If you would like to get involved in CSHP's Residents Task Force (for current CSHP Resident members only), contact our chair: Dani McKimmy

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The Great Eight: Residents Showcase


And the 2017 winners are: 

1. Alyssa Boutin, PharmD; Hartford Hospital 

2. Serena Chew, PharmD; Yale New Haven Hospital 

3. Andrew Gentry, PharmD; UConn John Dempsey Hospital 


Potential speakers submit abstracts that are judged using an objective rubric. The residents who submit the (eight) best abstracts are invited to present. You must be a current CSHP member to participate.

2017 Winning Abstracts

"Assessing venous thromboembolism prophylaxis in liver failure patients"

Primary Authors: Alyssa Boutin, PharmD

Supporting Authors: Laura Hobbs, PharmD; Spencer Martin, PharmD

Hartford Hospital, Hartford, Connecticut

OBJECTIVE: Patients with liver failure are a challenging population to assess venous thromboembolism (VTE) risk and provide appropriate prophylaxis. The objective of this study is to evaluate whether hospitalized patients with liver failure receive appropriate VTE care when admitted to a medicine service based on the International Medical Prevention Registry on Venous Thromboembolism (IMPROVE) score. Secondary outcomes are to assess the rate of VTE prophylaxis and the rate of VTE and bleeding events in hospitalized liver failure patients. Another aim is to determine if patients receive appropriate VTE care based on patient MELD scores.

METHODS: A retrospective cohort study of liver failure patients admitted to the medicine service at Hartford Hospital from November 1, 2014 to July 31, 2016 was performed. Patients were excluded if they were no longer followed by the medical service at any time during their admission, were pregnant, or were admitted for a pre-existing VTE or bleed. Demographic data, inpatient laboratory data, and bleeding and clotting events were collected through the electronic medical record system. Based on the information collected, the researcher determined each patient’s IMPROVE score and assessed whether appropriate VTE care was given.

RESULTS: Based on the IMPROVE score, 113 of 300 encounters of patients with liver failure received appropriate VTE care. The highest rate of appropriate VTE care was among moderate risk patients (p=0.013). Eleven patients had a bleeding event and 1 patient developed a VTE. There was no difference in rate of appropriate VTE care when patients were assessed based on their MELD scores (p=0.685).

CONCLUSION: Overall, 38% of patient encounters received appropriate VTE care. The severity of liver failure was not the driver of inappropriate VTE care. Low-risk and high-risk patients have the greatest room for improvement in appropriate VTE care.

 

"Expanding the pharmacy practice advancement initiative through student engagement in direct patient care activities"

Primary Author: Serena Chew, PharmD

Supporting Authors: Chelsea Bast, PharmD Candidate 2017; Sage Bagwell, PharmD Candidate 2017; Elizabeth Cohen, PharmD, BCPS; Amber Castle, PharmD, BCPS, BCCCP; Kimberly Boothe, PharmD, MHA
Yale New Haven Hospital

Objective: The Pharmacy Practice Advancement Initiative is a national program led by the American Society of Health-System Pharmacists whose goal is to positively impact the health and well-being of patients by supporting an innovative practice model that supports the effective use of pharmacists as direct patient care providers. In this institution, a layered learning model was initiated to optimize the utilization of advanced pharmacy practice experience students to expand direct patient care while enhancing the overall student learning experience. The purpose of this study is to evaluate the impact of student pharmacists as measured by the number and type of clinical interventions and estimated pharmacist time saved.

Methods: A syllabus was created for student pharmacists, including clear rotational outcomes, goals, and objectives based on rotation structure. Student pharmacists were required to perform a specific number of high priority clinical interventions such as medication reconciliation, intravenous to oral conversion, renal dose adjustment, patient counseling, and therapeutic drug monitoring for their patients. All students documented their clinical interventions and the student time spent per activity. Students were trained on proper intervention documentation and received weekly feedback regarding the quantity and quality of their interventions. Data including the total number of interventions made, student time spent per intervention, and pharmacist time saved were collected from August 2015 to March 2017. The primary endpoint is the percent increase of meaningful clinical interventions performed by students from the previous year. The secondary endpoint is the number of clinical interventions completed per student monthly and the average pharmacist time saved by students completing direct patient care activities. Descriptive statistics were used to compare the pre and post syllabus standardization from academic year 2015- 2016 vs. academic year 2016- 2017.

Results: Compared to baseline data, student pharmacists’ clinical interventions increased by 10 fold (p=<0.05), with medication reconciliation accounting for the majority of this increase. The average monthly clinical interventions completed per student increased from 14 to 43. (p=<0.05). The average monthly pharmacist time saved per student was 205 minutes. 

Conclusion: The implementation of a layered learning model has allowed pharmacy students to work as pharmacist extenders and has increased the overall direct patient care activities documented by pharmacy students and enhancing the overall student learning experience.

 

"Assessing the Immediate and Long-term Safety of Recombinant Tissue Type"

Plasminogen Activator (rtPA) for Use in Ischemic Stroke in Patients 80 Years and Older: A Retrospective Review

Primary Author: Andrew Gentry, PharmD

Supporting Authors: Kevin Chamberlin , PharmD, FASCP; S. Mittal
UConn John Dempsey Hospital, Farmington, Connecticut

OBJECTIVE: Currently, rtPA is considered the treatment of choice for patients who present to the hospital with acute ischemic stroke within three hours of symptom onset. However, the safety profile of this medication has not been well studied in patients 80 years and older. Since its inception in 2013, the UConn Stroke Program has had numerous patients that fall into this age demographic. The purpose of this study is to analyze rtPA use in this patient population in order to assess immediate, short-term and long-term outcomes. The data obtained from this study will serve to clarify the safety of rtPA use in the elderly population at various follow up points and help guide the therapeutic use of rtPA at UConn John Dempsey Hospital as a part of the stroke program.

