BEGIN:VCALENDAR VERSION:2.0 X-WR-CALNAME:pshp2026residencyconference X-WR-CALDESC:Event Calendar METHOD:PUBLISH CALSCALE:GREGORIAN PRODID:-//Sched.com PSHP 2026 Residency Conference//EN X-WR-TIMEZONE:UTC BEGIN:VEVENT DTSTAMP:20260520T135913Z DTSTART:20260518T120000Z DTEND:20260518T130000Z SUMMARY:Networking Breakfast DESCRIPTION: CATEGORIES:EVENT LOCATION:Franklin Square (13th Floor Downstairs)\, Center City\, Philadelphia SEQUENCE:0 UID:02d4c48c957ae0ed89f39ad4446b686f URL:http://pshp2026residencyconference.sched.com/event/02d4c48c957ae0ed89f39ad4446b686f END:VEVENT BEGIN:VEVENT DTSTAMP:20260520T135913Z DTSTART:20260518T120000Z DTEND:20260518T130000Z SUMMARY:Registration DESCRIPTION: CATEGORIES:REGISTRATION LOCATION:Franklin Square (13th Floor Downstairs)\, Center City\, Philadelphia SEQUENCE:0 UID:f8277537a7d6212fc8bebe5ba99e6e44 URL:http://pshp2026residencyconference.sched.com/event/f8277537a7d6212fc8bebe5ba99e6e44 END:VEVENT BEGIN:VEVENT DTSTAMP:20260520T135913Z DTSTART:20260518T130000Z DTEND:20260518T132000Z SUMMARY:Kickoff & Preceptor of the Year Award Presentation DESCRIPTION:Presented by Conference Co-Chairs\, Kayla Bardzel\, PharmD\, BCCCP and Shirley Bonanni\, PharmD\, BCPS CATEGORIES:GENERAL SESSION LOCATION:Forum (13th Floor Downstairs)\, Center City\, Philadelphia SEQUENCE:0 UID:4fe92b0fa58fb9c497f8614f2f64ceb4 URL:http://pshp2026residencyconference.sched.com/event/4fe92b0fa58fb9c497f8614f2f64ceb4 END:VEVENT BEGIN:VEVENT DTSTAMP:20260520T135913Z DTSTART:20260518T133000Z DTEND:20260518T135000Z SUMMARY:Joint Effort: Implementation of a Clinical Pharmacist within a Rheumatology Clinic DESCRIPTION:Purpose: Rheumatoid arthritis (RA) has persistent barriers to care\, and pharmacists may help bridge these gaps. The purpose of this project was to evaluate the impact of clinical pharmacist integration in an outpatient rheumatology clinic.\nMethods: \;A retrospective quality improvement project which reviewed interventions conducted by a clinical pharmacist embedded within Penn Rheumatology Washington Square. Patients included adults with RA with a documented intervention by the pharmacist\, and those who were seen only for non-RA conditions were excluded. The primary outcome was change in RA disease activity as measured by the Routine Assessment of Patient Index Data 3 (RAPID3) at 1 and 3 months post-intervention. Secondary outcomes included the type\, frequency\, and time associated with pharmacist interventions\, as well as changes in Clinical Disease Activity Index (CDAI) scores. This project was reviewed and determined to qualify and approved as quality improvement by the University of Pennsylvania’s Institutional Review Board.\nResults: \;Of 25 patients with a documented clinical pharmacist intervention\, all were included for analysis. Among patients with available RAPID3 data\, the mean difference in RAPID3 scores from baseline to 1 month following pharmacist intervention was -2.27 (p = 0.068\, n = 6) and from baseline to 3 months was 0.57 (p = 0.838\, n = 12). The clinical pharmacist completed 182 interventions during the project period. The most common interventions included patient education\, drug interaction checks\, clinical and laboratory monitoring\, comprehensive medication reviews\, and medication list reviews. Time associated with interventions varied by subtype. No CDAI scores were documented at baseline or follow-up.\nConclusion: Although no statistically significant changes in RA disease severity were observed\, integrating a clinical pharmacist into a rheumatology clinic yielded numerous meaningful\, medication-focused interventions addressing known barriers to RA care. Findings highlight clinical and operational value of pharmacists in multidisciplinary rheumatology care\, and an opportunity to standardize disease activity monitoring and enhance future outcome assessment. CATEGORIES:AMBULATORY CARE LOCATION:Broad Hub EAST\, Center City\, Philadelphia SEQUENCE:0 UID:6eaf43b273790d2973fc6c57ab6c667c URL:http://pshp2026residencyconference.sched.com/event/6eaf43b273790d2973fc6c57ab6c667c END:VEVENT BEGIN:VEVENT DTSTAMP:20260520T135913Z DTSTART:20260518T133000Z DTEND:20260518T135000Z SUMMARY:Adherence to Emergency Department Heart Failure Diuretic Panel Order Set DESCRIPTION:This study evaluated provider adherence to the emergency department diuretic order set for patients admitted with a heart failure exacerbation\, specifically assessing IV diuretic doses and timing of administration to optimize care.\n\n\nThis single-center\, retrospective chart review at Thomas Jefferson University Hospital included patients identified via the electronic medical record between 4/1/2025 and 9/30/2025 who presented to the emergency department with heart failure\, dyspnea\, or fluid overload and received an IV loop diuretic. Those with a mean arterial pressure <\; 65\, on dialysis\, or missing data were excluded. Patients were classified as adherent or non-adherent based on the standardized ED admission order set. Non-adherent patients were further classified as either under- or overdosed in relation to the dosing recommended in the order set. The primary endpoint analyzed provider adherence incidence using descriptive statistics. Secondary endpoints—door-to-diuretic time\, administration relative to timing of labs\, and method of arrival—were analyzed using descriptive statistics and compared between groups using Fisher’s exact and Kruskal-Wallis tests.\n\n\nA total of 210 patients were included\; 54% (114/210) were male and 60% (125/210) were African American. Providers were non-adherent to the order set in 66% (139/210) of patients\; 69% (96/139) of those were underdosed vs order set recommendations. 15% (31/210) of patients had a door-to-diuretic time of ≤100 minutes\, and 90% (190/210) had their first IV diuretic after labs resulted. Fisher’s exact test (p ≤ .001) showed a significant association between door-to-diuretic time and diuretics being given before labs resulted. Kruskal-Wallis test found no significant difference in door-to-diuretic time across the three methods of arrival to the ED (ambulatory\, fire rescue/emergency medical services\, unknown)\, χ2 ([2]\, N = 210) = 5.411\, p = .067.\n\n\nProvider adherence to the emergency department diuretic order set was low\, with frequent underdosing and delays in treatment. Early diuretic administration was uncommon\, and many providers waited to treat until after labs resulted\, prolonging door-to-diuretic time. These findings highlight opportunities to improve adherence and reduce delays in dosing to optimize outcomes in heart failure patients experiencing an exacerbation.\n\n\nIRB Approval: Exempt\n\n\nAuthors: Kaylee Morosky\, PharmD & Margo Graybill\, PharmD\; Thomas Jefferson University Hospital (TJUH)\, Philadelphia\, PA - Department of Pharmacy CATEGORIES:CARDIOLOGY LOCATION:Broad Hub WEST\, Center City\, Philadelphia SEQUENCE:0 UID:ddb727dd99bf46c43cc0b16f185b9293 URL:http://pshp2026residencyconference.sched.com/event/ddb727dd99bf46c43cc0b16f185b9293 END:VEVENT BEGIN:VEVENT DTSTAMP:20260520T135913Z DTSTART:20260518T133000Z DTEND:20260518T135000Z SUMMARY:Low- versus High- Dose Intravenous Methylprednisolone for High Eosinophilic Asthma and COPD Exacerbations in the Emergency Department DESCRIPTION:This study assessed whether low-dose versus high-dose intravenous (IV) methylprednisolone may affect clinical response in emergency department (ED) patients presenting with an acute asthma or COPD exacerbation and a high eosinophil count.  \;\n\n\nThis single-center\, retrospective cohort study included adult patients who presented to the ED with an acute asthma or COPD exacerbation and received IV methylprednisolone with a baseline eosinophil count greater than or equal to 3% or 300 cells/mcL. Patients were stratified into two groups\, low-dose versus high-dose (<\; 40 mg or >\;40 mg of IV methylprednisolone)\, based on the initial dose of steroid that was administered in the ED. The primary endpoint was to compare Intensive Care Unit (ICU)-free days within a 28-day period. Key secondary endpoints measured include baseline eosinophil count\, supplemental oxygen\, hospital length of stay\, and patient disposition. Cumulative correctional insulin use within 72 hours of initial methylprednisolone administration was evaluated as a surrogate for dose-dependent steroid-related adverse effects.  \;\n\n\nAmong 50 patients\, 25 received low-dose and 25 received high-dose corticosteroids in the ED. Mean ICU-free days at 28 days were similar between groups (27.9 ±\; 0.34 vs 27.5 ±\; 1.22\; p =0.577). The high-dose group had a higher baseline eosinophil count (median 6.1% [500 cells/mcL] vs 4.3% [400 cells/mcL]) and more patients on supplemental oxygen at baseline (6 vs 3). Hospital length of stay was longer in the high-dose group (4.15 vs 3.57 days\; p=0.638)\, and more patients required ICU admission (5 vs 1 patient\; p=0.172). Additionally\, cumulative correctional insulin use within 72 hours was higher in the high-dose group (median 22 [IQR 2.5-50]) vs 10 [IQR 1.5-61.5]). \;\n\n\nLow-dose IV methylprednisolone demonstrated similar outcomes to high-dose therapy. Patients receiving higher doses appeared more clinically complex at baseline\, with higher eosinophil counts and greater oxygen requirements. No significant differences in patient outcomes were observed. This study may support lower corticosteroid dosing in eosinophilic exacerbations to reduce potential steroid-related harm while maintaining clinical effectiveness. \;\n CATEGORIES:EMERGENCY MEDICINE LOCATION:a.Pavilion Hub WEST\, Center City\, Philadelphia SEQUENCE:0 UID:41d619b942ecd17eb66edf6a5cc3a954 URL:http://pshp2026residencyconference.sched.com/event/41d619b942ecd17eb66edf6a5cc3a954 END:VEVENT BEGIN:VEVENT DTSTAMP:20260520T135913Z DTSTART:20260518T133000Z DTEND:20260518T135000Z SUMMARY:Evaluating the Appropriateness of Venous Thromboembolism Prophylaxis in Hospitalized Patients DESCRIPTION:Purpose: The purpose of this study is to evaluate current institutional practices related to initiation and dosing of pharmacological venous thromboembolism (VTE) prophylaxis.  \;\n\n\nMethods: This retrospective\, single-center\, chart review evaluated 150 patients from January 1-June 30\, 2025. Adult patients who received at least 48 hours of pharmacologic VTE prophylaxis with a length of stay between 3 to 28 days were included. Patients were excluded if they had a clear indication for VTE prophylaxis (recent trauma\, surgery\, or active malignancy). The primary endpoint is the number of patients appropriately initiated on pharmacologic prophylaxis based on a Padua Prediction Score of &ge\;4. Secondary endpoints include the number of patients with appropriately dosed thromboprophylaxis based on body weight or BMI\, the incidence of adverse events\, and the number of readmissions due to bleeding or clotting events. Data included patient characteristics\, components of the Padua Prediction and HAS-BLED scores\, medication regimens\, adverse events\, and readmissions. Descriptive analysis was utilized to interpret the data.  \;\n\n\nResults: Fifty-eight patients (38.7%) with a Padua Prediction score of &ge\;4 were appropriately initiated on VTE prophylaxis. There were 125 patients (83.3%) initiated on VTE prophylaxis at an appropriate dose for their BMI/body weight. Of patients dosed inappropriately\, the highest rate of dosing errors (88.3%) occurred in those with a low BMI/body weight.  \;Adverse events and readmissions related to clotting or bleeding were rare. One DVT (0.7%) and one episode of major bleeding (0.7%) occurred during admission. Two patients had readmissions (1.4%)\, one related to bleeding\, and one related to clotting.  \;Enoxaparin was the agent used the most (56.7%) and had the greatest rate of inappropriate dosing among patients (11.3%). \;\n\n\nConclusion: In patients without a clear indication for VTE prophylaxis\, pharmacologic agents are frequently initiated unnecessarily. Patients with a low BMI/body weight demonstrated the highest rate of inappropriate dosing\, highlighting the need for improved risk assessment and standardized protocols at our institution. Optimizing the initiation of thromboprophylaxis presents an opportunity to reduce unnecessary medication use and healthcare costs.  \;\n\n\n(This study is IRB approved)\n CATEGORIES:PHARMACOTHERAPY LOCATION:a.Pavilion Hub EAST\, Center City\, Philadelphia SEQUENCE:0 UID:3582bd3b758209689a0a2cd69068d06e URL:http://pshp2026residencyconference.sched.com/event/3582bd3b758209689a0a2cd69068d06e END:VEVENT BEGIN:VEVENT DTSTAMP:20260520T135913Z DTSTART:20260518T135000Z DTEND:20260518T141000Z SUMMARY:Impact of Continuous Glucose Monitoring in Pharmacist-Led Medication Management in Type 2 Diabetes within a Collaborative Practice Agreement DESCRIPTION:Purpose: The purpose of this study was to determine whether the use of continuous glucose monitoring (CGM) in patients enrolled in a type 2 diabetes management program led to a significant change in glycemic control.\n\n\nMethods: This retrospective chart review included adult patients with type 2 diabetes enrolled in a Population Health clinical pharmacist-led diabetes management program operating under a collaborative practice agreement at Lehigh Valley Physician Group (LVPG) sites between July 1\, 2024 to March 31\, 2025. Eligible patients were adults (≥ 18 years of age) with uncontrolled type 2 diabetes managed by their primary care provider. Eligible patients had a baseline hemoglobin A1c (HbA1c) drawn within 30 days of enrollment in the program\, and at least 1 repeat HbA1c drawn during the study period. Patients were excluded if they had a diagnosis of type 1 diabetes\, were pregnant\, were managed by Endocrinology\, or lacked a repeat HbA1c. The two study groups included patients using CGM and those who did not use CGM. \;\n\n\nResults: The research data report generated a total of 251 unique patient charts for review\, of which 105 met at least one exclusion criteria. The remaining 146 patient charts were included in the final analysis. The study population was 58.22% male (n=85)\, 76.03% White or Caucasian (n=111)\, with a mean age of 60.68 years. The CGM group included 54 patients while the non-CGM group included 92 patients using a glucometer or no glucose-monitoring device. In both groups\, HbA1c decreased significantly from baseline to repeat (p<\;0.0001). The reduction was greater in the CGM group (median -1.70) compared with the non-CGM group (median -1.50). This difference did not reach statistical significance (p=0.2036).