A Multipreceptor Approach to Ambulatory Care Topic Discussions

Objective. To assess the impact of a multipreceptor approach to facilitating topic discussions on students'' knowledge and confidence in clinical decision-making during an ambulatory care advanced pharmacy practice experiences (APPEs).Design. Faculty members with relevant expertise and experience facilitated discussions with fourth-year doctor of pharmacy (PharmD) students regarding 7 ambulatory care topics. A student self-assessment survey and knowledge-assessment instrument was administered before and after discussions.Assessment. Students'' examination scores increased significantly from 59.1% ± 13.9% at baseline to 76.5% ± 12.6% at the end of the 5-week experience (p<0.001). The majority of participants were comfortable making therapeutic decisions regarding medication use as it related to all discussion topics except heart failure.Conclusions. Participation in topic discussions led by faculty members with expertise and experience for each ambulatory care topic was associated with a significant improvement in knowledge-assessment scores.     

Accuracy of Intravenous Infusion Flow Regulators in the Prehospital Environment

Objective: To assess the accuracy of multiple Intravenous Infusion Flow Regulators (IIFRs) at infusion rates and hanging heights common to the prehospital setting. Methods: Five different manufacturer's IIFRs were tested over a range of infusion rates while hanging at heights equivalent to the gurney pole, ambulance ceiling hook, and manufacturer's recommended height (if available). Each IIFR was run over a 15-minute period at each infusion rate and height three times. Drip effluent was collected and measured for comparison of volumes. Intra- and inter-device accuracy at different infusion rates and heights was calculated. Results: All devices deviated from the expected infusion volume regardless of infusion rate or height. There was inter-device variability across all IIFRs with some having reproducible though inaccurate volumes. Volumes were consistently below expected at lower heights and above expected at increased heights. Manufacturer recommended height guidelines provided slight improvements in accuracy. Conclusions: Significant deviations from expected IIFR volume were observed across all devices, flow rates, and heights in a static, laboratory environment. These findings would lend caution to the use of IIFRs as they could lead to inaccurate medication dosing (both over- or under-dosing) in the prehospital environment.     

Inconsistencies Between Actual and Estimated Blood Alcohol Concentrations in a Field Study of College Students: Do Students Really Know How Much They Drink?

BACKGROUND: Alcohol use by college students is commonly measured through the use of surveys. The validity of such data hinge on the assumption that students are aware of how much alcohol they actually consume. Recent studies call this assumption into question. Students tend to overestimate the appropriate sizes of standard drinks, suggesting that they might underestimate how much alcohol they consume. If this is true, then students' actual blood alcohol concentrations (BACs) should be higher than BACs estimated based on self-report data. The present study examined this issue METHODS: Breathalyzer readings and self-reported drinking data were collected from 152 college students during the fall of 2004. Estimated BACs were calculated by means of a standard formula, and the relation between actual and estimated BACs was examined. Factors contributing to discrepancies between the two values were identified RESULTS: Estimated BAC levels were significantly higher, not lower, than breath BAC measures. The accuracy of estimated BACs decreased as the number of drinks and amount of time spent drinking increased. Being male and drinking only beer predicted greater accuracy of estimated BACs CONCLUSIONS: Although laboratory data suggest that students underestimate how much they drink, the hypothesis was not supported by data collected in the field. It appears that students might actually overestimate rather than underestimate their levels of consumption when surveyed in the midst of a night of drinking. The findings corroborate observations made by other researchers and suggest that the findings of laboratory studies on college drinking do not necessarily extend to real-world settings.