METHODS: This study is a retrospective cohort analysis, reviewing patients admitted to John Dempsey Hospital for acute ischemic stroke. Patients 80 years or older were stratified into two cohorts based upon whether or not they received recombinant tissue type plasminogen activator. Their medical information, including diagnosis, comorbidities and functionality score, was reviewed and extracted as needed to obtain the data necessary for our study. All data collection was undertaken in a confidential manner. A preliminary power analysis determined that an alpha of 0.05 and a beta of 0.8 can be achieved with a sample size of approximately 42 patients per cohort.

RESULTS: The results of our primary endpoint showed that survival rates of patients 80 and older that received rtPA were significantly lower at 3 month follow-up. (P=0.002) Furthermore, there was a trend towards lower prevalence of survival at 6 and 12 month follow-up in the rtPA group with a p-value approaching significance. Immediate unfavorable events such as intracranial hemorrhage and discharge to hospice were higher in the rtPA cohort and this also approached significance. There was no difference in survival at short- term follow-up of 7 days.

CONCLUSION: The results of this study show an overall trend towards decreased survival in older patients that receive rtPA at longer follow-up points. The results of this study support the rationale for further investigation of the safety of this medication in patients 80 years and older. More studies with larger numbers of patients would be beneficial to give a clear picture of the clinical impact of the use of this medication in the elderly population.

2017 MOCK INTERVIEWS

3rd Annual Mock Interviews were held on Jan. 10th, 2017 at Hartford Hospital
The CSHP Residents Task Force organized this event for P4 pharmacy students of UCONN and USJ and PGY-1 and PGY-2 pharmacy residents .

Please direct any questions regarding this event to Resident Task Force Co-Chair Kellie Goodlet (kellie.goodlet@hhchealth.org).

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PREP FOR YOUR FUTURE WITH A CV REVIEW

In the fall of 2016, the CSHP Residents' Task Force offered a CV review to both students and residents applying for residencies, fellowships, and jobs in spring 2017.

2016 The Great Eight Winners

  1. Sylvia Narciso (Waterbury Hospital): Evaluating the appropriateness of double gram-negative coverage in severe septic patients in the emergency department
  2. Eva Pan (Hartford Hospital): Evaluation of carboplatin dosing using actual compared to adjusted body weight in gynecologic malignancies
  3. Emily Perriello (Hartford Hospital): Improper continuation of atypical antipsychotics after treatment and resolution of acute delirium in the intensive care unit
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2016 Mock Interview Event

by Mabel Wai, PharmD, BCPS; 2016 Resident Task Force Coordinator

The CSHP Resident Task Force (RTF) hosted its second annual Mock Interview Event at Hartford Hospital on January 14th. Students from The University of Connecticut and The University of Saint Joseph Schools of Pharmacy participated as interviewees. Member pharmacists, preceptors, and pharmacy directors comprised our interview panel.

Overall, the event was successful and we received wonderful feedback. The students found the event very helpful in preparing for future interviews and they greatly appreciated the advice from our pharmacists. Our interviewing panel also had a great deal of fun speaking to our students and sharing their experiences. We hope next year’s session will be just as eventful!

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ASHP President Explains Second Chance for Residency Match  

Next to graduation, pharmacy residency "Match" day is likely "the most anticipated day on the calendars of soon-to-be pharmacy graduates," writes ASHP President John A. Armitstead in InterSections, ASHP's member magazine. The new Phase II of the Match will help to ensure that student pharmacists and postgraduate year 1 residents seeking a second-year residency position will have another structured opportunity to connect with open positions. (source: ASHP NewsLink 12.22.15)


Publishing Opportunities for Residents in the AJHP Residents Edition

Formerly known as the Journal of Health-System Pharmacy Residents, AJHP Residents Edition is the only publishing forum dedicated to pharmacy residents where they can present their peer-reviewed research, contribute to the advancement of patient care and pharmacy practice, and see their work indexed by PubM
ed. Read more  


AJHP Call for Papers: Innovations in Pharmacy Residency Training  

AJHP cordially invites submissions of descriptive practice reports on innovative approaches to ASHP-accredited postgraduate year 1 and postgraduate year 2 pharmacy residency training and application of the ASHP Residency Accreditation Standards. Articles submitted by February 16 will have the best chance for consideration for inclusion in a 2016 issue of AJHP that will contain a collection of articles on innovations in pharmacy residency training.  (source: ASHP NewsLink 11.10.15)


ASHP Reaches Milestone with 2,000 Residency Programs
ASHP last week announced that it reached a new milestone in accreditation, with 2000 residency programs across the country undergoing the organization's accreditation process. The creation of residency training programs in institutions doubled from 500 to 1000 programs between 1999 and 2009 and has since doubled again. (ASHP NewsLink 10.27.15)

ASHP's Resident Reward and Recertification Program
The first program of its kind, ASHP's Resident Reward & Recertification Program takes professional development to the next level. If you are a resident or new practitioner considering a BCPS designation, you can register for our new program and get access to our pharmacotherapy review course—live or online—and the practice test at no cost. In return, you will complete your recertification cycle with ASHP for only $10/month. That price is guaranteed for the entire seven-year recertification cycle and includes more than the required 120 hours. Learn more and register (source: ASHP NewsLink 3.17.15)