\n\n\nConclusion: This analysis supports that pharmacist-led interventions can result in HbA1c reduction. Both CGM and non-CGM users experienced significant improvements in glycemic control. Although the median reduction in HbA1c was greater among CGM users\, this difference was not statistically significant. A larger study over a longer period of time could further evaluate whether CGM use impacts glycemic control in our patient population.  \; \; CATEGORIES:AMBULATORY CARE LOCATION:Broad Hub EAST\, Center City\, Philadelphia SEQUENCE:0 UID:83194357db0d0c76ab827bd32e741c30 URL:http://pshp2026residencyconference.sched.com/event/83194357db0d0c76ab827bd32e741c30 END:VEVENT BEGIN:VEVENT DTSTAMP:20260520T135913Z DTSTART:20260518T135000Z DTEND:20260518T141000Z SUMMARY:Pharmacist Intervention To Optimize Guideline-Directed Medication Therapy (GDMT) In Patients With Heart Failure With Reduced Ejection Fraction (HFrEF) DESCRIPTION:Title: \;Pharmacist Intervention To Optimize Guideline-Directed Medication Therapy (GDMT) In Patients With Heart Failure With Reduced Ejection Fraction (HFrEF)\nPurpose: The objective of this study is to showcase the benefits of pharmacist involvement in reference to HFrEF patients and support the addition of a heart failure pharmacist practicing under a collaborative practice agreement (CPA).\nMethods: The study was a retrospective chart review with the primary endpoints assessing patient GDMT and readmission. Secondary endpoints will include an assessment of how quickly an 80% cut-off of GDMT score can be reached and time used for providers. These will be assessed over a 6-month period and may be compared depending on the endpoint. Inclusion and exclusion criteria will mirror previous reviews done at our institution. The GDMT scoring system was determined to assess GDMT utilization and was agreed upon by authors prior to implementation. Appropriate statistical assessments were conducted to the data.\nResults: \;Demographics were comparable between both arms of the review. The transition of care (TOC) group included 41 patients versus the general population (control) group’s 49 patients. Baseline scores were comparable (3.85±2.23 vs 3.96±2.12\; p=0.819). At 6 months\, the TOC arm had higher GDMT scores (4.93±2.34 vs 3.94±2.25\; p=0.031) and a greater change in scores (1.07±2.34 vs -0.02±1.70\; p=0.015). During the observational period\, readmission favored the TOC group (24.4% vs 40.8%\; p=0.100) and provider office time used was comparable (126.95±66.19 vs 137.14±60.94 minutes\; p=0.449). Achievement of ≥80% GDMT score occurred in 2 patients in the TOC group and 1 patient in the control group.\nConclusions: Pharmacist intervention via TOC had a positive impact on HFrEF patients. Future studies should increase the number of charts reviewed and use a more validated scoring system. Repeating this study would improve case numbers and comparing cohorts may show progression in care practices. Additionally\, a comparison between TOC encounters and patients managed by a pharmacist under a CPA may help distinguish pharmacist led care to another degree. CATEGORIES:CARDIOLOGY LOCATION:Broad Hub WEST\, Center City\, Philadelphia SEQUENCE:0 UID:2ec49590b2fbdfbfebbdd565efbdc9ba URL:http://pshp2026residencyconference.sched.com/event/2ec49590b2fbdfbfebbdd565efbdc9ba END:VEVENT BEGIN:VEVENT DTSTAMP:20260520T135913Z DTSTART:20260518T135000Z DTEND:20260518T141000Z SUMMARY:Intracranial Hemorrhage After Tenecteplase Administration for Acute Ischemic Stroke DESCRIPTION:Purpose: \;Tenecteplase (TNK) is guideline-recommended for acute ischemic stroke (AIS) but carries a risk of symptomatic intracranial hemorrhage (sICH). \;The purpose of this study is to analyze risk factors for sICH after TNK \;administration \;in AIS. \;\nMethods: This is a retrospective\, IRB approved\, \;observational analysis of hospitalized adults who received intravenous \;TNK \;for \;AIS. \;Key exclusion criteria \;include lack of \;repeat imaging\, known factor \;deficiency\, \;or clotting disorder. \;The primary \;objective \;is \;the incidence \;of \;sICH \;after \;TNK \;administration. \;Secondary objectives \;encompass: \;identifying factors associated with hemorrhagic conversion (time from last known normal to TNK \;administration\, time from stroke activation to TNK \;administration\, age >\; 80 years\, NIHSS >\; 25 or <\;5\, \;large vessel \;occlusion\, underwent mechanical thrombectomy\, \;smoker\, atrial fibrillation\, diabetes \;antiplatelet use and \;anticoagulant \;use within past 7 days) \;and \;incidence of completing CTH 24 hours \;after \;IV thrombolytic \;was given \;per protocol. \;\nResults: \;In the 153 patients included\, 11 \;(7.2%) \;patients developed a \;sICH \;after receiving TNK. \;Age greater than 80 years \;(p=0.003)\, antiplatelet use \;(p=0.019)\, and NIHSS >\; 25 \;(p=0.042) \;were \;considered to be \;potential contributing factors recognized as \;an increased \;risk after \;receiving TNK. \;Interestingly\, patients who received an anticoagulant within the 7 days preceding TNK \;therapy \;were associated with a lower risk of developing a \;sICH\, \;although it \;was not statistically significant (p=1.000). \;Thirty \;patients (19.6%) did not receive a repeat CTH 24-hours after receiving \;TNK\, \;which is \;required \;per \;hospital \;protocol \;for \;thrombolytic \;use in CATEGORIES:EMERGENCY MEDICINE LOCATION:a.Pavilion Hub WEST\, Center City\, Philadelphia SEQUENCE:0 UID:7a4335e469a5100c726e10aa0d36693a URL:http://pshp2026residencyconference.sched.com/event/7a4335e469a5100c726e10aa0d36693a END:VEVENT BEGIN:VEVENT DTSTAMP:20260520T135913Z DTSTART:20260518T135000Z DTEND:20260518T141000Z SUMMARY:Evaluation of Anti-Xa Levels in Patients with Obesity Receiving Therapeutic Enoxaparin DESCRIPTION:Purpose: \;\nThis study aims to evaluate real-world enoxaparin dosing and anti-Xa levels among patients with obesity to assess whether dose reductions improved the proportion of therapeutic anti-Xa levels and reduced supratherapeutic exposure.\n \;\nMethods: \;\nThis single-center retrospective chart review at Penn State Health Milton S. Hershey Medical Center evaluated adults with body mass index ≥35 kg/m2 receiving therapeutic enoxaparin every 12 hours with at least one appropriately timed anti-Xa level between June 2023 and June 2025. Therapeutic enoxaparin included standard weight-based dosing (1 mg/kg) using actual body weight with institutional syringe rounding\, continuation of home regimen\, or empiric dose adjustments based on body mass index or prior anti-Xa levels. Data collected included demographics\, enoxaparin doses\, anti-Xa levels\, and bleeding events. The therapeutic anti-Xa range was defined as 0.5-1 IU/mL. The primary outcome was the proportion of patients requiring dose reduction based on anti-Xa levels. Secondary outcomes included percent dose reduction and bleeding events. Descriptive statistics and subgroup analyses by dosing group and obesity class were performed.\n \;\nResults: \;\nAmong 174 patients\, 56% had supratherapeutic\, 41% therapeutic\, and 3% subtherapeutic initial anti-Xa levels. Lower initial doses (<\;0.85 mg/kg) were associated with higher therapeutic rates (64-65%) and lower supratherapeutic rates (18-32%) compared with >\;0.95 mg/kg (35% therapeutic\, 65% supratherapeutic). Patients receiving <\;0.75 mg/kg had significantly lower odds of supratherapeutic levels (OR 0.11\, p<\;0.001). The mean therapeutic dose was 0.84 mg/kg among all patients\, however 0.81 mg/kg among those with class 3 obesity. Repeat anti-Xa monitoring occurred in 16% of patients with therapeutic anti-Xa levels\, with 71% remaining therapeutic. Bleeding occurred in 6% of patients\, with 82% of events in those with supratherapeutic levels.\n \;\nConclusion:\nReduced enoxaparin dosing (<\;0.85 mg/kg) in patients with obesity was associated with improved therapeutic anti-Xa levels and significantly lower supratherapeutic anti-Xa levels compared with standard dosing (>\;0.95 mg/kg). Supratherapeutic levels were common and linked to most bleeding events. These results support lower initial dosing and more targeted anti-Xa monitoring in patients with obesity. CATEGORIES:PHARMACOTHERAPY LOCATION:a.Pavilion Hub EAST\, Center City\, Philadelphia SEQUENCE:0 UID:717f6bb68d885728cea5aafcc6b6fda7 URL:http://pshp2026residencyconference.sched.com/event/717f6bb68d885728cea5aafcc6b6fda7 END:VEVENT BEGIN:VEVENT DTSTAMP:20260520T135913Z DTSTART:20260518T141000Z DTEND:20260518T143000Z SUMMARY:Evaluating the Effect of GLP-1 Agonists on INR Time in Therapeutic Range for Warfarin Patients DESCRIPTION:Purpose: Warfarin monitoring of the international normalized ratio (INR) within a narrow range is assessed by time in therapeutic range (TTR). This study evaluates whether glucagon-like peptide-1 (GLP-1) agonists impact TTR in stable patients.\n\n\nMethods: This retrospective cohort study included adult patients managed at an anticoagulation clinic at the University of Pennsylvania Health System who were on stable warfarin therapy and initiated a GLP-1 agonist between January 2023 and September 2025. Patients required ≥3 values and documented targets in 6-month pre/post periods. Exclusions included unstable therapy\, insufficient data\, anticoagulant changes\, or therapy discontinuation. The primary endpoint was change in TTR from baseline to 6 months post-initiation. Secondary endpoints included percentage of INRs within range\, frequency of warfarin dose interventions\, bleeding events\, and weight change at 6 months. Data was collected via electronic records and REDCap. The primary endpoint was analyzed using a Wilcoxon signed-rank test\; secondary endpoints were summarized descriptively.\n\n\nResults: A total of 52 patients were included. Median TTR decreased from 91.6% pre-initiation to 86.6% post-initiation (p=0.107)\, which was not statistically significant. Few bleeding events were observed (n=2). Patients experienced a significant reduction in weight at 6 months (mean change −7.3 kg\, p<\;0.001). Data on INR within range and dose interventions showed variability\, but no clear pattern of increased instability.\n\n\nConclusion: Initiation of GLP-1 agonists in stable warfarin patients was not associated with a statistically significant change in TTR\, though a numerical decline was observed. Concurrent use is well tolerated\, with minimal bleeding events and significant weight loss. Findings suggest that safe warfarin therapy may be maintained with GLP-1 initiation\, though close INR monitoring remains prudent. Larger studies are needed to further clarify this relationship.\n\n\nIRB Approval: \;Protocol Number \;- \;859543 CATEGORIES:AMBULATORY CARE LOCATION:Broad Hub EAST\, Center City\, Philadelphia SEQUENCE:0 UID:2cb9671d26caec2d87fc81f19729b7aa URL:http://pshp2026residencyconference.sched.com/event/2cb9671d26caec2d87fc81f19729b7aa END:VEVENT BEGIN:VEVENT DTSTAMP:20260520T135913Z DTSTART:20260518T141000Z DTEND:20260518T143000Z SUMMARY:Evaluation of Venous Thromboembolism Prophylaxis in Underweight and Overweight Patients Receiving Enoxaparin or Unfractionated Heparin DESCRIPTION:The purpose of this research project is to evaluate current dosing practices and identify opportunities to improve safety in underweight and overweight patients through development and implementation of a dosing guideline.\n\n\nA retrospective chart review was conducted to evaluate adult patients from January to June 2025 who received venous thromboembolism (VTE) prophylaxis with enoxaparin and unfractionated heparin (UFH) and qualified for dosing adjustments instead of standard prophylaxis dosing. Inclusion criteria were adult patients weighing ≤ 45 kg (or with a body mass index (BMI) ≤ 18.5 kg/m2) or weighing ≥100 kg (or with a BMI ≥30 kg/m2) who received VTE prophylaxis for at least 48 hours. The primary outcome was incidence of VTE. Secondary outcomes include major bleeding events\, duration of therapy\, change in VTE prophylaxis regimen during the same admission period\, and length of stay. A dosing guideline was developed and approved by the appropriate committees followed by staff education.  \;Post guideline implementation data was collected from January to March 2026 to assess guideline compliance. This quality improvement project received IRB exemption.\n\n\nPre-guideline data (n=299 total) resulted in underweight patients with standard dose UFH having a 9.1% post-discharge bleeding rate and 4.5% VTE rate\, while reduced-dose recipients had none for both. Standard-dose enoxaparin had an 11.8% VTE rate versus none with reduced dosing. Among overweight patients\, standard-dose UFH had a 2% inpatient bleeding rate and 2% VTE rate. Post-guideline data (n=123 total) showed 88% and 86% guideline compliance in underweight and overweight patients\, respectively. Underweight patients with reduced-dose UFH had one VTE event and reduced-dose enoxaparin had one inpatient bleeding event. Overweight patients receiving dose-adjustments had 9.1% and 7.9% bleeding rates with UFH and enoxaparin\, respectively.