Letters
Need for pediatric antimicrobial stewardship
T
he primary goal of antimicrobial stewardship is to optimize clinical outcomes while reducing the consequences of unnecessary antimicrobial use. Despite the large body of evidence that supports antimicrobial stewardship programs and their effectiveness in reducing resistance rates and antimicrobial costs, most of these data focus on the improved use of antimicrobial agents in adults.1 While antimicrobial stewardship committees must include an infectious diseases (ID) physician and a clinical pharmacist with ID training as core members,1 most tend to lack an active pediatric ID physician or a pharmacist with adequate training in pediatric ID. The vast majority of current ID residency programs focus on the adult population, with very few institutions offering a pediatric ID residency for pharmacists, largely due to a lack of trained pharmacists in this area and a lack of funding resources. Flannery and colleagues2 conducted a survey at a pediatric tertiary care center and found that more than 80% of respondents considered recommendations from an ID pharmacist to be helpful. Tools such as a pediatric-specific antibiogram, didactic education, and clinical guidelines were also found to be useful. Such research clearly demonstrates that pharmacists with adequate training and experience can contribute to the interdisciplinary team that treats pediatric patients. The lack of resources, funding, and support from hospital administration for pediatric ID pharmacists can be addressed by tracking antimicrobial use among pediatric patients and the associated decrease in costs. For example, a four-month prospective observational study conducted by Metjian and colleagues3 found that having an ID pharmacist for the pediatric population not only improved the appropriate use of antimicrobial agents in children but saved $50,090 in drug acquisition costs alone. Offering more training in pediatric ID and obtaining the resources needed to hire pediatric ID pharmacists are war-
ranted in order to advance current antimicrobial stewardship programs. 1. Dellit TH, Owens RC, McGowan JE Jr et al. Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America guidelines for developing an institutional program to enhance antimicrobial stewardship. Clin Infect Dis. 2007; 44:159-77. 2. Flannery DD, Swami S, Chan S, Eppes S. Prescriber perceptions of a pediatric antimicrobial stewardship program. Clin Pediatr. 2014; 53:747-50. 3. Metjian TA, Prasad PA, Kogon A et al. Evaluation of an antimicrobial steward-
ship program at a pediatric teaching hospital. Pediatr Infect Dis J. 2008; 27:106-11.
Jonathan C. Cho, Pharm.D., Postgraduate Year 2 Pharmacy Resident in Infectious Diseases [email protected] Stephanie H. Stovall, M.D., FAAP, Pediatric Infectious Diseases Physician Lee Memorial Health System Fort Myers, FL
The authors have declared no potential conflicts of interest. DOI 10.2146/ajhp140844
Pharmacy students’ experience with a capstone project
D
ue to the growing needs within the healthcare system and the opportunity for more pharmacy involvement, it is essential that pharmacy curricula provide opportunities to develop students’ critical thinking skills as a way to address these needs. The Center for the Advancement of Pharmacy Education’s 2013 educational outcomes1 and the Accreditation Council for Pharmacy Education (ACPE) draft standards 20162 emphasize the need for higher-level thinking skills by recommending supplementary, applicationbased, and student-driven projects. Specifically, the ACPE draft standards 2016 highlight these higher-level projects as a way to encourage students to be selfdirected learners and innovative thinkers when addressing current issues affecting the healthcare system. A capstone project is a higher-level and culminating experience designed to promote the application of information to assist in developing effective communication skills, to allow students to apply knowledge in a creative manner, and to encourage team-building skills.3-5 Given their benefits and support by accrediting bodies, many pharmacy programs have started to incorporate capstone projects within the curricula as a way to promote
higher-level thinking.4,5 Capstone projects can be useful in developing these skills for students as they transition into advanced pharmacy practice experience (APPE) rotations and ultimately into members of the healthcare team. In fall 2013, 12 third-year doctor of pharmacy students from the Philadelphia College of Pharmacy at the University of the Sciences enrolled in an elective course focused on pharmacists’ roles within different levels of transitions of care (TOC). The course was delivered using mostly active learning techniques and handson activities. The course was designed to build on therapeutics knowledge, patient counseling, and communication skills. It also promoted the use of concepts about the TOC process, such as regulatory issues. Instead of a final examination, students were assigned a capstone project on which they worked together to create a TOC model and link the TOC process among a hospital, an ambulatory care clinic, and a community pharmacy. The course and the capstone project received an abundance of positive feedback from students. Aside from reinforcing therapeutics knowledge, the TOC capstone project provided students with the ability to continue to develop skills such as
Am J Health-Syst Pharm—Vol 72 Mar 1, 2015
