Past Winners - Safe Medication Practices Award

2019 award recipient 

Retrospective, Multicentre Matched Cohort Study Comparing Safety and Efficacy Outcomes of Intermittent Infusion and Continuous Infusion Vancomycin

Nathan H Ma

Sunnybrook Health Sciences Centre, Toronto, Ontario

Background: Patients with good renal function receiving intermittent infusion vancomycin (IIV) may require total daily doses ≥4g to achieve trough concentrations of 15-20mg/L, increasing the risk of vancomycin associated nephrotoxicity (VAN). Continuous infusion vancomycin (CIV) may enable attainment of target concentrations with a lower daily vancomycin dose, potentially reducing the risk of VAN.

Objectives: The primary objective was to compare VAN risk (serum creatinine [sCr] increase ≥50% from baseline) and renal damage (sCr increase ≥100% from baseline) in patients receiving IIV versus CIV. The secondary objective was to compare clinical cure between IIV and CIV in patients with vancomycin trough or steady state concentrations of ≥12mg/L, respectively.

Methods: Retrospective chart reviews for eligible inpatients at Sunnybrook Health Sciences Centre; Holland Orthopaedic and Arthritic Centre; St. John’s Rehab and Michael Garron Hospital between January 1, 2010 and December 31, 2016 were completed.  Adult inpatients who received ≥48 hours of vancomycin with ≥1 steady state vancomycin concentration were eligible. Baseline patient characteristics, safety and efficacy outcomes for the IIV and CIV cohorts were compared using appropriate statistical tests (Fisher’s exact, Student’s t-test, or Mann-Whitney), with significance defined as P<0.05. A generalized estimating equation model was used to identify independent predictors of VAN.

Results: Of 2136 patients who received vancomycin during the study period, 146 CIV patients were eligible and matched to 146 IIV patients. CIV was found to have a lower odds of developing nephrotoxic risk (odds ratio [OR] 0.42, 95% confidence interval [CI] 0.21-0.98, p=0.025) and renal injury (OR 0.19, 95% CI 0.05-0.59, p=0.004). There was no difference in clinical cure between IIV (62/67 [93%]) and CIV patients (58/62 [94%]; P>0.99).

Conclusion: CIV patients were less likely to experience nephrotoxic risk and renal damage. The results indicate there is no difference in clinical cure between patients who received IIV versus CIV.

Sponsored by HealthPRO Procurement Services Inc.
 

Past award recipients

Abstracts for the projects listed below can be viewed in the Canadian Journal of Hospital Pharmacy (CJHP). Award-winning abstracts are generally published in the first or second issue of each volume.

2018

Sponsored by HealthPRO Procurement Services Inc.

Michael Wan, Sandra A N Walker, Marion Elligsen, Lesley Palmay 

Vancomycin Trough Concentrations and Outcomes in Non-deep Seated Infections: A Retrospective Cohort Study (completed at Sunnybrook Health Sciences Centre, Toronto, Ontario)

2017

Sponsored by HealthPRO Procurement Services Inc.

Nicole MacDonald, Leslie Manuel, Haley Brennan, Richard Wanbon

Reliability of a Best Possible Medication History Completed by Non-Admitted Patients in the Emergency Department (completed at Moncton Hospital, Moncton, New Brunswick)

2017

Sponsored by Medbuy Corporation

Suzanne C Malfair, Sukhjinder Sidhu, Caitlin Lang, Adil Virani

An Evaluation of Pharmacist Intervention on Discharge Medication Reconciliation (completed at Surrey Memorial Hospital, Surrey, British Columbia)

2016

Sponsored by HealthPRO Procurement Services Inc.

Donna M M Woloschuk, Cenzina Caligiuri

Quality Assurance of Aseptic Compounding in Winnipeg Regional Health Authority Pharmacies (completed at Winnipeg Regional Health Authority, Winnipeg, Manitoba)

2016

Sponsored by Medbuy Corporation

Jean-François Bussières

Pilot Study of Biological Monitoring of Four Antineoplastic Drugs among Canadian Healthcare Workers (completed at CHU Sainte-Justine, Montréal, Québec)

2015

Sponsored by HealthPRO Procurement Services Inc.

Marisa Battistella

Targeted Deprescribing in an Outpatient Hemodialysis Unit to Decrease Polypharmacy: A Pilot Study (completed at University Health Network, Toronto, Ontario)

2015

Sponsored by Medbuy Corporation

Jennifer Li, Michal Racki

The Successful Implementation of a Fully Automated Robotic Intravenous System for Chemotherapy Preparation (completed at Royal Victoria Regional Health Centre, Barrie, Ontario)

2014

Sponsored by HealthPRO Procurement Services Inc.