\n\n\nPreliminary data suggests greater awareness of dose adjusting enoxaparin compared to heparin. In overweight patients\, dosing remained more conservative than dosing in underweight patients. After the implementation of a weight-based VTE prophylaxis guideline\, VTE events were reduced. Bleeding events persisted in some dose-adjusted groups\, which highlights the importance of continued monitoring and further study with a larger sample size. CATEGORIES:CARDIOLOGY LOCATION:Broad Hub WEST\, Center City\, Philadelphia SEQUENCE:0 UID:300103e2bd244cfc6134e708554f5f6c URL:http://pshp2026residencyconference.sched.com/event/300103e2bd244cfc6134e708554f5f6c END:VEVENT BEGIN:VEVENT DTSTAMP:20260520T135913Z DTSTART:20260518T141000Z DTEND:20260518T143000Z SUMMARY:Time to First Non-Benzodiazepine Antiseizure Medication in Status Epilepticus DESCRIPTION:Evaluate if time to first non-benzodiazepine antiseizure medication (ASM) correlates with the rate of intensive care unit (ICU) admissions in patients presenting with status epilepticus (SE) \;at Thomas Jefferson University Hospital (TJUH). \;\n\n\nThis single-center\, retrospective chart review included adult patients presenting with SE to the emergency department (ED) at TJUH between April 2022 and April 2024. Records from the electronic health record were reviewed for eligibility. The primary objective was ICU admission rates in patients receiving a non-benzodiazepine ASM <\;30 vs ≥30 minutes. Secondary outcomes included ED length of stay (LOS)\, ICU LOS\, hospital LOS\, progression to refractory SE\, cases of intubation\, guideline-directed ASM loading dose administered\, administration as intravenous (IV) push vs IV piggyback\, medication procurement source\, and ED pharmacist presence. Categorical variables were analyzed using chi-square or Fisher’s exact tests\, and continuous variables using the Mann-Whitney U test. Multiple logistic regression controlling for Acute Physiology and Chronic Health Evaluation II (APACHE II) score and time to ASM administration was conducted. \;\n\n\nA total of 202 patient encounters were reviewed\, of which 110 met inclusion criteria. Majority of patients were African American males. Among these\, 22 encounters received ASM within <\;30 minutes\, with a median APACHE II score of 22.5 and GCS of 4\, while 88 encounters received ASM ≥30 minutes\, with a median APACHE II of 8.5 and GCS of 9. ICU admission occurred in 86.4% of the <\;30-minute group and 45.5% of the ≥30-minute group (OR 7.6\, 95% CI: 2.1–27\, p<\;0.001). Median time to ASM was 19.5 vs 102 minutes. Median ED LOS was 2.71 vs 4.49 hours\, ICU LOS 3.97 vs 0 days\, and hospital LOS 7.39 vs 3.73 days\, respectively. Higher rates of intubation\, full loading doses\, and drug procurement via automated dispensing systems were seen in the <\;30-minute group. Logistic regression showed time to non-benzodiazepine ASM was not associated with ICU admission\, but higher APACHE II scores were independently associated (OR 1.272\, 95% CI: 1.179–1.398). \;\n\n\nEarly non-benzodiazepine ASM use was linked to higher ICU admissions\, but there was no association after controlling for disease severity. Disease severity\, demonstrated by higher APACHE II scores\, were independently associated with increased ICU admission rates\, particularly in patients receiving ASM <\;30 minutes. Further studies are needed to clarify the relationship between ASM timing and ICU admissions. CATEGORIES:EMERGENCY MEDICINE LOCATION:a.Pavilion Hub WEST\, Center City\, Philadelphia SEQUENCE:0 UID:4dfb8dfab4ed8fd7b4b5de8d2aa52c08 URL:http://pshp2026residencyconference.sched.com/event/4dfb8dfab4ed8fd7b4b5de8d2aa52c08 END:VEVENT BEGIN:VEVENT DTSTAMP:20260520T135913Z DTSTART:20260518T141000Z DTEND:20260518T143000Z SUMMARY:Improving Pharmacy Quality Through Structured Governance: Quality Needs Assessment at the Hospital of the University of Pennsylvania DESCRIPTION:Purpose: \;\nTo improve visibility\, coordination\, accountability\, and sustainability of pharmacy initiatives by developing a program to centralize oversight of pharmacy quality efforts across inpatient\, ambulatory\, and retail settings\n \;\nMethods: \;\nA quality needs assessment was conducted at the Hospital of the University of Pennsylvania\, a 1\,067-bed academic quaternary referral center with over 600 pharmacy staff. This assessment was carried out using an anonymous electronic survey distributed to pharmacists\, technicians\, and interns across all main practice areas\, including inpatient\, ambulatory\, and retail settings. The survey assessed baseline perceptions of departmental quality priorities\, preferred communication styles\, awareness of and current involvement in quality initiatives\, and perceived value of establishing a formal quality program. Quantitative Likert-scale responses and qualitative free-text answers were reviewed to identify major themes and opportunities for improvement for a structured governance model. Survey findings were used to refine and guide the program’s design and structure.\n \;\nResults: \;\nA total of 150 responses were collected. Over half of respondents could not name a current pharmacy quality initiative\, highlighting the limited awareness of ongoing work in the department. The most common barriers to participating in initiatives included lack of protected time or visibility of opportunities. Most respondents agreed or strongly agreed that time spent on quality work is a worthwhile investment. This suggests that while staff may feel disconnected from the process\, they still recognize the value of quality improvement work. Staff strongly supported formal committee creation: 74% agreed or strongly agreed that a designated quality committee could improve visibility\, coordination\, and outcomes of pharmacy quality work.\n \;\nConclusion: \;\nSurvey findings demonstrated strong departmental support and need for a centralized Pharmacy Quality Initiatives Program. Establishing a designated committee may reduce fragmented efforts\, strengthen accountability\, and create a sustainable framework for quality improvement. In the long term\, a committee may enhance patient safety and operational efficiency while also highlighting pharmacy’s value across the health system. \;\n \;\nNo IRB approval necessary. \; CATEGORIES:PHARMACOTHERAPY LOCATION:a.Pavilion Hub EAST\, Center City\, Philadelphia SEQUENCE:0 UID:620f2a10c192ec6d8ad0ee233b5f9705 URL:http://pshp2026residencyconference.sched.com/event/620f2a10c192ec6d8ad0ee233b5f9705 END:VEVENT BEGIN:VEVENT DTSTAMP:20260520T135913Z DTSTART:20260518T144000Z DTEND:20260518T150000Z SUMMARY:Dose by Design: Comparing the Clinical Utility of Low-Dose and Standard Buprenorphine Induction in a Community Hospital DESCRIPTION:Purpose: To assess the feasibility and benefits of low dose buprenorphine induction (LDBI) for opioid use disorder (OUD) management in patients using illicit fentanyl compared with standard buprenorphine induction.\nMethods: A single-center\, retrospective cohort study was conducted at St. Mary Medical Center between August 1\, 2024-December 1\, 2025. Included patients reported fentanyl use and were inducted on buprenorphine for OUD treatment during hospitalization. The primary outcome was successful completion of buprenorphine induction defined as receiving at least 8 mg/day of buprenorphine and Clinical Opiate Withdrawal Score maintained at less than or equal to 12 from protocol start to completion or reported\, subjective low levels of withdrawal. Secondary outcomes included length of stay (LOS)\, induction duration\, clinical pharmacy specialist (CPS) consult\, buprenorphine prescription on discharge and within 30 days\, and switch to alternative therapy. The safety outcomes were naloxone administration\, precipitated withdrawal occurrence\, and rapid response events. \;\nResults: \;Sixteen patients in the standard induction arm and 18 patients in the LDBI arm were enrolled.  \;More patients in the LDBI arm successfully completed induction compared with standard (9 [50%] vs. 3 [19%]\, p =0.08). CPS was consulted in 100% of successful low dose inductions. The odds of precipitated withdrawal were significantly higher among patients receiving standard induction compared to LDBI (OR 5.7\, 95% CI 1.31-25.05) and 19% of standard induction patients had a rapid response event attributed to precipitated withdrawal. The LDBI group had a longer LOS of 6.8 days compared with 2.6 days in the standard group\, but had less patient directed discharges and more buprenorphine prescriptions on discharge and within 30 days. \;\nConclusion: LDBI was found to be associated with a higher rate of successful inpatient buprenorphine inductions compared with standard induction. LDBI had significantly lower odds of precipitated withdrawal and patients were more likely to follow up based on a higher incidence of discharge scripts. LDBI provides a feasible and well-tolerated alternative to standard induction for inpatient illicit fentanyl withdrawal management. \;\nIRB Approval: Approved\n CATEGORIES:ACUTE CARE ADDICTION MEDICINE/PAIN MANAGEMENT LOCATION:Broad Hub WEST\, Center City\, Philadelphia SEQUENCE:0 UID:1968d9215e45b00b6d64379bb1208d43 URL:http://pshp2026residencyconference.sched.com/event/1968d9215e45b00b6d64379bb1208d43 END:VEVENT BEGIN:VEVENT DTSTAMP:20260520T135913Z DTSTART:20260518T144000Z DTEND:20260518T150000Z SUMMARY:Evaluating the Efficacy and Safety of Tapering Dexmedetomidine With and Without Clonidine in the Intensive Care Unit DESCRIPTION:Purpose: This study aims to retrospectively analyze and evaluate the efficacy and safety of dexmedetomidine being tapered with and without clonidine in critically ill patients. A cost analysis comparing tapering methods was also conducted. \;\n\n\nMethods: This study includes patients aged 18 years and older who were admitted to the ICU from July 1\, 2023\, to June 30\, 2025\, and received dexmedetomidine intravenously for two or more consecutive days. Exclusion criteria include clonidine use solely for blood pressure management or for opioid withdrawal\, and dexmedetomidine discontinuation within 48 hours of discharge. The primary endpoint includes the incidence of at least two signs of agitation or withdrawal from the start of infusion taper to 48 hours after dexmedetomidine discontinuation. Signs of withdrawal include a RASS score greater than +1\, use of fast-acting sedatives\, use of restraints\, heart rate greater than 100 bpm\, and systolic blood pressure greater than 140 mmHg or mean arterial pressure greater than 90 mmHg. Secondary endpoints include length of inpatient stay\, length of ICU stay\, duration of dexmedetomidine\, and incidence of hypotension or bradycardia. \;\n\n\nResults: There was not a statistically significant difference in occurrence of at least three withdrawal symptoms between patients tapering dexmedetomidine with clonidine compared to tapering without clonidine (86.0% vs 83.7%\; p=1.00). There was a greater incidence of RASS >\; +1 in the clonidine taper group (p=0.03). The clonidine taper group had a longer average inpatient length of stay (35 vs 24 days)\, average ICU length of stay (18 vs 16 days)\, and average duration of dexmedetomidine infusion (11 vs 7 days) compared to the group tapering without clonidine. The group tapering without clonidine had a higher incidence of hypotension and bradycardia. The overall cost was greater in the group tapering with clonidine ($18\,410.96 vs $8\,035.20). \;\n\n\nConclusion: Prescribing bias led to the use of clonidine in more severe patients or with alcohol withdrawal\, causing the group tapering with clonidine to have longer duration of stays and length of infusions. Overall\, tapering dexmedetomidine with clonidine did not reduce the incidence of withdrawal compared to tapering dexmedetomidine without clonidine and tapering with clonidine did not provide a cost benefit. \;\n CATEGORIES:CRITICAL CARE LOCATION:Broad Hub EAST\, Center City\, Philadelphia SEQUENCE:0 UID:c62b7330ed24a394da3ff2690d82ca54 URL:http://pshp2026residencyconference.sched.com/event/c62b7330ed24a394da3ff2690d82ca54 END:VEVENT BEGIN:VEVENT DTSTAMP:20260520T135913Z DTSTART:20260518T144000Z DTEND:20260518T150000Z SUMMARY:Oral Stepdown Therapy for Gram-Negative Bacteremia in Obesity: High-Bioavailability Agents (Fluoroquinolones\, Sulfamethoxazole-Trimethoprim) Versus Low-Bioavailability Agents (Beta-Lactams) DESCRIPTION:Purpose: The purpose of this study was to compare outcomes in obese patients with aerobic gram-negative rod (GNR) bacteremia treated with either high- or low-bioavailability antibiotics for oral stepdown therapy.\nMethods: This retrospective single‑center cohort study compared clinical outcomes in adult patients with a body mass index ≥ 30 kg/m2 who received oral stepdown with either a high‑bioavailability (sulfamethoxazole-trimethoprim\, fluoroquinolones) or low‑bioavailability (beta-lactams) agent for uncomplicated GNR bacteremia. All patient and clinical data were obtained from the electronic health record by automated reports and manual review\, then compiled in Excel. Patients were identified from Lehigh Valley Health Network Cedar Crest\, Muhlenberg\, Hecktown Oaks\, Hazleton\, Schuylkill\, Pocono\, and Carbon campuses. The primary outcome was 30-day bacteremia recurrence\, which was analyzed descriptively due to limited events. Secondary outcomes were 90-day bacteremia recurrence\, 30- and 90-day all-cause mortality\, length of stay\, and 30- and 90-day all-cause readmission\, which were analyzed using both descriptive and inferential statistics.\nResults: A total of 203 individuals were included\, with 127 in the high‑bioavailability group and 76 in the low‑bioavailability group. Urinary sources accounted for 75% of infections\, E. coli for 66% of pathogens\, and most patients received 3 days of IV therapy followed by 7 days of oral step‑down\, typically with a fluoroquinolone (55%). No bacteremia recurrences occurred at 30 days\, and only one recurrence was observed in the low‑bioavailability group at 90 days. All secondary outcomes were similar between groups\, apart from all‑cause 30‑day readmission\, which was higher in the high‑bioavailability step‑down group.\nConclusion: One 90‑day bacteremia recurrence occurred in a patient receiving oral cefpodoxime 100 mg twice daily\, a notably low dose. The findings of this study suggest that oral stepdown for uncomplicated GNR bacteremia in obesity may be more nuanced than distinguishing between the bioavailability of agents. Clinical factors and real‑world dosing practices may influence outcomes\, extending beyond what oral bioavailability alone can predict. CATEGORIES:INFECTIOUS DISEASES LOCATION:a.Pavilion Hub WEST\, Center City\, Philadelphia SEQUENCE:0 UID:6951ecef4521b9594a5b255ea40c552e URL:http://pshp2026residencyconference.sched.com/event/6951ecef4521b9594a5b255ea40c552e END:VEVENT BEGIN:VEVENT DTSTAMP:20260520T135913Z DTSTART:20260518T144000Z DTEND:20260518T150000Z SUMMARY:Dexmedetomidine Use on Recovery Time in General Laparoscopic/Robotic Procedures DESCRIPTION: \;To compare PACU recovery time\, opioid use\, and postoperative outcomes in adults undergoing general laparoscopic/robotic surgery managed with dexmedetomidine versus standard therapy without dexmedetomidine.