347
Need for pediatric antimicrobial stewardship
T
he primary goal of antimicrobial stewardship is to optimize clinical outcomes while reducing the consequences of unnecessary antimicrobial use. Despite the large body of evidence that supports antimicrobial stewardship programs and their effectiveness in reducing resistance rates and antimicrobial costs, most of these data focus on the improved use of antimicrobial agents in adults.1 While antimicrobial stewardship committees must include an infectious diseases (ID) physician and a clinical pharmacist with ID training as core members,1 most tend to lack an active pediatric ID physician or a pharmacist with adequate training in pediatric ID. The vast majority of current ID residency programs focus on the adult population, with very few institutions offering a pediatric ID residency for pharmacists, largely due to a lack of trained pharmacists in this area and a lack of funding resources. Flannery and colleagues2 conducted a survey at a pediatric tertiary care center and found that more than 80% of respondents considered recommendations from an ID pharmacist to be helpful. Tools such as a pediatric-specific antibiogram, didactic education, and clinical guidelines were also found to be useful. Such research clearly demonstrates that pharmacists with adequate training and experience can contribute to the interdisciplinary team that treats pediatric patients. The lack of resources, funding, and support from hospital administration for pediatric ID pharmacists can be addressed by tracking antimicrobial use among pediatric patients and the associated decrease in costs. For example, a four-month prospective observational study conducted by Metjian and colleagues3 found that having an ID pharmacist for the pediatric population not only improved the appropriate use of antimicrobial agents in children but saved $50,090 in drug acquisition costs alone. Offering more training in pediatric ID and obtaining the resources needed to hire pediatric ID pharmacists are war-
ranted in order to advance current antimicrobial stewardship programs. 1. Dellit TH, Owens RC, McGowan JE Jr et al. Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America guidelines for developing an institutional program to enhance antimicrobial stewardship. Clin Infect Dis. 2007; 44:159-77. 2. Flannery DD, Swami S, Chan S, Eppes S. Prescriber perceptions of a pediatric antimicrobial stewardship program. Clin Pediatr. 2014; 53:747-50. 3. Metjian TA, Prasad PA, Kogon A et al. Evaluation of an antimicrobial steward-
ship program at a pediatric teaching hospital. Pediatr Infect Dis J. 2008; 27:106-11.
Jonathan C. Cho, Pharm.D., Postgraduate Year 2 Pharmacy Resident in Infectious Diseases [email protected] Stephanie H. Stovall, M.D., FAAP, Pediatric Infectious Diseases Physician Lee Memorial Health System Fort Myers, FL
The authors have declared no potential conflicts of interest. DOI 10.2146/ajhp140844
Pharmacy students’ experience with a capstone project
D
ue to the growing needs within the healthcare system and the opportunity for more pharmacy involvement, it is essential that pharmacy curricula provide opportunities to develop students’ critical thinking skills as a way to address these needs. The Center for the Advancement of Pharmacy Education’s 2013 educational outcomes1 and the Accreditation Council for Pharmacy Education (ACPE) draft standards 20162 emphasize the need for higher-level thinking skills by recommending supplementary, applicationbased, and student-driven projects. Specifically, the ACPE draft standards 2016 highlight these higher-level projects as a way to encourage students to be selfdirected learners and innovative thinkers when addressing current issues affecting the healthcare system. A capstone project is a higher-level and culminating experience designed to promote the application of information to assist in developing effective communication skills, to allow students to apply knowledge in a creative manner, and to encourage team-building skills.3-5 Given their benefits and support by accrediting bodies, many pharmacy programs have started to incorporate capstone projects within the curricula as a way to promote
higher-level thinking.4,5 Capstone projects can be useful in developing these skills for students as they transition into advanced pharmacy practice experience (APPE) rotations and ultimately into members of the healthcare team. In fall 2013, 12 third-year doctor of pharmacy students from the Philadelphia College of Pharmacy at the University of the Sciences enrolled in an elective course focused on pharmacists’ roles within different levels of transitions of care (TOC). The course was delivered using mostly active learning techniques and handson activities. The course was designed to build on therapeutics knowledge, patient counseling, and communication skills. It also promoted the use of concepts about the TOC process, such as regulatory issues. Instead of a final examination, students were assigned a capstone project on which they worked together to create a TOC model and link the TOC process among a hospital, an ambulatory care clinic, and a community pharmacy. The course and the capstone project received an abundance of positive feedback from students. Aside from reinforcing therapeutics knowledge, the TOC capstone project provided students with the ability to continue to develop skills such as
Am J Health-Syst Pharm—Vol 72 Mar 1, 2015
347
