Pharmacotherapy
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Randomized Controlled Trial Multicenter Study Clinical Trial
Randomized, multicenter comparison of oral granisetron and oral ondansetron for emetogenic chemotherapy.
To compare the antiemetic effectiveness and safety of oral granisetron plus dexamethasone with those of oral ondansetron plus dexamethasone administered before emetogenic chemotherapy. ⋯ Oral granisetron 1 mg and ondansetron 16 mg plus dexamethasone are safe and effective in preventing nausea and vomiting related to emetogenic chemotherapy.
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Using the balanced scorecard to measure outcomes, a multidisciplinary team worked to improve antiemetic therapy and decrease postoperative nausea and vomiting. Patient satisfaction measures were nausea and pain scales (10 cm, nonnumbered, visual analog). The quality measure was number of vomiting episodes. ⋯ There were no deteriorations in pain scores or length of stay. Balanced scorecard measurements suggest no adverse unintended outcomes consequent to changes in prescribing behavior. Balanced scorecard processes assisted consensus among pharmacists, nurses, and physicians that may have accelerated behavioral changes.
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To identify and describe the scope of practice that characterizes the critical care pharmacist and critical care pharmacy services. Specifically, the goals were to define the level of clinical practice and specialized skills characterizing the critical care pharmacist as clinician, educator, researcher, and manager; and to recommend fundamental, desirable, and optimal pharmacy services and personnel requirements for the provision of pharmaceutical care to critically ill patients. Hospitals having comprehensive resources as well as those with more limited resources were considered. ⋯ By combining the strengths and expertise of critical care pharmacy specialists with existing supporting literature, these recommendations define the level of clinical practice and specialized skills that characterize the critical care pharmacist as clinician, educator, researcher, and administrator. This position paper recommends fundamental, desirable, and optimal pharmacy services as well as personnel requirements for the provision of pharmaceutical care to critically ill patients.