\n\n\nThis is a retrospective cohort study conducted at Penn Medicine Princeton Medical Center. Medical records of adult patients (≥18 years) undergoing laparoscopic/robotic procedures in the surgery center between July 1\, 2024\, and June 30\, 2025. General laparoscopic/robotic surgeries were predominantly abdominal and gastrointestinal cases. Patients were stratified by dexmedetomidine use in the anesthesia care plan. Primary outcome was total PACU recovery time from admission to discharge. Secondary outcomes included postoperative nausea/vomiting occurrence\, opioid administration converted to morphine milligram equivalents (MME)\, and postoperative pain scores. Data collected included demographic\, comorbidities\, and anesthetic details including anesthesia minutes\, use of inhaled gases and sedatives. Statistical analyses applied were independent t-tests for independent variables and Chi-square tests for categorical outcomes. \;\n\n\nA total of 1\,475 patients were included (222 dexmedetomidine\; 1\,253 control). Median PACU length of stay was not statistically significant with dexmedetomidine (98.4 minutes [IQR 77.5-129.5] versus 92.1 minutes [IQR 81.9-117.8])\, along with the median anesthesia duration (158 minutes vs 174.3 minutes). Reduced sevoflurane exposure was statistically significant (68.1 minutes vs 109.8 minutes). Although not statistically significant\, the median opioid requirements were lower in the dexmedetomidine group compared to control (MME 7.5mg versus 11.8mg) but had more PACU opioid use (57.7% versus 50.8%)\, with moderate-to-severe pain being less frequent in the dexmedetomidine group with a median of 2 patients vs 7 patients.\n\n\nIn this retrospective study\, dexmedetomidine use in general laparoscopic/robotic procedures did not significantly improve PACU recovery time compared to standard anesthesia. However\, it reduced anesthesia exposure and sevoflurane use. Patients receiving dexmedetomidine reported lower rates of moderate-to-severe postoperative pain and required less total opioid use\, suggesting a reasonable addition to standard of care with comparable outcomes. CATEGORIES:PHARMACY OPERATIONS LOCATION:a.Pavilion Hub EAST\, Center City\, Philadelphia SEQUENCE:0 UID:d29ceb040b6ffb20b79781e3892d9dc1 URL:http://pshp2026residencyconference.sched.com/event/d29ceb040b6ffb20b79781e3892d9dc1 END:VEVENT BEGIN:VEVENT DTSTAMP:20260520T135913Z DTSTART:20260518T150000Z DTEND:20260518T152000Z SUMMARY:Impact of Adjunctive Medications on Hospital Length of Stay in Medetomidine-Adulterated Opioid Withdrawal DESCRIPTION:PURPOSE: Medetomidine-adulterated fentanyl is associated with complex withdrawal\, increasing the need for hospital resources. This research characterizes the use of adjunctive medications to de-escalate the level of care in this population.\n\n\nMETHODS: \;This retrospective chart review conducted from 1/1/25-9/15/25 included patients admitted for opioid withdrawal receiving intravenous opioids with another adjunctive agent (alpha-2 agonists\, benzodiazepines\, gabapentin\, or antiemetics). Patients were excluded for mechanical ventilation >\;48 hours\; concurrent alcohol or benzodiazepine withdrawal\; admission to surgical\, trauma\, or burn services\; or patient-directed discharge prior to ICU discharge. \;\nVariables were collected throughout ICU course\, 72 hours following ICU discharge\, and at time of hospital discharge. \;\nThe primary endpoint was the impact of clonidine initiated on day 1 (early initiation) versus after (late initiation) on hospital length of stay (LOS). The impact of high dose (>\;0.6 mg) clonidine on day 1 compared to low dose (≤0.6 mg) clonidine on hospital LOS was analyzed. The relationship between receipt of additional adjunctive agents and hospital LOS was also analyzed.\n\n\nRESULTS: One hundred patients were included: median age 42 years\, 61% male\, and median fentanyl use 10 bags/day. Ninety-three received clonidine\, 58 gabapentin\, 29 tizanidine\, 91 benzodiazepines\, and 98 dexmedetomidine. Median ICU LOS was 58 hours and hospital LOS 120 hours. \;\nEarly clonidine was not associated with shorter hospital LOS (p=0.091). In the early clonidine group\, patients remained in the ICU for an additional 2 days in the high dose versus 3 days in the low dose group (p=0.14). Dexmedetomidine duration did not differ with clonidine dose or timing. \;\nFor each adjunctive medication added to therapy\, there was a 19% decrease in hospital LOS (p=0.018). This relationship was not seen with ICU LOS. Additional analysis is ongoing.\n\n\nCONCLUSION: \;Though not statistically significant\, early clonidine reduced hospital LOS\, while early\, high dose clonidine appeared to reduce ICU LOS. Additional adjunctive medications on ICU day 1 significantly reduced hospital LOS. The findings suggest multimodal and early withdrawal management may decrease hospital and ICU LOS. Further research into clonidine dosing strategies is needed to demonstrate impact. CATEGORIES:ACUTE CARE ADDICTION MEDICINE/PAIN MANAGEMENT LOCATION:Broad Hub WEST\, Center City\, Philadelphia SEQUENCE:0 UID:adc6c39bdf5a48af524aa8abb3db5bd3 URL:http://pshp2026residencyconference.sched.com/event/adc6c39bdf5a48af524aa8abb3db5bd3 END:VEVENT BEGIN:VEVENT DTSTAMP:20260520T135913Z DTSTART:20260518T150000Z DTEND:20260518T152000Z SUMMARY:Balancing Blood Pressure in Subarachnoid Hemorrhage: The Role of Vasopressors During Nimodipine Administration DESCRIPTION:Purpose: \;The purpose of this study was to \;determine \;the \;differences in outcomes between patients who received \;nimodipine with and without vasopressors \;initially presenting with \;subarachnoid hemorrhage. \;\nMethods: \;This was a retrospective single center study which included patients between ages 18 and 65 years of age who experienced subarachnoid hemorrhage and received nimodipine for the prevention of vasospasm and delayed cerebral ischemia. Patients who received at least one vasopressor \;were \;assigned to the vasopressor group and compared to patients who received nimodipine alone. Patients were excluded from the \;study if they \;were transferred from a hospital not within the Penn State Health network within \;48 hours \;of hemorrhage\, left against medical advice within 7 days of admission or died during admission. The primary outcome \;was \;length of intensive care unit \;stay. Secondary outcomes included the duration of nimodipine therapy\, duration of vasopressor therapy\, and discharge disposition. \;\nResults/Conclusions: \;Between 2018 and 2025\, a total of \;153 \;patients \;were included in the study. A total of 34 patients were included in the group who received nimodipine and at least one vasopressor\, and 119 patients were included in the nimodipine alone group. The \;average \;duration of \;ICU \;length of stay \;was \;16.1 days \;in the vasopressor group versus 9.9 days in the group who received nimodipine alone. \;At the time of submission of this abstract\, secondary \;outcomes \;and data \;analysis \;of all \;endpoints \;are in progress. \; \;\n\n\n CATEGORIES:CRITICAL CARE LOCATION:Broad Hub EAST\, Center City\, Philadelphia SEQUENCE:0 UID:0463f32ad5c05867a6f57e15e32dfe56 URL:http://pshp2026residencyconference.sched.com/event/0463f32ad5c05867a6f57e15e32dfe56 END:VEVENT BEGIN:VEVENT DTSTAMP:20260520T135913Z DTSTART:20260518T150000Z DTEND:20260518T152000Z SUMMARY:Oral Third Generation Cephalosporins versus Standard of Care for the Treatment of Penicillin-non-susceptible\, Ceftriaxone-susceptible Alpha-hemolytic Streptococcal Infections DESCRIPTION:Identify whether oral third generation cephalosporins are as effective as standard of care\, ceftriaxone or vancomycin\, for the treatment of penicillin-non-susceptible\, ceftriaxone-susceptible alpha-hemolytic Streptococcal infections. This retrospective chart review evaluated patients >\; 18 years old admitted to St. Luke&rsquo\;s University Health Network for treatment of penicillin-non-susceptible\, ceftriaxone-susceptible alpha-hemolytic Streptococcal infections from January 2017 to December 2025.  Patients were included if they received parenteral-only therapy with ceftriaxone/vancomycin or oral transition therapy with cefpodoxime/cefdinir. Sterile cultures obtained from blood\, fluid\, and tissue were assessed. Patients were excluded if they had deep-seated and/or polymicrobial infections or were transitioned to comfort/hospice prior to treatment completion. The primary outcome was 90-day all-cause mortality. Secondary outcomes included recurrence of infection\, hospital length of stay\, and treatment-related adverse events. For analysis of continuous variables\, the Student&rsquo\;s T-test or Mann-Whitney U Test were utilized and the Chi-square or Fisher&rsquo\;s exact test were conducted for categorical data. A total of 409 patients were screened. Of those\, 43 were included in the IV group and 9 were included in the oral transition group. The gastrointestinal tract was the most common source of infection among both groups (42.3%) and most patients had secondary bacteremia (94.2%). No significant difference in all-cause mortality at 90-days was observed between the IV-only and oral transition therapy groups (9.3% vs. 11.1%\; p = 1.00). In patients that received oral-transition therapy\, the total duration of definitive therapy was significantly shorter (10 vs. 15 days\; p <\; 0.01). The median hospital length of stay was significantly shorter in the oral-transition group (5 vs. 8 days\, p <\; 0.05). No significant difference in adverse effects was observed between the groups. It remains unclear if there is a difference in all-cause mortality or recurrence of Streptococcal infections at 90 days between the IV-only and oral transition groups.  \;However\, results suggest oral transition therapy with cefpodoxime and cefdinir may significantly reduce median hospital length of stay and total duration of definitive therapy.\n CATEGORIES:INFECTIOUS DISEASES LOCATION:a.Pavilion Hub WEST\, Center City\, Philadelphia SEQUENCE:0 UID:36f40c0d66915700d38cdc896e6aaf62 URL:http://pshp2026residencyconference.sched.com/event/36f40c0d66915700d38cdc896e6aaf62 END:VEVENT BEGIN:VEVENT DTSTAMP:20260520T135913Z DTSTART:20260518T150000Z DTEND:20260518T152000Z SUMMARY:Assessing Pennsylvania Community Pharmacists’ Understanding of Standard-of-Care (SOC) Regulatory Models DESCRIPTION:Purpose\nThe primary objective of this study is to assess Pennsylvania Community pharmacist awareness of SOC regulatory models. The secondary objective is to determine pharmacist perception on SOC regulation change in Pennsylvania.\n\n\nMethods\nThis mixed-methods study will explore pharmacists’ awareness and perceptions of SOC using survey questions guided by the Consolidated Framework for Implementation Research (CFIR).\nThe survey will be conducted via Qualtrics. Eligible participants include pharmacists who are licensed and practicing in a community pharmacy in Pennsylvania. A flyer for the research project survey was distributed to pharmacies via email\, in-person\, and direct messaging.\nEach qualifying participant will have the option to enter a drawing. Participant responses to the survey will not be linked to their raffle entry. Twenty (20) participants will be randomly selected to each receive a $50 gift card. Survey results will be exported\, and descriptive statistics will be utilized to assess results of both the primary and secondary objectives.\n\n\nResults\nFindings presented represent ongoing preliminary data from 32 respondents as of 4/15/26. Respondents were across chain (36%)\, grocery/mass merchant (55%)\, and independent (9%) settings. Most reported limited familiarity with SOC (48% slightly familiar\, 33% not at all). Following educational material\, respondents viewed SOC favorably. 85% agreed it would improve patient satisfaction\, 85% supported updating the current regulatory model\, and 81% considered SOC an important initiative. Most expressed confidence in their ability to follow SOC guidelines (88%) and their willingness to advocate for it (72%). Top barriers included workflow constraints and staffing requirements (50% each)\, policymakers (47%)\, and training requirements (44%).\n\n\nConclusions\nPreliminary findings suggest strong pharmacist support for SOC regulatory models\, with most recognizing their importance and potential to improve patient care. Key barriers reflect systemic challenges requiring stakeholder collaboration. As data collection continues\, these trends may inform targeted strategies to advance pharmacist-led SOC advocacy and adoption.\n\n\nApproved by Temple University Institutional Review Board (IRB). CATEGORIES:PHARMACY OPERATIONS LOCATION:a.Pavilion Hub EAST\, Center City\, Philadelphia SEQUENCE:0 UID:c3a835fdaad8b49fd1b468e172041f78 URL:http://pshp2026residencyconference.sched.com/event/c3a835fdaad8b49fd1b468e172041f78 END:VEVENT BEGIN:VEVENT DTSTAMP:20260520T135913Z DTSTART:20260518T152000Z DTEND:20260518T154000Z SUMMARY:A Quasi Experimental Evaluation of Dexmedetomidine Following Creation of a Clinical Guideline for α2 withdrawal. DESCRIPTION:The purpose of this study is to evaluate the effects of implementation of a new dexmedetomidine clinical practice guideline (CPG) in intermediate and intensive care units to manage α2 withdrawal at Thomas Jefferson University Hospital.