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Learning Objectives: Mortality has been reported to be as high as 50% in patients presenting to the emergency department (ED) with sepsis, severe sepsis, or septic shock. The clinical pharmacist in the ED plays an instrumental role in providing appropriate dosing and empiric therapy recommendations for management of these patients. The Surviving Sepsis Campaign Guidelines recommend administration of broad-spectrum intravenous (IV) antibiotic therapy be administered within three hours and within one hour of recognizing severe sepsis or septic shock. We hypothesized that a clinical pharmacist in the ED would expedite the time to antibiotic administration in sepsis patients. Methods: We conducted a retrospective review of patients presenting to the ED of an academic medical center between January 2014 and June 2014 with a diagnosis of sepsis, severe sepsis, or septic shock requiring IV antibiotic therapy. 120 patients (60 with pharmacist present and 60 with no pharmacist) were included in the analysis. The primary outcome of this study was to determine if the presence of a clinical pharmacist in the ED was associated with a faster order to administration time for IV antibiotics in sepsis patients as opposed to when a clinical pharmacist was not present. Results: Baseline characteristics including age, sex, APACHE II, sepsis category, and site of infection were similar between the two groups. With a clinical pharmacist present, patients were more likely to receive antibiotics sooner (0.66 hours vs. 1.25 hours, p=0.003) as well as meet the Surviving Sepsis Campaign goal of antibiotics within one hour [N=55 (92%) vs. N=41 (68%), p=0.001] and within three hours [N=60 (100%) vs. N=55 (92%), p=0.022]. No significant differences between groups were noted in hospital length of stay (LOS), intensive care unit (ICU) LOS, ventilator days, or in-hospital mortality. Conclusions: Our results support the hypothesis that the presence of a clinical pharmacist in the ED helps expedite the time to administration of IV antibiotics for sepsis patients, helping patients achieve the goals set forth by the Surviving Sepsis Campaign Guidelines. Publication type: Journal: Conference Abstract Source: EMBASE Full text: Available Critical care medicine at Critical Care Medicine 19.Title: Pharmacist involvement at discharge with the joint commission heart failure core measure: Challenges and lessons learned Citation: Hospital Pharmacy, December 2014, vol./is. 49/11(1017-1021), 0018-5787;1945-1253 (01 Dec 2014) Author(s): Herring H., Smith W., Ripley T., Farmer K. Language: English Abstract: Background: Pharmacists are vital health care providers to patients with heart failure (HF), but their compliance to the HF core measure has not been clearly defined. Objective: The objective of this study was to measure the impact of pharmacist involvement at discharge on compliance with The Joint Commission HF core measure. Methods: This prospective study was conducted at a 361-bed academic teaching institution. A pharmacist performed chart reviews just prior to discharge on adult patients with a preliminary diagnosis of HF (ie, clinical suspicion) to evaluate compliance with the HF core measure. The pharmacist then intervened as needed to ensure compliance. The primary outcome was HF core measure compliance rates with pharmacist involvement at discharge compared to rates during the same 3-month period during the previous year (without pharmacist involvement). Results: Of 92 patients admitted with clinical suspicion of HF, the pharmacist was able to review 45 patient charts at discharge (49%). The majority of interventions made by the pharmacist were due to medication discrepancies within the discharge instructions found during medication reconciliation. Rates of compliance with the HF core measure did not differ between the period with pharmacist involvement at discharge and the previous period (without pharmacist involvement, P = .39). However, barriers to compliance related to discharge medication documentation, inter-disciplinary communication, and manpower were identified through the process. Conclusion: Although pharmacist involvement at discharge did not translate into improved compliance with the HF core measure, systematic barriers to compliance were identified and are currently being addressed. Publication type: Journal: Review