Between Dec 19, 2024 and Jan 2, 2025, datasets can be submitted to DRUM but will not be processed until after the break. Staff will not be available to answer email during this period, and will not be able to provide DOIs until after Jan 2. If you are in need of a DOI during this period, consider Dryad or OpenICPSR. Submission responses to the UDC may also be delayed during this time.

Browsing by Author "Brahm, Nancy C."

Now showing 1 - 4 of 4
  • Thumbnail Image
    Item
    Acceptance Rates for Pharmacist-Initiated Interventions in Long-Term Care Facilities
    (University of Minnesota, College of Pharmacy, 2013) Carson, Gina L.; Crosby, Kimberly; Huxall, Garrett R.; Brahm, Nancy C.
    Objectives: Describe individualized medication interventions, categorize intervention types, and report acceptance rates by prescribers following a pilot medication intervention program in which a pharmacist rounded with the patient care team in long-term care facilities in addition to their traditional medication regimen review (MRR) process. Design: Prospective Chart review Setting: Two primary long-term care (LTC) facilities Participants: Fifty randomly selected patient charts. Inclusion criteria were adult patients (18 years old or older) residing in one of the LTC facilities receiving consultant pharmacist services. Patient charts not meeting inclusion criteria were excluded from the review. Interventions: Recommendations made according to the needs of each patient and categorically reported. Main Outcome Measures: Intervention acceptance rates by prescribers and aggregate reporting for type of medication interventions. Results: For 50 patient charts (68% female, 32% male) 66 interventions were reported. The average patient age was 81.5 years. Approximately 45% of the interventions pertained to drug utilization concerns, and 21% involved pain management. Additional categories included treatment of eye and skin conditions and pharmacotherapy for mental health. A ‘nonpharmacotherapy’ designation was given to individual interventions not fitting into a larger category. New medications and regimen changes were the most common medication therapy outcomes (42% and 32%, respectively). Overall 92% of all pharmacist interventions were either fully or partially accepted by the prescriber where partial acceptance was defined as implementation of the recommendation with an adjustment. Interventions related to drug utilization or pain management each approached a 93% acceptance rate. Conclusions: The consultant pharmacist provided personalized recommendations following extensive chart review and patient assessment. Our chart review suggests that high prescriber acceptance rates along with medication therapy optimization may produce similar benefits in other LTC facilities.
  • Thumbnail Image
    Item
    Building a Community of Scholars in Educational Research: A Case Study for Success
    (University of Minnesota, College of Pharmacy, 2011) Brahm, Nancy C.; Davis, Tamra S.; Peirce, Gretchen L.; Lamb, Michelle M.
    Objective: To present the model of the Education Research/Scholarship of Teaching Community of Scholarship (EdCOS) as one Community of Scholars (COS) within a department of pharmacy. Case Study: A case study describing the Education Research/Scholarship of Teaching Community of Scholars (EdCOS). Faculty members were self-selected into one or more of eight COS. The EdCOS was comprised of 14 members. The EdCOS developed a vision statement to “foster and support a learning culture that enables faculty to capture and evaluate teaching and learning experiences.” The process by which the EdCOS set out to initiate this COS will be discussed. Since its inception all members of the EdCOS have become IRB Certified. Through a combined project, members had the opportunity to develop, learn, and acquire experience in areas of conducting research from the conception of a project through final submission of the manuscript. Departmental publications and grant funding increased over the years after the implementation of the COS. Conclusion: Although cause and effect cannot be explicitly determined, the EdCOS has had a positive impact on its members building confidence, experience, and ideas for future projects.
  • Thumbnail Image
    Item
    Design and Implementation of Acute Emergency Decision Making Tools to Aid Case Managers: A Focus Group Study
    (University of Minnesota, College of Pharmacy, 2013) Bradshaw, Marquita D.; Washington, Nicole B.; Munoz, Ricky; Brahm, Nancy C.
    Objectives: To evaluate and determine if use of specific reference cards for diabetes, stroke, and heat stroke [1] heightened understanding of the signs and symptoms of these conditions and [2] helped case managers (CMs) on the community-based integrated multidisciplinary program of assertive community treatment (IMPACT) team better evaluate patients. Background: Healthcare professionals who service those with a severe mental illness (SMI) diagnosis face many unique challenges. One particular challenge is medical assessment of patients with a SMI diagnosis. Often CMs do not have a background or work experience differentiating medical concerns from psychiatric signs and symptoms. Methods: Reference cards were developed at the request of the IMPACT team. Feedback was elicited through a one-time focus group session conducted by an independent party on the use of the reference cards as an educational tool. Anonymity was maintained. The responses were evaluated for themes. The moderator asked questions regarding the reference cards in each of the following areas: usability when answering questions about hypo- and hyperglycemia, stroke and heat stroke, understanding key points, recommendations for enhancement, and presentation of information. Results: Of the 8 CMs on the IMPACT team, 5 participated. Identified themes were quick reference and easily identifiable information. The use of pictures to illustrate the concepts was helpful. The language was appropriate for the cards and readily understandable. Suggestions for changes to the existing cards included use of a larger font, lighter background color, and moving medication information to the same side of the card. The limited availability of the heat stroke card in the summer was an identified limitation. Conclusions: The use of reference cards as an educational tool for CMs has not been extensively reviewed. Although data are limited from this pilot project, the CMs are enthusiastic about this resource and requested cards on additional topics.
  • Thumbnail Image
    Item
    Development of a Medication Monitoring System for an Integrated Multidisciplinary Program of Assertive Community Treatment (IMPACT) Team
    (University of Minnesota, College of Pharmacy, 2012-12) Watkins, Sarah C.; Winchester, Bruce R.; Brahm, Nancy C.
    Purpose: The primary goal was to improve medication management oversight for a severely mentally ill (SMI) community-based population by developing a medication monitoring system based on current guidelines to optimize pharmacotherapy and minimize potential medication-related adverse effects. The secondary goal was improvement in coordination of care between healthcare providers. Methods: Guidelines for medication used for psychiatric indications were reviewed. A database of medication for psychiatric indications with monitoring recommendation was developed. Results: Medication regimens for 68 members of the Integrated Multidisciplinary Program of Assertive Community Treatment (IMPACT) program qualified for review. Fourteen medications, carbamazepine, chlorpromazine, clozapine, fluphenazine and fluphenazine long-acting injections (LAI), haloperidol and haloperidol LAI, lithium, lurasidone, olanzapine, paliperidone and paliperidone LAI, perphenazine, quetiapine, risperidone and risperidone LAI, valproic acid/divalproex, and ziprasidone, were identified. In total, 111 medications are used on a monthly basis. Each member receives more than one medication qualifying for review. Additional monitoring parameters that were evaluated included changes in laboratory orders for members with insulin-dependent diabetes. Annual lipid panels were changed to every 6 months, if applicable. Conclusions and Future Directions: This medication monitoring program was developed to help ensure IMPACT members receive the most effective care and minimize potential medication-related adverse effects. The secondary goal was to improve coordination of care. Medication monitoring will be added as a continuous quality assurance measure. Lab results will be reviewed at least monthly. The medication monitoring program will be evaluated annually.