\nAn update was made to the local clinical practice guidelines for the use of dexmedetomidine for α2 withdrawal management including an increase in the maximum allowed infusion rate and changing the titration parameters from RASS to vital signs (heart rate and blood pressure). A SlicerDicer report generated by Epic electronic health record (EHR) identified patients who had a dexmedetomidine continuous infusion order and a consult with the Jefferson Addiction Multidisciplinary Service (JAMS) from 01/01/2026-02/01/2026 for the pre-intervention group and from 3/17/2026-4/17/2026 for the post-intervention group. The primary endpoint was the average length of stay (LOS). Secondary endpoints included\, disposition\, ICU admission rate\, ICU LOS\, intubation rate\, vital sign abnormalities\, adverse side event occurrence\, and dexmedetomidine infusion data. Descriptive statistics were used. The study was approved as exempt by the Jefferson IRB.\nThe baseline characteristics between the pre and post intervention groups were similar.  \;The primary endpoint of average length of stay was shorter in the post intervention group compared to the pre intervention group (5.2 vs 7.3 days). Results of the secondary endpoints were similar between both groups. The rate of ICU admission was greater in the post intervention group (45.4 vs 41.4%). The average maximum and minimum heart rates were marginally decreased in the post intervention group compared to the pre intervention group (128 vs 124\; 63 vs 60 bpm). The duration of dexmedetomidine therapy was shorter in the post intervention group (64 vs 65.9 hours). None of the differences seen in the secondary outcomes were clinically significant.\nThe updated clinical guideline for dexmedetomidine resulted in a shorter length of stay in the post intervention group versus the pre intervention group.  \;All other endpoints remained similar between the two groups. Limitations included a small sample size\, challenges in implementation\, nursing workflow constraints\, and an abbreviated data collection period. Further research is warranted to refine this approach to α2 withdrawal management. \; CATEGORIES:ACUTE CARE ADDICTION MEDICINE/PAIN MANAGEMENT LOCATION:Broad Hub WEST\, Center City\, Philadelphia SEQUENCE:0 UID:fc52bfdf897510d80d9839caf9909a28 URL:http://pshp2026residencyconference.sched.com/event/fc52bfdf897510d80d9839caf9909a28 END:VEVENT BEGIN:VEVENT DTSTAMP:20260520T135913Z DTSTART:20260518T152000Z DTEND:20260518T154000Z SUMMARY:Clinical Impact of Stress Dose Hydrocortisone Dosing Strategy During National Shortage DESCRIPTION:Purpose: To evaluate whether an alternative hydrocortisone (HC) dosing regimen used during a national shortage\, 100 mg IV every 8 hours (q8h)\, provides comparable clinical outcomes to the standard regimen\, 50 mg IV every 6 hours (q6h)\, in the management of septic shock in adult patients.  \;\n\n\nMethods: This single-center\, retrospective cohort study included adults treated for septic shock in intensive care units. Patients were included if they received HC 50 mg IV q6h (5/21/2022&ndash\;9/9/2022) or HC 100 mg IV q8h (5/21/2023&ndash\;9/9/2023)\, had suspected infection\, met &ge\;2 SIRS criteria\, required vasopressors for >\;4 hours\, and received &ge\;200 mg of the HC regimen of interest. Exclusion criteria included pregnancy or breastfeeding\, vasopressor \;initiation at an outside hospital\, or receipt of >\;200 mg daily hydrocortisone for indications other than septic shock. The primary outcome was time to shock reversal\, defined as discontinuation of vasopressors for &ge\;24 hours. Secondary outcomes included mortality (in-hospital\, 28-day\, 90-day)\, ICU length of stay\, duration of mechanical ventilation\, and hyperglycemia. Descriptive statistics were used to describe baseline characteristics. Outcomes were analyzed using the Mann&ndash\;Whitney U and chi-square tests. \;\n\n\nResults: Of 290 screened patients\, 121 were included (50 mg q6h\, n=35\; 100 mg q8h\, n=86). Baseline characteristics\, illness severity\, and vasopressor use were similar between groups. Shock reversal occurred in 51.4% of patients receiving 50 mg q6h and 54.7% receiving 100 mg q8h (p=0.747). Median time to shock reversal was 84.0 hours (IQR 46.3&ndash\;145.0) versus 72.5 hours (IQR 46.2&ndash\;136.8)\, respectively (p=0.769). There were no significant differences in mortality\, ICU length of stay\, duration of mechanical ventilation\, or hyperglycemia between groups. \;\n\n\nConclusion: This single-center\, retrospective cohort study showed that the alternative dosing strategy of HC 100 mg q8h demonstrated similar clinical outcomes compared to the standard regimen of HC 50 mg q6h in patients with septic shock. Future prospective\, randomized trials are needed to confirm findings. \;\n \;\n CATEGORIES:CRITICAL CARE LOCATION:Broad Hub EAST\, Center City\, Philadelphia SEQUENCE:0 UID:db4d3e1800f7adac20dc35421f35043b URL:http://pshp2026residencyconference.sched.com/event/db4d3e1800f7adac20dc35421f35043b END:VEVENT BEGIN:VEVENT DTSTAMP:20260520T135913Z DTSTART:20260518T152000Z DTEND:20260518T154000Z SUMMARY:Comparison of Polymerase Chain Reaction (PCR) vs. Culture-Based Methicillin-Resistant Staphylococcus aureus (MRSA) Nasal Screenings on Time to Vancomycin De-escalation during Pneumonia Treatment DESCRIPTION:Purpose: To compare the impact of polymerase chain reaction (PCR)-based and culture-based methicillin-resistant Staphylococcus aureus (MRSA) nasal swab testing on time to vancomycin de-escalation\, test turnaround time\, and cost-effectiveness.  \;\nMethods: A multi-center\, retrospective\, observational pre-/post-implementation cohort study was conducted within two community hospitals in a large academic health system. The study evaluated hospitalized adults receiving empiric intravenous vancomycin for suspected pneumonia during March 1st to August 1st\, 2024 (culture-based MRSA screening) and March 1st to August 1st\, 2025 (MRSA nasal PCR screening). The primary outcome was time from MRSA screening test collection to vancomycin discontinuation. Secondary outcomes included test turnaround time\, total vancomycin days of therapy\, proportion of patients de-escalated within 36 hours\, and rate of reinitiation of MRSA therapy during the admission. A cost analysis was also conducted.  \;\nResults: \;Implementation of MRSA PCR testing significantly reduced the time from screening collection to vancomycin discontinuation. Median time decreased from 34.9 hours (IQR 25.8&ndash\;51.0) pre-implementation to 18.8 hours (IQR 9.7&ndash\;36.2) post-implementation (p <\; 0.001). Turnaround time was also significantly shorter with PCR (4.9 vs 28.3 hours\, p <\; 0.001). While median total vancomycin days of therapy \;remained \;2.0 days in both groups\, the difference was still statistically significant (p = 0.004). De-escalation within \;36 hours \;was numerically \;higher \;post-implementation (68% vs 51%\, p = 0.132). \;\nConclusions: Implementation of MRSA nasal PCR screening was associated with significantly faster test turnaround time and earlier discontinuation of vancomycin compared with culture-based screening. These findings support the use of rapid molecular diagnostics as a valuable tool in antimicrobial stewardship in the aim of timely de-escalation of empiric anti-MRSA therapy in patients with suspected or confirmed pneumonia. \n CATEGORIES:INFECTIOUS DISEASES LOCATION:a.Pavilion Hub WEST\, Center City\, Philadelphia SEQUENCE:0 UID:414fa371de828999e2fc3effc0cd0e59 URL:http://pshp2026residencyconference.sched.com/event/414fa371de828999e2fc3effc0cd0e59 END:VEVENT BEGIN:VEVENT DTSTAMP:20260520T135913Z DTSTART:20260518T152000Z DTEND:20260518T154000Z SUMMARY:Outpatient Parenteral Antimicrobial Therapy in Patients with Limited Insurance Coverage: Cost Impact of Early Discharge with Long-Acting Dalbavancin DESCRIPTION:Purpose: Uninsured patients face long hospital stays for IV antibiotics. This study evaluated cost savings and length of stay for patients discharged after receiving dalbavancin via patient assistance programs compared to standard IV antibiotics.\n\n\nMethods: The patient population included those who received a dose of inpatient dalbavancin from a patient assistance program for treatment of a gram-positive infection. De-identified data in this retrospective evaluation were collected from the electronic medical record and included demographics\, microbiological results\, admission/discharge dates\, and inpatient antibiotic therapies. The analysis compared actual length of hospital stay prior to dalbavancin administration with projected inpatient duration with a full course of standard IV antibiotics. Estimates for prolonged inpatient stay were derived from treatment plans and antimicrobial practice guidelines. Hospital costs were calculated with cost-per-day estimations and drug costs for inpatient antibiotics. Investigators evaluated cost impact of dalbavancin compared to standard antibiotics and assessed potential implications for expanding access to patients with limited insurance coverage.\n\n\nResults: Twelve patients were included in the study population. Actual length of hospital stay prior to dalbavancin was compared to the projected inpatient duration had the patient received a full course of standard antibiotics. Length of stay (LOS) cost was determined using an approximation of $800 per day. The early discharges saved a cumulative 355 inpatient days\, with cost savings of $284\,000.00. The cost of inpatient antibiotic therapy was estimated using hospital acquisition costs. Dalbavancin was acquired at no cost through the patient assistance program. Total projected cost of standard therapy was $5\,229.00\, compared to actual cost of $3\,665.00 with early discharge. The total cost savings afforded to the hospital amounted to $349\,877.46.\n\n\nConclusion: Compared to standard inpatient IV antibiotics\, early discharge with dalbavancin resulted in reduced costs and shortened length of stay. Through patient assistance programs\, access to outpatient IV antibiotics can be expanded to include patients without insurance coverage or with high out-of-pocket costs. The significant cost savings and benefits of early discharge support the value of incorporating dalbavancin into clinical practice.\n\n\nIRB Approval: The IRB reviewed your project and determined that it is not human subjects research per the federal \;\nregulations found at 45 CFR 46.102(l). \; CATEGORIES:PHARMACY OPERATIONS LOCATION:a.Pavilion Hub EAST\, Center City\, Philadelphia SEQUENCE:0 UID:4c85132ea24768ad91fdec1cb3f83c08 URL:http://pshp2026residencyconference.sched.com/event/4c85132ea24768ad91fdec1cb3f83c08 END:VEVENT BEGIN:VEVENT DTSTAMP:20260520T135913Z DTSTART:20260518T154000Z DTEND:20260518T160000Z SUMMARY:Grab Provided Lunch (Take to Networking Session) DESCRIPTION:\n CATEGORIES:EVENT LOCATION:Franklin & Rittenhouse Square\, Center City\, Philadelphia SEQUENCE:0 UID:31ea746f4d7f4d82fb09eeacfe76ae1f URL:http://pshp2026residencyconference.sched.com/event/31ea746f4d7f4d82fb09eeacfe76ae1f END:VEVENT BEGIN:VEVENT DTSTAMP:20260520T135913Z DTSTART:20260518T154000Z DTEND:20260518T164000Z SUMMARY:Lunch Networking Administration/Med Safety/Quality Improvement DESCRIPTION:Open to all residents and preceptors. Choose the networking session most of interest. CATEGORIES:EVENT LOCATION:Midnight Boardroom\, Center City\, Philadelphia SEQUENCE:0 UID:bd8bd8b8e884ee8fa6f5dffa157f2e9a URL:http://pshp2026residencyconference.sched.com/event/bd8bd8b8e884ee8fa6f5dffa157f2e9a END:VEVENT BEGIN:VEVENT DTSTAMP:20260520T135913Z DTSTART:20260518T154000Z DTEND:20260518T164000Z SUMMARY:Lunch Networking Ambulatory Care/Pediatrics DESCRIPTION:Open to all residents and preceptors. Choose the networking session most of interest. CATEGORIES:EVENT LOCATION:Broad Hub WEST\, Center City\, Philadelphia SEQUENCE:0 UID:7d07f891159b3e2d18185e2c67e29806 URL:http://pshp2026residencyconference.sched.com/event/7d07f891159b3e2d18185e2c67e29806 END:VEVENT BEGIN:VEVENT DTSTAMP:20260520T135913Z DTSTART:20260518T154000Z DTEND:20260518T164000Z SUMMARY:Lunch Networking Critical Care/Emergency Medicine/Cardiology DESCRIPTION:Open to all residents and preceptors. Choose the networking session most of interest. CATEGORIES:EVENT LOCATION:Forum (13th Floor Downstairs)\, Center City\, Philadelphia SEQUENCE:0 UID:bd9fbde4e6f18a8ea506f16d03fbf899 URL:http://pshp2026residencyconference.sched.com/event/bd9fbde4e6f18a8ea506f16d03fbf899 END:VEVENT BEGIN:VEVENT DTSTAMP:20260520T135913Z DTSTART:20260518T154000Z DTEND:20260518T164000Z SUMMARY:Lunch Networking Infectious Diseases/Solid Organ Transplant DESCRIPTION:Open to all residents and preceptors. Choose the networking session most of interest. CATEGORIES:EVENT LOCATION:a.Pavilion Hub WEST\, Center City\, Philadelphia SEQUENCE:0 UID:931a287d8a882063dbecabf2ac9a24dc URL:http://pshp2026residencyconference.sched.com/event/931a287d8a882063dbecabf2ac9a24dc END:VEVENT BEGIN:VEVENT DTSTAMP:20260520T135913Z DTSTART:20260518T154000Z DTEND:20260518T164000Z SUMMARY:Lunch Networking Internal Medicine/Pharmacotherapy/Oncology DESCRIPTION:Open to all residents and preceptors. Choose the networking session most of interest. CATEGORIES:EVENT LOCATION:a.Pavilion Hub EAST\, Center City\, Philadelphia SEQUENCE:0 UID:d12e3a179ef44fb62198ad52b5eab593 URL:http://pshp2026residencyconference.sched.com/event/d12e3a179ef44fb62198ad52b5eab593 END:VEVENT BEGIN:VEVENT DTSTAMP:20260520T135913Z DTSTART:20260518T154000Z DTEND:20260518T164000Z SUMMARY:Lunch Networking Specialty/Community Pharmacy/Transitions of Care DESCRIPTION:Open to all residents and preceptors. Choose the networking session most of interest. CATEGORIES:EVENT LOCATION:Snow Boardroom \, Center City\, Philadelphia SEQUENCE:0 UID:110e8b3b405a1a1b0bbe82c631b1baaf URL:http://pshp2026residencyconference.sched.com/event/110e8b3b405a1a1b0bbe82c631b1baaf END:VEVENT BEGIN:VEVENT DTSTAMP:20260520T135913Z DTSTART:20260518T165000Z DTEND:20260518T171000Z SUMMARY:Effect Of Glucagon-Like Peptide Receptor Agonists on Thyroid-Stimulating Hormone Levels and Levothyroxine Doses: A Retrospective Chart Review DESCRIPTION:Purpose:\nTo determine whether initiating a glucagon-like peptide (GLP) receptor agonist (GLP)in adults with hypothyroidism on a stable levothyroxine regimen leads to a change in levothyroxine requirements.