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Improved Pharmacy Department Workflow with New Method of Order Entry for Single-Agent, High-Dose Methotrexate

Purpose To determine whether a process change impacted the proportion of orders for single-agent, high-dose methotrexate entered by chemotherapy pharmacists instead of general pharmacy staff. Coordination of antiemetic premedication and leucovorin rescue with the new method of order entry was evalua...

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Published in:Hospital pharmacy (Philadelphia) 2014-12, Vol.49 (11), p.1039-1043
Main Authors: Kintzel, Polly E., VanDyke, Thomas H., Athmann, Paul W., Mills, Lisa B., Bonter, Michael P., Bremer, Matthew W., Dougherty, Mary L., Foster, Ryan W., Knight, Sandra K., Slot, Martha G., Steinmetz-Malato, Laura L.
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container_end_page 1043
container_issue 11
container_start_page 1039
container_title Hospital pharmacy (Philadelphia)
container_volume 49
creator Kintzel, Polly E.
VanDyke, Thomas H.
Athmann, Paul W.
Mills, Lisa B.
Bonter, Michael P.
Bremer, Matthew W.
Dougherty, Mary L.
Foster, Ryan W.
Knight, Sandra K.
Slot, Martha G.
Steinmetz-Malato, Laura L.
description Purpose To determine whether a process change impacted the proportion of orders for single-agent, high-dose methotrexate entered by chemotherapy pharmacists instead of general pharmacy staff. Coordination of antiemetic premedication and leucovorin rescue with the new method of order entry was evaluated. Methods Adults treated with single-agent, high-dose methotrexate were identified retrospectively. Order entry of methotrexate and ancillary medications was examined to determine whether the old or new method was used and whether it was performed by a chemotherapy pharmacist. The fundamental difference between the old and new methods for order entry is use of the “unscheduled” frequency of medication administration to replace the administration frequency of “once” with a specified date and time. Timing of antiemetic premedication and leucovorin rescue relative to methotrexate administration were tallied for the new method. Chi-square analysis was performed for the primary objective. Observational statistics were performed otherwise. Results The number of evaluable encounters identified was 158. A chemotherapy pharmacist entered a greater proportion of orders when the new method was utilized (P < .0001). The proportion of orders entered by a chemotherapy pharmacist increased during the hours of 0700 and 2259 with the new method. Appropriate coordination of antiemetic and leucovorin administration was documented for 96% and 100% of cases with the new method of order entry. Conclusion The proportion of orders for single-agent, high-dose methotrexate entered by a chemotherapy pharmacist was significantly greater with the use of the new method. Administration of antiemetic premedication and leucovorin rescue were appropriately coordinated with the use of the new method for order entry of single-agent, high-dose methotrexate.
doi_str_mv 10.1310/hpj4911-1039
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Coordination of antiemetic premedication and leucovorin rescue with the new method of order entry was evaluated. Methods Adults treated with single-agent, high-dose methotrexate were identified retrospectively. Order entry of methotrexate and ancillary medications was examined to determine whether the old or new method was used and whether it was performed by a chemotherapy pharmacist. The fundamental difference between the old and new methods for order entry is use of the “unscheduled” frequency of medication administration to replace the administration frequency of “once” with a specified date and time. Timing of antiemetic premedication and leucovorin rescue relative to methotrexate administration were tallied for the new method. Chi-square analysis was performed for the primary objective. Observational statistics were performed otherwise. Results The number of evaluable encounters identified was 158. A chemotherapy pharmacist entered a greater proportion of orders when the new method was utilized (P &lt; .0001). The proportion of orders entered by a chemotherapy pharmacist increased during the hours of 0700 and 2259 with the new method. Appropriate coordination of antiemetic and leucovorin administration was documented for 96% and 100% of cases with the new method of order entry. Conclusion The proportion of orders for single-agent, high-dose methotrexate entered by a chemotherapy pharmacist was significantly greater with the use of the new method. Administration of antiemetic premedication and leucovorin rescue were appropriately coordinated with the use of the new method for order entry of single-agent, high-dose methotrexate.