Mário de Lemos, Joan Fabbro

Systematic Approach to Evaluate Hazardous Antineoplastic Drugs by a Provincial Healthcare Organization (completed at the BC Cancer Agency, British Columbia)

2014

Sponsored by Medbuy Corporation

Claudia Bucci, Artemis Diamantouros

Implementation and Evaluation of an "Avoid-Heparin" Program on the Incidence, Clinical Consequences and Resource Use Associated with Heparin-Induced Thrombocytopenia (completed at Sunnybrook Health Sciences Centre, Toronto, Ontario)

2013

Sponsored by HealthPRO Procurement Services Inc.

Jean-François Bussières

Multicenter Study of Environmental Contamination with Hazardous Drugs in Quebec Hospitals (completed at CHU Sainte-Justine, Montréal, Québec)

2013

Sponsored by McKesson Canada Corporation

Mary-Lou Lester, Piera Calissi

Medication Reconciliation Standardization in a Regional Health Authority Renal Program (completed at Kelowna General Hospital, Kelowna, British Columbia)

2013 

Sponsored by Medbuy Corporation

Donna M M Woloschuk, Wendy Simoens, Lorraine Woods, Florence Mendelson

Development of a Training Program for Hazardous Drugs Handling (completed at Winnipeg Regional Health Authority, Winnipeg, Manitoba)

2012

Sponsored by Baxter Corporation

Certina Ho

Extending Hospital-Based Medication Incident Reporting to Enhance Medication Safety and Continuous Quality Assurance in Pharmacy Practice (completed at ISMP Canada, Richmond Hill, Ontario)

2012

Sponsored by Hospira Healthcare Corporation

Natalie LeBlanc, Leslie Manuel, Timothy MacLaggan, Julie Levesque, Rochelle Johnston

Implementation and Evaluation of a Medication Reconciliation Tool on Internal Hospital Transfer (completed at the Moncton Hospital, Moncton, New Brunswick)

2011

Sponsored by Baxter Corporation (Canada)

Olavo Fernandes, Anna W Lee, Gary Wong, Jennifer Harrison, Michael Wong,
Margaret Colquhoun

What is the Impact of a Centralized Provincial Drug Profile Viewer on the Quality and Efficiency of Patient Admission Medication Reconciliation? A Randomized Controlled Trial (completed at University Health Network, Toronto, Ontario)

2011

Sponsored by Hospira Healthcare Corporation

Justin Lee, Kori Leblanc, Olavo Fernandes, Jin-Hyeun Huh, Gary Wong, Jana Bajcar, Jennifer Harrison

Medication Reconciliation During Internal Hospital Transfer and Impact of Computerized Prescriber Order Entry (completed at University Health Network, Toronto, Ontario)

2010

Sponsored by Baxter Corporation

Sarah Heather Miller, Colette Raymond, Hannah Wheaton, Nick Honcharik

Attitudes and Behaviours of Pharmacy Staff toward Near Misses: Reliability and Validity of
a Survey Tool (completed at Winnipeg Regional Health Authority, Winnipeg, Manitoba)

2010

Sponsored by Hospira Healthcare Corporation

Trudy Arbo, Nadia Chishti, Jaclyn LeBlanc, Moira Wilson

Medication Reconciliation and the Role of the Pharmacy Technician: A Pilot Project with
Acute Care Cardiac Services (completed at New Brunswick Heart Centre, Saint John, New Brunswick)

2009

Sponsored by Baxter Corporation

James Conklin, Mário de Lemos, Dennis Jang, Dianne Kapty, Lynne Nakashima, Susan Walisser

Improving Risk Management with the Development of a Best Evidence-Based, Provincial Chemotherapy Preparation and Stability Chart (completed at BC Cancer Agency, Vancouver, Vancouver, British Columbia)

2009

Sponsored by Hospira Healthcare Corporation

Danica Irwin, Régis Vaillancourt, Elaine Wong

Standard Concentration of High Alert Drug Infusions across Paediatric Acute Care (completed at Children's Hospital of Eastern Ontario, Ottawa, Ontario)

Inquiries should be directed to :

Robyn Rockwell, Membership & Awards Administrator
awards@cshp.pharmacy
Toll Free: 1 (877) 340-2756, ext. 222
Direct: (613) 736-9733, ext. 222