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Implementing services for pediatric cystic fibrosis treatment in a community hospital
Paige Grube1, Heather Nichols2, Sarah Ferrell2
1Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
Insights
A community hospital pharmacy department successfully prepared to care for pediatric patients with cystic fibrosis (PwCF) through a phased implementation of new protocols and staff training. This ensured safe and efficient specialized care.
Area of Science:
- Pharmacy Practice
- Pediatric Care
- Cystic Fibrosis Management
Background:
- Community hospitals face increasing demands for specialized pediatric care.
- Pediatric patients with cystic fibrosis (PwCF) require a higher level of care than typical pediatric patients.
- Pharmacy departments must be prepared to manage the unique medication needs of PwCF.
Purpose of the Study:
- To prepare a community hospital's pharmacy department for the safe and efficient care of pediatric patients with cystic fibrosis (PwCF).
- To develop specialized protocols and resources for managing PwCF medication regimens.
Main Methods:
- A phased implementation approach was utilized, encompassing protocol development, staff education, and clinical decision support.
- Developed antibiotic dosing protocols, order sets (IV and oral), and pharmacokinetic guides for aminoglycosides and vancomycin.
- Created a pharmacokinetic calculator for aminoglycoside dosing and monitoring.
- Provided comprehensive education modules for pharmacists on cystic fibrosis and its common treatments.
Main Results:
- Successfully implemented new antibiotic dosing protocols and order sets tailored for pediatric PwCF.
- Developed and deployed pharmacokinetic tools to aid in medication management.
- Enhanced pharmacist knowledge and readiness to manage PwCF through targeted education.
Conclusions:
- A phased implementation strategy was critical for the successful and timely completion of the project within one year.
- The pharmacy department is now better equipped to provide safe and efficient care for pediatric PwCF.
Purpose:
Our community hospital was recently charged with providing care for pediatric people with cystic fibrosis (PwCF). Pediatric PwCF generally need a higher level of care than is required by other pediatric patients cared for at our institution. This project aimed to prepare the pharmacy department to care for this specialized population safely and efficiently.
Summary:
The implementation process was divided into 3 phases to accomplish the larger purpose. These phases were as follows: (1) creating order sets and protocols; (2) providing staff and clinical pharmacists with training and resources; and (3) creating and managing clinical decision support. The central aspect of preparing inpatient pharmacy staff to care for PwCF was the development of antibiotic dosing protocols and order sets comprised of intravenous and oral antibiotics as well as aminoglycoside and vancomycin pharmacokinetic guides. A pharmacokinetic calculator was created to assist with aminoglycoside dosing and monitoring. During phase 2, pharmacist education modules were created to provide guidance on cystic fibrosis and medications commonly used to treat it. As the newly designed protocols were enacted, education was provided on how to use them. Phase 3 occurred concurrently, as clinical decision support was vital to completing phases 1 and 2.
Conclusion:
The phased approach was imperative to the project's success and kept individual components on track. All parts were completed in just over one year.
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