Assessing Real-World Spot Urine Sodium Values During Continuous Intravenous Infusion of Loop Diuretics
Rachel Propst and Michael Akers
- The use of spot urine sodium (UNa)>60 mmol/L as an objective measure to guide diuretic therapy in patients receiving bolus intravenous loop diuretics has been associated with increased weight loss and decreased length of stay.
- There is limited published data evaluating UNa use in patients receiving continuous intravenous loop diuretic infusions.
Evaluation of Antibiotic Use and Duration for Febrile Neutropenia
Kayla Jensen, Patricia Aubert, Joy Ward, and Ann Wigton
- Febrile neutropenia (FN) affects over 80% of patients with hematologic cancer and 10% to 50% of patients with solid tumors
- National Comprehensive Cancer Network (NCCN) guidelines recommend empiric broad-spectrum monotherapy until the absolute neutrophil count (ANC) is over 500 cells/uL.
- Extended durations with broad-spectrum agents leads to increased risk of antibiotic resistance, toxicity and C. difficile infection.
- To evaluate antibiotic prescribing patterns for patients with FN to optimize antibiotic stewardship.
Retrospective Study of Warfarin Use in the CentraCare Family Health Clinic
Lauren Martens and Jessica Lind
- Warfarin is FDA approved for a variety of indications
- Recommended INR goal ranges can vary depending on indication
- Appropriate warfarin management is necessary for safety and efficacy of the medication
- Since November 2019, warfarin has been managed by the ambulatory pharmacist in the Family Health Clinic
- To further understand the patterns of use of warfarin within the CentraCare Family Health Clinic
- Specifically, determine the prevalence of warfarin indications and corresponding INR goals.
Evaluation of Heparin-Induced Thrombocytopenia Antibody Laboratory Use and Anticoagulation Prescribing Patterns
Piper Swanson, Jesse Greenlee, Gregory Schaefer, and Paul Huiras
- Heparin-induced thrombocytopenia (HIT) is a rare adverse reaction
- Calculating a 4T score prior to ordering a heparin-PF4 immunoassay is recommended. For a score < 4, HIT probability is low and an assay is not advised
- If high suspicion of HIT (4T greater than or equal to 4), an assay should be ordered, all heparin products discontinued, and a non-heparin anticoagulant initiated.
- Determine if heparin immunoassay ordering was indicted according to retrospective 4T score
- Assess anticoagulation prescribing depending on the result of the assay
- Serve as a pre-group for a planned perverse post-HIT order set implementation analysis
Assessing the Use of Pre-Treatment Medications in the Management of Infusion-Related Reactions in an Outpatient Infusion Center
Alyssa Boesche, Alyssa Augst, and Bill Kuhlman
- Infusion-related reactions (IRRs) are well-known adverse drug reactions of many biological agents and antineoplastic medications
- While typically mild-to-moderate in intensity, IRRs can be severe, with potentially life-threatening consequences requiring urgent interventions
- Appropriate use of pre-treatment medications, such as corticosteroids, antihistamines, intravenous fluids, and antiemetics reduces the incidence and severity of IRRs
- Evaluate the use of pre-treatment medications in patients with experienced IRRs at an outpatient infusion center
- Identify opportunities to improve treatment plans and reduce the occurrence of IRRs
Evaluating the Effect of Sodium Zirconium Cyclosilicate in Acute Hyperkalemia Management
Austin Brandes, Hannah Thompson, and Paul Huiras
- Sodium zirconium cyclosilicate (ZS-9) can acutely decrease serum potassium (K) levels after one dose and may have favorable side effects compared to sodium polystyrene sulfate (SPS).
- ZS-9 replaced oral SPS in the Hyperkalemia Order Set at St. Cloud Hospital in April 2019
- To characterize the acute potassium-lowering effects of one 10-gram dose of sodium zirconium cyclosilicate in conjunction with other potassium-lowering medications
Evaluation of Neonatal Abstinence Syndrome Management and Prescribing Patterns
Kaylee Erickson, Anthony Wieland, and Kaia Ringwald
- Identify medications prescribed to manage NAS due to opioids and /or amphetamines.
- Evaluate average daily medication wean rates.
- Assess length of stay (LOS) and length of treatment (LOT)
Evaluation of the Transition to a Fixed-Dose Prothrombin Complex Concentrate Regimen at a Tertiary Regional Medical Center
John Mullen and Lance McNab
- Evaluate order set use in patients that received PCC for emergent warfarin reversal in the emergency department both before and after implementation of a fixed-dose protocol.
- Evaluate INR response to administration of PCC pre- and post- implementation and the percentage of post-infusion INRs that were less than 2 and 1.5.
- Assess cost of therapy before and after implementation of the fixed-dose protocol.
Evaluation of Antibiotic Prescribing Patterns for Community Acquired Pneumonia
Gregory Schaefer and Ann Wigton
Purpose: To evaluate duration of antibiotic therapy and prescribing patterns for non-ICU CAP at St Cloud Hospital, a tertiary community hospital.
Evaluation of Cost Savings with the Addition of a Matrix Assisted Laser Desorption Ionization-Time of Flight Machine (MALDI-TOF) at a Tertiary Hospital
Hannah Packer and Ann Wigton
Purpose: To evaluate potential cost savings of the addition of a MALDI-TOF machine in comparison to current costs of standard methods at St. Cloud Hospital, a tertiary community hospital with 489 licensed beds.
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