\n\n\nMethods:\nA retrospective study was conducted by chart review using electronic health records at Penn Medicine Lancaster General Health from July 2020 to June 2024. Patients were included if they were at least 18 years of age\, diagnosed with hypothyroidism\, on a stable dose of levothyroxine prior to initiation of a glucagon-like peptide receptor agonist continued for at least 6 consecutive months\, and at least 1 thyroid-stimulating hormone level within 6 months before and after a glucagon-like peptide receptor agonist. The primary endpoint is change in levothyroxine dose at 6 months after initiation of a glucagon-like peptide receptor agonist. Secondary endpoints include percentage weight loss at 6 months\, change in thyroid-stimulating hormone at 6 months\, change in levothyroxine dose at 12 months\, and percentage of weight loss compared to percentage change in levothyroxine at 6 months.\n\n\nResults:\nAmong 136 patients\, 18 (13.2%) had a levothyroxine dose change within 6 months of glucagon-like-peptide receptor agonist initiation. Firth logistic regression found no significant associations between dose change and glucagon-like-peptide receptor agonist type\, age\, sex\, smoking status\, or weight change (all p>\;0.05). Secondary analysis showed patients with levothyroxine dose changes had greater reductions in thyroid-stimulating hormone at 6 months versus those without changes (median -1.69 vs 0.00 mIU/L\; p=0.015). At 12 months\, weight change did not differ between groups requiring levothyroxine adjustment and those without adjustment (p=0.790).\n\n\nConclusion:\nGlucagon-like-peptide receptor agonist initiation was not associated with predictable changes in levothyroxine requirements based on baseline patient factors or weight loss. However\, greater reductions in thyroid-stimulating hormone were associated with levothyroxine dose adjustments\, suggesting thyroid function should be monitored after glucagon-like-peptide receptor agonist initiation. Larger studies are needed to confirm these findings.\n\n\nIRB APPROVAL:\nPENN IRB Protocol #: 859751\; approved 11/16/2025\n CATEGORIES:AMBULATORY CARE LOCATION:Broad Hub EAST\, Center City\, Philadelphia SEQUENCE:0 UID:2550279d1eed3c3aa660eb90f8bf2aab URL:http://pshp2026residencyconference.sched.com/event/2550279d1eed3c3aa660eb90f8bf2aab END:VEVENT BEGIN:VEVENT DTSTAMP:20260520T135913Z DTSTART:20260518T165000Z DTEND:20260518T171000Z SUMMARY:Nutritional Support Guidance for Critically Ill Patients Receiving Multiple High Dose Pressors DESCRIPTION:Purpose: \;\nTo evaluate enteral nutrition (EN) practices and tolerance in critically ill patients receiving &ge\;2 vasopressors and to inform evidence-based feeding recommendations for this \;high risk \;population. \;\nMethods: \;\nThis single center\, retrospective chart review included adult ICU patients receiving &ge\;2 vasopressors between \;September \;2024 and \;September \;2025. The primary outcome was incidence of clinically significant EN intolerance\, defined as abdominal pain\, distention\, nausea/vomiting\, diarrhea\, or interruption/discontinuation of feeds. Secondary outcomes included EN route\, \;initial \;and maximum EN rates\, and vasopressor requirements quantified as norepinephrine equivalents. \;\nResults: \;\n286 patients were screened\, while only \;29 patients were included\, with only 2 (6.9%) who had \;documented \;EN intolerance\, \;recorded as regurgitation and fecal intolerance. \;\nEN was \;most commonly delivered \;via \;nasogastric (NG) and orogastric (OG) \;tube \;(72.4%)\, followed by \;percutaneous \;endoscopic \;gastrostomy \;(PEG) \;(27.6%). \;Vital \;AF 1.2 Liter®\; \;was the most \;frequently \;used formula (58.6%)\, with other formulas used less commonly. \;Patients were managed across multiple ICUs\, reflecting consistent feeding practices. \;\nSeptic (38%) and cardiogenic (37%) shock were most prevalent. At EN initiation\, the mean norepinephrine equivalent dose was \;0.3 [0.34] \;mcg/kg/min\, with most patients receiving moderate to high vasopressor support. EN was \;initiated \;conservatively \;20 [35] cc/hour \;and advanced as tolerated to a mean maximum of \;45 \;[30] \;cc/hr. \;\nConclusion: \;\nDespite frequent mechanical ventilation and \;continuous renal replacement therapy (CRRT) \;use\, EN intolerance was uncommon \;evidenced by continued feeding until tolerating food by mouth or discharge. \;Institutional practice \;demonstrated \;a tendency to \;discontinue \;tube feeds when patients \;escalate \;to three vasopressors or high \;vasopressor doses. \;EN was typically \;initiated \;at trophic rates and advanced cautiously. \;\nThese findings suggest that EN may be tolerated in select critically ill patients receiving multiple vasopressors\, particularly at low infusion rates. However\, feeding practices remain conservative\, highlighting the need for further research to define safe and standardized thresholds for EN initiation and continuation in this population. \;\n CATEGORIES:CRITICAL CARE LOCATION:a.Pavilion Hub EAST\, Center City\, Philadelphia SEQUENCE:0 UID:0b78f21dd22a5df66f30950df4627acc URL:http://pshp2026residencyconference.sched.com/event/0b78f21dd22a5df66f30950df4627acc END:VEVENT BEGIN:VEVENT DTSTAMP:20260520T135913Z DTSTART:20260518T165000Z DTEND:20260518T171000Z SUMMARY:Characterization of Delayed Infusion-Related Reactions with Polatuzumab vedotin (PV) DESCRIPTION:Purpose: The incidence of delayed infusion reactions from PV is unknown. The label recommends post-infusion monitoring for delayed infusion reactions. This study investigates the incidence and characterization of delayed infusion reactions with PV. \;\n\n\nMethods: This is an IRB approved\, single-institution\, retrospective\, cohort study utilizing electronic health record data within the Penn Medicine health system. All adult patients who received a dose of PV between June 10th\, 2019\, and August 31st\, 2025 were included for analysis. Data collected included patient and disease demographics\, infusion administrations\, and infusion reaction event documentation. The primary endpoint was the incidence of delayed infusion reactions occurring within 72 hours after infusion completion. Secondary endpoints include symptom characterization of delayed infusion reactions\, time of onset of delayed infusion reactions\, incidence and symptom characterization of all infusion reactions\, and ambulatory infusion chair time. Analyses of primary and secondary endpoints were conducted using descriptive statistics. \;\n\n\nResults: Overall\, 352 patients with lymphoma were included\, and a total of 1310 infusions of PV were administered. The frequency of delayed infusion reactions was 0.5% (6/1310) of total infusions occurring in 1.4% (5/352) of total patients. Of these reactions\, 33% (2/6) and 66.7% (4/6) were CTCAE grade 1 and 2\, respectively. Median time to delayed reaction onset was 30 minutes (IQR 25-63). Frequency of delayed infusion reactions occurring on first infusion was 50% (3/6) and one reaction occurred each with 2nd\, 3rd\, and 4th doses. Median chair time for regimens consisting of first and subsequent PV administrations was 6 (IQR 4–8) and 5 (IQR 4– 6) hours respectively. \;\n\n\nConclusion: To our knowledge\, this is the first characterization of delayed infusion reactions to PV. We determined the incidence of delayed infusion reactions to be 0.5% out of 1310 infusions. Of those who experienced delayed reactions\, all were grade 2 or lower requiring minimal intervention\, and no resulting hospitalizations were reported secondary to events. Our results suggest that observation post-PV infusions may be potentially mitigated or omitted. \;\n\n\nAuthors: Michael P. Roney\, PharmD\; Oxana Megherea\, PharmD\, BCOP\; Niti Patel\, PharmD\, BCOP\; Mitchell E. Hughes\, PharmD\, BCOP CATEGORIES:ONCOLOGY LOCATION:a.Pavilion Hub WEST\, Center City\, Philadelphia SEQUENCE:0 UID:f33870e89103b62fc9f2d1aa43a545a1 URL:http://pshp2026residencyconference.sched.com/event/f33870e89103b62fc9f2d1aa43a545a1 END:VEVENT BEGIN:VEVENT DTSTAMP:20260520T135913Z DTSTART:20260518T165000Z DTEND:20260518T171000Z SUMMARY:Evaluating the Use and Safety of Amiodarone in Lung Transplant Recipients with New-Onset Post-Operative Atrial Arrhythmias: A Retrospective Cohort Study DESCRIPTION:Purpose: \;To evaluate the real-world patterns and outcomes of amiodarone therapy in lung transplant recipients who develop new-onset post-operative atrial arrhythmias (POAA) after surgery. \;\nMethods: \;This is a retrospective\, single-center chart review of 46 lung transplant recipients at Temple University Hospital from September 1\, \;2021 \;to August 31\, 2025\, who were discharged on amiodarone due to new-onset atrial arrhythmia. The cumulative amiodarone dose received and the total number of days of amiodarone use were calculated using information from the electronic medical record. Secondary endpoints included incidence of amiodarone induced pulmonary toxicity\; discontinuation of amiodarone due to pulmonary toxicity\, thyroid dysfunction\, or hepatotoxicity\; incidence of readmissions due to arrhythmias\; and risk factors associated with atrial arrhythmias after lung transplant. Data collection included baseline characteristics\, rate control therapy\, anticoagulation\, and information \;regarding \;electrophysiology (EP) follow-up. Descriptive statistics were \;utilized \;to analyze the data. \;\nResults: \;Amiodarone therapy was used for longer than six months in 10/46 patients. \;The average cumulative amiodarone dose was \;29\,228 mg\, 95% CI [26\,069\, 32\,387] and average duration of amiodarone was \;100 days\, 95% CI [86\, 115]. There were no reports of amiodarone-induced pulmonary toxicity. Amiodarone was \;discontinued \;for one patient that was found to have elevated liver enzymes attributed to amiodarone. Two patients had elevated TSH levels attributed to amiodarone\, but the medication was not \;discontinued. Twenty-five patients followed up with EP at an average of \;88 days \;after discharge. Risk factors for the patient population evaluated included 88% over the age of 60 years\, 78% male\, and 56% \;with a history of coronary artery disease (CAD). \;\nConclusion: \;Lung transplant recipients face increased risk of POAA. Amiodarone was \;generally well \;tolerated in this cohort\, with short treatment durations and no cases of pulmonary toxicity. Limited adverse effects occurred\, including one discontinuation for hepatotoxicity and two cases of thyroid dysfunction. Consideration should be given to defining \;optimal \;treatment duration\, adverse effect monitoring\, EP follow-up\, and assessment of risk factors. \; CATEGORIES:SOLID ORGAN TRANSPLANT LOCATION:Broad Hub WEST\, Center City\, Philadelphia SEQUENCE:0 UID:b3de580d3a3b79e4c7ea3a6fdc258851 URL:http://pshp2026residencyconference.sched.com/event/b3de580d3a3b79e4c7ea3a6fdc258851 END:VEVENT BEGIN:VEVENT DTSTAMP:20260520T135913Z DTSTART:20260518T171000Z DTEND:20260518T173000Z SUMMARY:Reducing Inappropriate Use of Sulfonylureas in Older Veterans DESCRIPTION:Purpose:\nSulfonylureas (SU) increase risks of hypoglycemia\, weight gain\, and uncertain long‑term glycemic control. This project evaluates how Clinical Pharmacy Practitioners (CPPs) improve diabetes care by deprescribing SUs and optimizing therapy.\n \;\nMethods:\nPatients were identified from a CMCVAMC report of those with an active SU prescription or via provider referral. CPPs then conducted comprehensive medication management visits to assess therapy and optimize diabetes care when appropriate. The primary outcome was the change in reported hypoglycemia before and after CPP interventions. Secondary outcomes included changes to preferred agents\, A1c\, and weight. Patients were included if they are ≥60 years old\, have an A1c ≤10.5%\, have an active VA or non‑VA prescription for glipizide\, glimepiride\, or glyburide\, and were identified as at risk for adverse outcomes from SU use. A follow‑up assessment of SU use occurred with the CPP or Primary Care Physician (PCP) at least once. Patients were excluded if they receive hospice care\, are under 60 years old\, or have an A1c >\;10.5%.\n \;\nResults:\nThe population was predominantly male and white\, with 41.9% having baseline CKD and 51.2% having ASCVD. Most participants were overweight or obese. All patients (100%) were initially receiving a SU\, alongside varying use of metformin\, SGLT2 inhibitors\, DPP‑4 inhibitors\, GLP‑1 agents\, and insulin therapies. Hypoglycemia was reported by 32.6% at baseline and after interventions the incidence declined to 7.4%. Following CPP review\, 51.8% had the SU discontinued\, 12.9% had dose reduction\, and 10.6% were instructed to take the medication before meals\, while 27.1% had no intervention. The final regimen demonstrated shifts toward metformin (63.4%)\, SGLT2 inhibitors (64.6%)\, and GLP‑1 agents (25.6%)\, with SU use decreasing to 41.5%.\n\n\nConclusion:\nInterventions targeting SU therapy led to regimen optimization and a reduction in hypoglycemia. Increased uptake of metformin\, SGLT2 inhibitors\, and GLP‑1 therapies reflects improved safety and closer adherence to guideline‑preferred treatments\, highlighting the value of proactive medication review performed by CPPs. CATEGORIES:AMBULATORY CARE LOCATION:Broad Hub EAST\, Center City\, Philadelphia SEQUENCE:0 UID:a8815ca3c88e72781abecc16d86e2666 URL:http://pshp2026residencyconference.sched.com/event/a8815ca3c88e72781abecc16d86e2666 END:VEVENT BEGIN:VEVENT DTSTAMP:20260520T135913Z DTSTART:20260518T171000Z DTEND:20260518T173000Z SUMMARY:Evaluation of a Critical Care Phenobarbital Protocol for Alcohol Withdrawal Management DESCRIPTION:To evaluate the safety and effectiveness of a standardized phenobarbital protocol for alcohol withdrawal syndrome in a mixed ICU at a community hospital compared to benzodiazepine based management. \;\n\n\nThis retrospective cohort study evaluated adults admitted to a mixed ICU at a community hospital with alcohol withdrawal (AWS) between May&ndash\;November 2024 and May&ndash\;November 2025. Adults with a diagnosis of AWS and critical care admission who received phenobarbital through a standardized weight-based protocol\, or benzodiazepines through the medical AWS order set were included. Exclusion criteria consisted of mechanical ventilation before medication initiation\, use of phenobarbital or benzodiazepines prior to admission based on the home medication list or dispense history\, or benzodiazepine-treated patients who received phenobarbital. The primary outcome was incidence of escalation to continuous sedation or intubation within 72 hours\, with secondary outcomes assessing safety\, medication use\, symptom control\, adjunctive sedative use\, and length of stay (LOS).