</description><identifier>ISSN: 0018-5787</identifier><identifier>EISSN: 1945-1253</identifier><identifier>DOI: 10.1310/hpj4911-1039</identifier><identifier>PMID: 25673893</identifier><language>eng</language><publisher>Los Angeles, CA: SAGE Publications</publisher><ispartof>Hospital pharmacy (Philadelphia), 2014-12, Vol.49 (11), p.1039-1043</ispartof><rights>2014 SAGE Publications</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c2029-e6c7a790700257665548cd850a06193fe3ed7b1a91be5acf549ba29b526c7b133</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925,79364</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25673893$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kintzel, Polly E.</creatorcontrib><creatorcontrib>VanDyke, Thomas H.</creatorcontrib><creatorcontrib>Athmann, Paul W.</creatorcontrib><creatorcontrib>Mills, Lisa B.</creatorcontrib><creatorcontrib>Bonter, Michael P.</creatorcontrib><creatorcontrib>Bremer, Matthew W.</creatorcontrib><creatorcontrib>Dougherty, Mary L.</creatorcontrib><creatorcontrib>Foster, Ryan W.</creatorcontrib><creatorcontrib>Knight, Sandra K.</creatorcontrib><creatorcontrib>Slot, Martha G.</creatorcontrib><creatorcontrib>Steinmetz-Malato, Laura L.</creatorcontrib><title>Improved Pharmacy Department Workflow with New Method of Order Entry for Single-Agent, High-Dose Methotrexate</title><title>Hospital pharmacy (Philadelphia)</title><addtitle>Hosp Pharm</addtitle><description>Purpose To determine whether a process change impacted the proportion of orders for single-agent, high-dose methotrexate entered by chemotherapy pharmacists instead of general pharmacy staff. Coordination of antiemetic premedication and leucovorin rescue with the new method of order entry was evaluated. Methods Adults treated with single-agent, high-dose methotrexate were identified retrospectively. Order entry of methotrexate and ancillary medications was examined to determine whether the old or new method was used and whether it was performed by a chemotherapy pharmacist. The fundamental difference between the old and new methods for order entry is use of the “unscheduled” frequency of medication administration to replace the administration frequency of “once” with a specified date and time. Timing of antiemetic premedication and leucovorin rescue relative to methotrexate administration were tallied for the new method. Chi-square analysis was performed for the primary objective. Observational statistics were performed otherwise. Results The number of evaluable encounters identified was 158. A chemotherapy pharmacist entered a greater proportion of orders when the new method was utilized (P &lt; .0001). The proportion of orders entered by a chemotherapy pharmacist increased during the hours of 0700 and 2259 with the new method. Appropriate coordination of antiemetic and leucovorin administration was documented for 96% and 100% of cases with the new method of order entry. Conclusion The proportion of orders for single-agent, high-dose methotrexate entered by a chemotherapy pharmacist was significantly greater with the use of the new method. 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Coordination of antiemetic premedication and leucovorin rescue with the new method of order entry was evaluated. Methods Adults treated with single-agent, high-dose methotrexate were identified retrospectively. Order entry of methotrexate and ancillary medications was examined to determine whether the old or new method was used and whether it was performed by a chemotherapy pharmacist. The fundamental difference between the old and new methods for order entry is use of the “unscheduled” frequency of medication administration to replace the administration frequency of “once” with a specified date and time. Timing of antiemetic premedication and leucovorin rescue relative to methotrexate administration were tallied for the new method. Chi-square analysis was performed for the primary objective. Observational statistics were performed otherwise. Results The number of evaluable encounters identified was 158. A chemotherapy pharmacist entered a greater proportion of orders when the new method was utilized (P &lt; .0001). The proportion of orders entered by a chemotherapy pharmacist increased during the hours of 0700 and 2259 with the new method. Appropriate coordination of antiemetic and leucovorin administration was documented for 96% and 100% of cases with the new method of order entry. Conclusion The proportion of orders for single-agent, high-dose methotrexate entered by a chemotherapy pharmacist was significantly greater with the use of the new method. Administration of antiemetic premedication and leucovorin rescue were appropriately coordinated with the use of the new method for order entry of single-agent, high-dose methotrexate.</abstract><cop>Los Angeles, CA</cop><pub>SAGE Publications</pub><pmid>25673893</pmid><doi>10.1310/hpj4911-1039</doi><tpages>5</tpages><oa>free_for_read</oa></addata></record>
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title Improved Pharmacy Department Workflow with New Method of Order Entry for Single-Agent, High-Dose Methotrexate
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