of reasons including: 1- certification will better equip technicians to perform their current duties, 2- certification will provide a platform upon which technicians can improve their skills to assume more complex duties, 3- in addition to education and experience requirements, certification gives VA pharmacy technicians a career ladder to progress to more demanding positions, thereby increasing job satisfaction and retention and 4- over time, emphasizing certification will raise the minimum skill sets required for technicians and will reduce variation in practice across the VA system." VA pharmacy technicians hold positions in a number of different pharmacy settings including inpatient hospital care, outpatient care, pharmacy automation, phone advice lines, and the Consolidate Mail Outpatient Pharmacy, which provides mail order prescriptions to veterans.

As bariatric surgery becomes more common, hospital pharmacists have an important role to play in developing patient education processes and materials necessary for the success and safety of the surgery. Following the surgery, patients can only swallow food able to fit through an opening approximately the size of a pencil, requiring them to convert tablet dosages to liquids in many cases. Unity Hospital in Fridley, Minn. has ensured hospital pharmacists are involved in the management of all bariatric cases for 15 years. Patients undergo a formal, one-on-one education session with a pharmacist, they receive a booklet that explains post-surgery medication changes, and all patients have a pharmacy consult on scheduled for the day following their surgery. These measures appear to be effective, as an analysis of the program's results show no re-admissions due to gastrointestinal blockage or medication misuse, and all recommendations made by pharmacists were accepted.

A panel at the American Pain Society's Annual Scientific Session recently discussed potential strategies and challenges for reducing opioid abuse. One of the challenges to deterring abuse is the wide variety of methods used to abuse opioid medications. A database that captures routes of administration in abusers includes oral, snorting, smoking, injecting, and other methods. The same database found that medications containing hydrocodone were most commonly abused orally, while fentanyl-containing medications were primarily smoked. Another study found that a subset of individuals who abuse opioids may begin taking the drug orally and later tamper with the agent so it can be snorted. These variations make it difficult to develop opioid medications that deter all types of abuse. Despite these challenges, the most common strategy for deterrence remains making it as difficult as possible for potential abusers to extract the active ingredient from a medication. One unpublished study indicated that 80 percent of opioid abusers would take up to 10 minutes to tamper with an agent in order to abuse it.

A third of infection preventionists polled by the Association for Professionals in Infection Control and Epidemiology (APIC) indicated their facilities could be doing more to prevent and control the spread of Clostridium difficile infection (CDI). Fifty-three percent of respondents adopted additional control strategies over the last 18 months, though fewer than a quarter were able to hire more prevention staff. Institutions that failed to add interventions believe their rates of CDI are under control. The association's CEO, Kathy Warye, said the group is concerned about the large number of respondents that may not have the adequate staff and resources to protect patients. Institutions employ multiple strategies to address CDI: 83 percent have hospital-wide hand hygiene initiatives, 90 percent perform surveillance to promptly identify CDI cases, 94 percent always place patients with CDI on Contact Precautions, and 86 percent have increased their emphasis on environmental cleaning. Still, fewer than 30 percent of respondents monitor the number of colectomies at their institutions, which can serve as an indicator for a severe strain of CDI; and nearly a quarter do not monitor the effectiveness of environmental cleaning efforts. APIC President Cathryn Murphy, RN, PhD, CIC, said variations in hand hygiene, isolation, environmental cleaning and monitoring, and CDI testing and surveillance provide a valuable "roadmap" to improving the standardization of prevention measures.

A U.K. survey of 460 patients scheduled for elective surgery gauged their anxiety levels on 24 different issues, discovering that 85 percent of patients who answered questions shortly after their operations admitted to being anxious about receiving general anesthetic. The top five anxiety-inducing concerns were waiting their turn in theater, the thought of arriving at the theater door, dying while asleep, failing to awaken after surgery, and waking up during the procedure. Additionally, 41 percent of patients said they did not like the thought of trusting a stranger. Anxiety levels were lowest during interactions with medical staff and when the support of a partner or friend was evident. Dr. Mark Mitchell, senior lecturer in the Faculty of Health and Social Care at the University of Salford, said the research underscored "the importance of patients receiving planned and timely information about [anesthesia], prior to the day of surgery, in order to limit their anxiety." Information about how anesthesia is managed should be provided to dispel the misconceptions that cause anxiety. Mitchell said the first step to paying closer attention to the psychological aspect of care is to provide a "formal and timely provision of information about the planned surgery--together with a patient-centered approach to the provision of information, such as pre-assessment clinics."

A new survey conducted by the American Society of Health-System Pharmacists (ASHP) and the Society of Hospital Medicine (SHM) indicates that 13 percent of formulary system decisions made by Pharmacy and Therapeutics committees in hospitals are influenced by pharmacoeconomic methods. In the study, 87 percent of respondents also noted that pharmacoeconomic methods should be used when considering additions or deletions to their hospital formulary. However, when making formulary decisions, the respondents said that clinical and therapeutic factors contribute most to these decisions (54 percent), followed by drug costs (24 percent) and patient quality of life (9 percent). These findings are based on a survey of 319 ASHP members who serve as directors of pharmacy or members of ASHP's Pharmacy Practice Managers Section. Based on their findings, ASHP and SHM encourage a wider use of pharmacoeconomics in order to allow hospitals to improve the quality and safety of patient care through management of the formulary system while also reducing costs.

It takes skill, technology, caring, commitment and most importantly teamwork to treat patients in critical condition, hospital nurses say. Without the support of a dedicated team, it would be close to impossible to carry out his extensive list of daily nursing responsibilities, said Brent Thomas, a registered nurse in Grady Memorial Hospital's Burn Center in Atlanta. "Helping burn patients recover takes a team that is willing to do whatever needs to be done," he said. Nurses assist one another with everything from two-hour dressing changes to general problem-solving. "My job is to help my staff develop and evolve as a team," said nurse Jacinta Okolie. It requires everyone's absolute focus to follow stringent infection-control measures and the evidenced-based standard procedures that help mitigate bloodstream infections, ventilator-associated pneumonia, catheter-related infections and bed sores. "When everyone is analyzing and monitoring care, the outcomes are always better," nurse Debbie Malone said.

Premier Inc. is working with the U.S. Centers for Disease Control and Prevention (CDC) to test new technologies for predicting central-line associated bloodstream infections (CLABSIs), which are linked to the use of catheters in large veins. The project seeks to automate the reporting of CLABSIs to the CDC's National Healthcare Safety Network. Premier--a strategic healthcare alliance--and the CDC intend to examine specific traits of positive blood cultures across a subset of Premier's 2,300 member hospitals to develop an automated electronic surveillance tool that can predict the presence of CLABSIs. In Chicago, Stroger Hospital researchers will assess the effectiveness of the tool in an actual clinical setting. The aim is to develop a standardized way of detecting and reporting infections using existing health information systems. Data will come from Premier's Perspectives database, its SafetySurveillor infection control and surveillance software, and Health and Human Services information systems. The project is expected to take about two years, and Premier will integrate the resulting surveillance tool into SafetySurveillor.