\n\n\nOf 230 patients reviewed\, 170 met inclusion criteria (phenobarbital n=90\; benzodiazepine n=80). The primary outcome occurred in 18 phenobarbital patients and 24 benzodiazepine patients. Phenobarbital was associated with lower odds of escalation (20% vs 32.5%)\; however\, this was not statistically significant (OR 0.59\, 95% CI 0.29&ndash\;1.19\; p=0.14). Median ICU LOS (2.1 vs 2.9 days\; p=0.008)\, hospital LOS (4 vs 5 days\; p=0.032)\, and as needed benzodiazepine use (1 vs 38.5 milligrams\; p&le\;0.001) were significantly lower with phenobarbital. Adverse respiratory events were more frequent with phenobarbital (13.3% vs 0%\; p&le\;0.001)\, while seizures (1.1% vs 10%\; p=0.013) and delirium tremens (0% vs 83.8%\; p&le\;0.001) were more frequent with benzodiazepines.\n\n\nAlthough the primary outcome was not statistically significant\, the findings suggest potential clinical benefit. A standardized phenobarbital protocol was associated with reduced ICU and hospital LOS and decreased incidence of seizure and delirium tremens when compared to benzodiazepine based management. Further studies with larger populations are needed to confirm these findings.\n CATEGORIES:CRITICAL CARE LOCATION:a.Pavilion Hub EAST\, Center City\, Philadelphia SEQUENCE:0 UID:756490a21c3845d01f6729d0eb208309 URL:http://pshp2026residencyconference.sched.com/event/756490a21c3845d01f6729d0eb208309 END:VEVENT BEGIN:VEVENT DTSTAMP:20260520T135913Z DTSTART:20260518T171000Z DTEND:20260518T173000Z SUMMARY:Impact of a Clinic Based Solid Tumor Pharmacist\, A Pilot Project DESCRIPTION:Purpose \nThe care of oncology patients is complex\, requiring multidisciplinary support. Due to the complex nature of these patients\, a pilot project was implemented to assess the value of a clinic based pharmacist to support solid tumor patients.  \;\n\n\nMethods \nFor a \;three-week \;period\, a PGY-2 hematology/oncology pharmacy resident was embedded into the \;medical oncology \;clinic \;space. \;During this \;time \;the resident \;provided \;patient education\, worked with the oncology providers\, and developed quality improvement projects. \;Patient \;education \;was \;provided \;to all solid tumor \;patients prior to the start of their first cycle and follow up calls \;were made \;about \;1 week after chemotherapy. \;All interventions \;were tracked within \;the patient chart\, \;and categorized \;as patient education\, \;drug information\, medication error\, toxicity management\, medication \;reconciliation\, \;or \;chemotherapy \;adjustment. \;Interventions were then \;examined and based on previously published \;data\, \;cost value associations were assigned to each to \;determine \;a return on investment. \;In addition\, \;the resident met with physicians to discuss \;quality improvement projects that a pharmacist could \;assist \;with \;or champion.\n \;\nResults \nDuring the pilot period 160 pharmacist interventions were made. Of these 160 interventions\, 39 separate patient educations were completed\, 34 chemotherapy regimens were adjusted\, 17 chemotherapy toxicities were managed\, 29 medication reconciliations were completed\, and 35 drug information questions were answered\, 13 of which were related to antimicrobial stewardship. For the 160 interventions made over the course of the 3 weeks\, cost savings were estimated to be $76\,976. This results in an estimated annualized cost savins of $1\,334\,651. Two quality improvement projects were identified\, one focused on developing a standardized pathway for prescribing bone modifying agents and a second focused on patient education.  \;\n\n\nConclusion \;\nThe addition of a clinical pharmacist in solid tumor clinics offers both cost savings and improved quality of care. These savings can offset the added FTE while providing enhanced clinical support to providers\, improving patient satisfaction\, and driving ongoing advancements in patient care. \;\n CATEGORIES:ONCOLOGY LOCATION:a.Pavilion Hub WEST\, Center City\, Philadelphia SEQUENCE:0 UID:80affdd6623a14377afa00e1adeef64e URL:http://pshp2026residencyconference.sched.com/event/80affdd6623a14377afa00e1adeef64e END:VEVENT BEGIN:VEVENT DTSTAMP:20260520T135913Z DTSTART:20260518T171000Z DTEND:20260518T173000Z SUMMARY:Comparing the Drug-Drug Interactions Between Tacrolimus and Low-dose Fluconazole Versus Clotrimazole for Oropharyngeal Candidiasis Prophylaxis in Kidney Transplant Recipients DESCRIPTION:Purpose: Evaluate the impact of low-dose fluconazole (LDF) versus clotrimazole (CTZ) on tacrolimus (TAC) trough levels\, dose adjustments needed to maintain serum levels\, and prophylaxis (ppx) of oropharyngeal candidiasis (OC).\nMethods: This was a single-center\, IRB-exempt\, retrospective chart review at Jefferson Einstein Philadelphia Hospital including adult kidney transplant recipients (KTRs) transplanted between 4/1/23 - 4/30/25\, who received TAC and OC ppx. They were excluded if they had a multiorgan transplant\, history of gastric bypass\, concomitant CYP inhibitors/inducers\, or positive yeast donor cultures. KTRs received rabbit antithymocyte globulin\, mycophenolate\, and steroids per protocol. KTRs were stratified based on antifungal received. TAC trough levels were monitored throughout with a difference of >\;1.5 ng/mL determined to be clinically significant. The primary endpoint was the change in the TAC trough level 7 days after discontinuation of OC ppx. Secondary endpoints included the change in the TAC trough level 14 days after discontinuation\, incidence of OC at 30 and 60 days\, and the impact of sex\, race\, and early steroid withdrawal on TAC levels.\nResults: Of 139 KTRs\, 112 were included in the final analysis\, with 71 in the CTZ group and 41 in the LDF group. The mean difference in TAC level change between CTZ and LDF was 1.83 ng/mL 7 days after discontinuation of OC ppx [95% CI (0.4\, 3.3)\; p = 0.0123]. The mean TAC level change on day 7 in the CTZ group was -2.52 ng/mL [95% CI (-3.5\, -1.6)\; p<\;0.001] and -0.69 ng/mL in the LDF group [95% CI (-1.5\, -0.2)\; p = 0.166]. The mean dose of TAC increased from 6.6 mg to 9.4 mg in CTZ KTRs 14 days after discontinuation while LDF KTRs remained stable. There was a larger TAC level decrease seen in the steroid-free KTRs only in the CTZ group. There were no differences between sex and race. No patients developed OC.\nConclusion: Among KTRs that received OC ppx\, there was a larger reduction in tacrolimus trough levels following discontinuation of clotrimazole than with low-dose fluconazole. Both antifungals were effective in preventing OC. This data suggests that low-dose fluconazole is preferred to clotrimazole to minimize drug-drug interactions among KTRs started on tacrolimus for immunosuppression with no difference in OC ppx efficacy.\n CATEGORIES:SOLID ORGAN TRANSPLANT LOCATION:Broad Hub WEST\, Center City\, Philadelphia SEQUENCE:0 UID:cb57203860e700e4fd3a8b87ce91eecf URL:http://pshp2026residencyconference.sched.com/event/cb57203860e700e4fd3a8b87ce91eecf END:VEVENT BEGIN:VEVENT DTSTAMP:20260520T135913Z DTSTART:20260518T173000Z DTEND:20260518T175000Z SUMMARY:Bridging Education and Practice: Assessing Advanced Pharmacy Practice Experience Students’ Confidence in Medication Prescribing Upon Graduation DESCRIPTION:This study examines the confidence of advanced pharmacy practice experience students in prescribing medications after graduation and the teaching strategies influencing their confidence.\nA Qualtrics survey was sent to APPE students at 19 pharmacy schools to assess their confidence in prescribing medications as future pharmacists. The Likert-scale survey measured prescribing confidence\, teaching strategies\, work experience\, demographics\, and post-graduation plans. Data collection runs from 3/16/2026 to 5/16/2026. Descriptive statistics will evaluate prescribing confidence\, and ordinal regression will analyze the association between teaching strategies on prescribing confidence. This study received IRB approval from Saint Joseph&rsquo\;s University.\n\n\nData collection is ongoing. As of 04/10/2026 a total of 154 students responded with 67.97% feeling confident to prescribe upon graduation. Among those reporting prescribing confidence\, cardiovascular 14.40% and gastrointestinal 13.62% diseases had more than 10% of students reporting prescribing confidence. Teaching strategies respondents selected as extreme contributors to their confidence include experiential learning 67.80%\, case-based learning 29.66%\, independent study 20.34%\, role-play 19.49%\, didactic learning 15.25%\, team-based learning 11.02%\, and flipped classroom 10.17%. Additionally\, 59.32% reported needing more training before starting a prescribing role\, while 40.68% felt prepared without additional training.\n\n\nPreliminary analysis suggests that a majority of students feel confident prescribing medications upon graduation and attribute this confidence most often to experiential learning. Students who felt confident prescribing also felt more confident prescribing medications for cardiovascular and gastrointestinal diseases. More students feel more training is needed before starting a prescribing role.\n\n\nIRB Approval: Approved January 26\, 2026 by the Saint'\;s Joseph'\;s University IRB\n CATEGORIES:AMBULATORY CARE LOCATION:Broad Hub EAST\, Center City\, Philadelphia SEQUENCE:0 UID:4650b663d5357da7b66587a260984430 URL:http://pshp2026residencyconference.sched.com/event/4650b663d5357da7b66587a260984430 END:VEVENT BEGIN:VEVENT DTSTAMP:20260520T135913Z DTSTART:20260518T173000Z DTEND:20260518T175000Z SUMMARY:Ketamine for Sedation in Mechanically Ventilated Critically Ill Patients: A Retrospective Study DESCRIPTION:Purpose: To evaluate whether ketamine-based sedation is associated with a difference in duration of mechanical ventilation compared with standard sedation strategies in mechanically ventilated medical intensive care unit patients. \;\n\n\nMethods: A single center retrospective study of patients admitted to the medical intensive care unit at a community teaching hospital between January 2023 and July 2025 was conducted. Patients administered continuous sedation with or without ketamine for at least 6 hours while mechanically ventilated for at least 24 hours were identified. The primary outcome was duration of mechanical ventilation. Secondary outcomes included mortality\, intensive care unit and hospital length of stay\, CAM-ICU results\, and fentanyl requirements. Patients on adjunctive ketamine were compared to those on standard sedation regimens. Baseline characteristics were collected and compared between groups. Continuous variables were analyzed using medians with interquartile ranges and compared using Mann-Whitney U. Categorical variables were compared using chi-square or Fisher&rsquo\;s exact tests. The study was IRB approved.\n\n\nResults: Twenty-eight patients were included with 14 in each arm. Patients in the ketamine arm received adjunctive sedation with propofol\, dexmedetomidine\, or midazolam compared to patients sedated with at least two of the previously mentioned agents. Median duration of mechanical ventilation did not differ between the ketamine and standard sedation groups (10.6 days vs 8.4 days\, p=0.603). Mortality was lower in the ketamine group (7.1% vs 50%\, p=0.012). Hospital and intensive care unit length of stay were similar between groups. Patients receiving ketamine required higher median fentanyl doses (200 mcg/hr vs 100 mcg/hr\, p=0.007).\n\n\nConclusion: Ketamine-based sedation was not associated with reduced duration of mechanical ventilation compared with standard sedation strategies. However\, ketamine use was found to have a lower observed mortality. Larger prospective studies are needed to further evaluate the role of ketamine in intensive care unit sedation regimens.\n CATEGORIES:CRITICAL CARE LOCATION:a.Pavilion Hub EAST\, Center City\, Philadelphia SEQUENCE:0 UID:34d0f4edb56e03f34e08ed09a690b90a URL:http://pshp2026residencyconference.sched.com/event/34d0f4edb56e03f34e08ed09a690b90a END:VEVENT BEGIN:VEVENT DTSTAMP:20260520T135913Z DTSTART:20260518T173000Z DTEND:20260518T175000Z SUMMARY:Assessment Of The Efficacy Of IV Iron 1500 mg vs. 1000 mg On Hematologic Response DESCRIPTION:Purpose \;\nThe purpose of this \;retrospective review is to compare hematologic and iron-related responses between traditional \;1000 mg \;iron courses\, and high dose courses. The goal is to inform \;optimal \;dosing strategies and maximize clinical outcomes.\nMethods \;\nThis single center\, retrospective study evaluated patients who received IV iron between January \;1st \;2024 \;and December 31st \;2024 \;at Thomas Jefferson University. Patients were divided into two arms based on total IV iron dose: \;1000 mg \;or \;1500 mg. Exclusion criteria was applied removing comorbidities and incomplete records\, with final \;patients \;case-control matched on: ferritin\, baseline hemoglobin (hgb)\, age\, and gender. The primary outcome was mean change in \;hgb \;from baseline to between 4-52 weeks \;post infusion. Secondary outcomes included changes in relevant iron labs (ferritin\, transferrin saturation (TSAT)\, total iron binding capacity (TIBC)\, iron\, and hematocrit (Hct)) and regression analysis of variable associated with change in \;hgb \;greater than the 25th \;percentile (>\;P25). \; \;\n\n\nResults \;\nFrom 3\,508 patients\, 591 met \;eligibility \;after exclusions. A random sample of 300 patients (150 per arm) \;were \;chart reviewed\, with exclusions for missing data yielding 213. After matching 166 patients\, 83 in each arm\, were used for analysis.  \;IV iron formulation was the significant demographic\, with 76 vs 0 receiving ferric \;carboxymaltose \;in 1500 mg vs 1000 mg \;arms \;respectively. \;Mean Hgb increased by 3.4 \;vs 2.7 g/dL (p=0.002) in the 1500 mg vs \;1000 mg \;arms \;respectively. Greater improvements in Hct\, iron\, TSAT\, TIBC\, and ferritin (p<\;0.01)\, were CATEGORIES:ONCOLOGY LOCATION:a.Pavilion Hub WEST\, Center City\, Philadelphia SEQUENCE:0 UID:90e046ecfb644f0395cd8ae2a6901412 URL:http://pshp2026residencyconference.sched.com/event/90e046ecfb644f0395cd8ae2a6901412 END:VEVENT BEGIN:VEVENT DTSTAMP:20260520T135913Z DTSTART:20260518T173000Z DTEND:20260518T175000Z SUMMARY:Evaluation of Insulin Use Post-Thoracic Transplant DESCRIPTION:Purpose: This study aimed to determine the incidence of solid organ transplant recipients receiving insulin therapy following taper to maintenance corticosteroid dose\, which is around the 6-month mark at our institution\n\n\nMethods: This single-center retrospective study included adult heart or lung transplant recipients transplanted between September 1\, 2023\, and September 1\, 2024\, with at least 6 months of follow-up. Patients with a history of prior or multi-organ solid organ transplantation\, or those who did not survive 6 months post-transplant\, were excluded. The primary outcome was the proportion of patients remaining on insulin therapy at 6 months post-transplant. Secondary outcomes included use of non-insulin antihyperglycemic agents\, median corticosteroid dose at 6 months\, incidence of treated acute rejection episodes\, occurrence of hyperglycemia-related infections\, and HbA1c trends during the follow-up period. Descriptive statistics were used to analyze the baseline characteristics\, primary\, and secondary outcomes. Time-to-event analysis was performed to evaluate the association between patient subgroups and time to insulin discontinuation.\n\n\nResults: During the study period\, 102 patients were screened and 91 met inclusion criteria (36 heart\, 55 lung). Overall\, 21% had prior diabetes and 47% had endocrinology follow-up. At 2 weeks post-transplant\, 80% of patients required insulin with a median prednisone dose of 30 mg. By 6 months\, this declined to 41.8% with a median dose of 10 mg. Time-to-event analysis demonstrated that prior diabetes (log-rank p=0.009) and endocrinology follow-up (p<\;0.001) were associated with delayed insulin discontinuation. Steroid discontinuation\, rejection treatment\, and transplant type were not significantly associated with time to insulin discontinuation.\n\n\nConclusion: A substantial proportion of patients remained on insulin therapy at the time of steroid weaning\, although the incidence declined across successive follow-up periods over the first post-transplant year. This trend likely reflects the progressive reduction in corticosteroid dosing over time following transplantation.\n\n\nIRB Approval: IRB #859535\n CATEGORIES:SOLID ORGAN TRANSPLANT LOCATION:Broad Hub WEST\, Center City\, Philadelphia SEQUENCE:0 UID:3fa0f7327432355a54602f3275792448 URL:http://pshp2026residencyconference.sched.com/event/3fa0f7327432355a54602f3275792448 END:VEVENT BEGIN:VEVENT DTSTAMP:20260520T135913Z DTSTART:20260518T180000Z DTEND:20260518T182000Z SUMMARY:Impact of bromocriptine on suspected neurogenic fever DESCRIPTION:Purpose: Bromocriptine is hypothesized to have an antipyretic effect in patients with neurogenic fever\, however the evidence is limited to small retrospective studies. This study aimed to evaluate the impact of bromocriptine on neurogenic fever.\n\n\nMethods: \;This retrospective chart review included adult patients admitted to the neurological intensive care unit (ICU) who received at least one dose of bromocriptine for suspected neurogenic fever between 6/1/2020 and 6/1/2025. The primary outcome was the change in maximum body temperature (Tmax) from the 24-hour period prior to bromocriptine administration (day 0) to the 48-to-72-hour period after initial administration (day 3). Secondary outcomes included change in Tmax from day 0 compared to 0 to 24 hours after administration (day 1) and 24 to 48 hours after administration (day 2)\, duration of fever\, ICU length of stay (LOS)\, hospital LOS\, and mortality during and 30 days after bromocriptine administration. Outcomes were analyzed by Mann-Whitney U test.\n\n\nResults: A total of 75 patients were included in the analysis with a median age of 53 years. Administration of bromocriptine resulted in a significant decrease in temperature on day 3 (38.8 ºC vs 38.2 ºC\, p <\; 0.001). The median dose of bromocriptine administered was 15mg on day 1\, 30mg on day 2\, and 40mg on day 3. Patients with a traumatic injury (n=22) had a greater reduction in fever compared to those with a non-traumatic injury at 72 hours (-0.8 ºC vs -0.5 ºC\, p=0.002). The median duration of fever was 2 days. Hypotension occurred in 27 patients after administration\, and 20 patients experienced nausea.\n\n\nConclusion: In patients with suspected neurogenic fever\, bromocriptine may be an option for temperature reduction when added to other antipyretics. Patients with traumatic injury demonstrated a greater reduction in fever\, suggesting greater efficacy in this population. Further investigation into dosing strategies is needed\n\n\nIRB Approval: This study went through IRB approval and received exempt status. CATEGORIES:CRITICAL CARE LOCATION:a.Pavilion Hub WEST\, Center City\, Philadelphia SEQUENCE:0 UID:c63f4ea1f8cca88ddd1d07bec607623e URL:http://pshp2026residencyconference.sched.com/event/c63f4ea1f8cca88ddd1d07bec607623e END:VEVENT BEGIN:VEVENT DTSTAMP:20260520T135913Z DTSTART:20260518T180000Z DTEND:20260518T182000Z SUMMARY:Empiric Yet Suboptimal: Assessment of Inappropriate Empiric Antibiotics for Pneumonia and Urinary Tract Infections in the Emergency Department DESCRIPTION:Purpose: To evaluate the frequency and address any contributing factors associated with inappropriate empiric antibiotic prescribing in the Emergency Department (ED) based on national and institutional guidelines.\nMethods: A retrospective record review was conducted at St. Mary Medical Center of electronic patient health records from January 1\, 2025- June 30\, 2025. Adults aged 18-89 years presenting to the ED with suspected or confirmed pneumonia (PNA) or urinary tract infection (UTI)\, who received pre-identified broad-spectrum antibiotics were included. The primary outcome looked at frequency of inappropriate empiric broad-spectrum antibiotic prescribing in the ED. Secondary outcomes included post ED antimicrobial course\, hospital length of stay (LOS)\, and subgroup analyses of patients who met SIRS criteria and those with multidrug-resistant organism (MDRO) risk factors. Safety endpoints included adverse drug reactions and mortality. Initial treatment strategy was assessed based on the 2019 American Thoracic Society pneumonia guidelines\, and 2010 Infectious Diseases Society of America UTI guidelines with local resistance pattern guidance.  \;\nResults: Of the 166 patients included\, 98 (59%) received antibiotics for PNA and 68 (41%) for UTI. Overall\, 108 (65%) received inappropriate empiric antibiotics. In the inappropriate group\, 71 (66%) met SIRS criteria\, of which 1 (0.9%) had septic shock. Anti-MRSA antibiotics were discontinued in 57 (53%) patients\, and antipseudomonal therapy was narrowed in 54 (50%) patients. Vancomycin was administered to 89 (54%) patients\, despite only 16 patients meeting criteria for empiric MRSA coverage. Common MDRO risk factors were IV antibiotic use within 90 days and prior MDRO positive cultures within 1 year. The inappropriate group also had a longer mean LOS by 57 hours. Acute kidney injury occurred in 7 (6%) patients\, and 3 (3%) patients died. \;\nConclusion: Inappropriate empiric treatment was associated with providing unnecessary gram positive and gram-negative coverage\, indicating a pattern of reflexive broad-spectrum prescribing. Targeted education on current national and institutional practice guidelines may reduce unnecessary broad-spectrum antibiotic use and reduce antimicrobial resistance. \; CATEGORIES:EMERGENCY MEDICINE LOCATION:a.Pavilion Hub EAST\, Center City\, Philadelphia SEQUENCE:0 UID:1b27076d511b79ec479285b2c7a9be7c URL:http://pshp2026residencyconference.sched.com/event/1b27076d511b79ec479285b2c7a9be7c END:VEVENT BEGIN:VEVENT DTSTAMP:20260520T135913Z DTSTART:20260518T180000Z DTEND:20260518T182000Z SUMMARY:Real-World Safety and Tolerability of Contemporary Dual Beta-Lactam Regimens Initiated During Hospitalization DESCRIPTION:Dual beta-lactam (DBL) regimens are leveraged for a variety of infections. Concerns regarding additive toxicity are prevalent despite limited evidence. This study aimed to describe the safety and tolerability of contemporary DBL regimens.\n\n\nThis was a retrospective single-arm cohort study including adult inpatients who received at least 72 hours of pre-specified DBL regimens from September 2021 to August 2025. Patients were excluded if any portion of a DBL course was given at an outside hospital. The primary outcome was the incidence of adverse drug events (ADEs) associated with DBL discontinuation. DBL discontinuation was defined as cessation of one or both beta-lactams due to a documented ADE. Secondary outcomes included time-to-ADE metrics and incidence of pre-specified ADE types (renal\, neurologic\, hepatobiliary\, hematologic\, hypersensitivity\, or gastrointestinal). Causality was assessed using the WHO-UMC system with secondary adjudication by a co-investigator. Baseline characteristics and outcomes were analyzed using descriptive statistics. The Wilson Score method was used to calculate a 95% confidence interval (CI) for ADE incidence. \;\n\n\nA total of 175 patients were included. The most common DBL regimens were ceftriaxone plus ampicillin (52.0%) and cefepime plus ampicillin (21.7%). The most common DBL indications were E. faecalis synergy and empiric coverage of meningitis. A total of 124 patients (70.8%) had DBL therapy discontinued during admission. Only six discontinuations were associated with a documented ADE (3.4%\; 95% CI\, 1.6-7.3). Of these\, only three were assigned a causality of possible or higher (1.7%\; 95% CI\, 0.6-4.9). These were leukopenia (n=2) and gastrointestinal intolerance (n=1)\, which resolved with DBL discontinuation. The median time to any ADE associated with DBL discontinuation was 6.5 days (IQR\, 5.3-7.9). \;\n\n\nTreatment-limiting ADEs associated with contemporary DBL regimens were rare and reversible with discontinuation. These findings reinforce conclusions reported in prior literature. These results also suggest that clinicians&rsquo\; perceived risk of DBL-related ADEs is likely to far exceed the actual risks associated with these regimens. Our findings support the use of DBL when clinically appropriate and in alignment with antimicrobial stewardship. \;\n CATEGORIES:INFECTIOUS DISEASES LOCATION:Broad Hub EAST\, Center City\, Philadelphia SEQUENCE:0 UID:c42def7e13428ce23ce8131ff3bd6edb URL:http://pshp2026residencyconference.sched.com/event/c42def7e13428ce23ce8131ff3bd6edb END:VEVENT BEGIN:VEVENT DTSTAMP:20260520T135913Z DTSTART:20260518T180000Z DTEND:20260518T182000Z SUMMARY:Evaluation of time to first dose antibiotics in neonates with late-onset sepsis in a level-III intensive care nursery DESCRIPTION:Purpose\nTo evaluate the compliance rate of administering the first dose of antibiotic within 60 minutes to neonates diagnosed with late-onset sepsis following the implementation of interdisciplinary education and electronic order set modifications. \;\n \;\nMethods\nThis was a retrospective\, single center\, observational study utilizing a pre- and post-intervention cohort of patients 72 hours old to 180 days old. Study timeframes for the pre- and post-interventional cohort were June 1\, 2023 to December 31\, 2023 and June 1\, 2025 to December 31\, 2025. The primary outcome of time to administration is a composite of the time from ordering to verification\, verification to final preparation check\, and final preparation check to administration. Antibiotics were not assessed for time to administration if they were not the very first antibiotic given for a new infection or an agent used to broaden antibiotic coverage. Antibiotic orders that did not broaden coverage were excluded if an antibiotic was given within the last 72 hours and all orders for treatment of early-onset sepsis were excluded. Secondary outcomes reviewed all-cause 14-day and 30-day mortality and presence of high-risk comorbidities.  \;\n \;\nResults \;\nThe primary outcome of time to antibiotic administration from order placement was statistically significant for being shorter in the post-cohort with a median difference of 12.5 minutes (p <\; 0.001) and 47.7% of patients in the post-cohort had antimicrobials within 60 minutes as compared to 23.9% of patients in the pre-cohort (p = 0.007). Furthermore\, every component of the composite primary outcome was statistically significant for being shorter in the post-cohort (p <\; 0.001). The secondary outcomes of the number of patients with late-onset sepsis risk factors (p = 0.804)\, 14-day mortality (p = 0.244)\, and 30-day mortality (p = 0.818) were not statistically different between cohorts.  \;\n \;\nConclusion\nA greater percentage of patients received antibiotics within 60 minutes\, which suggests that the interventions made by Pennsylvania Hospital made a clinical difference. The secondary outcome data suggests that neonates in both the pre- and post-cohort had comparable risk factors for developing late-onset neonatal sepsis. There was no statistical difference in mortality between the cohorts. \;\n CATEGORIES:PEDIATRICS LOCATION:Broad Hub WEST\, Center City\, Philadelphia SEQUENCE:0 UID:b901c4859a00cde9516a447dfa939556 URL:http://pshp2026residencyconference.sched.com/event/b901c4859a00cde9516a447dfa939556 END:VEVENT BEGIN:VEVENT DTSTAMP:20260520T135913Z DTSTART:20260518T182000Z DTEND:20260518T184000Z SUMMARY:Lorazepam Usage with a Gabapentin Taper vs. No Taper for Inpatient Management of Alcohol Withdrawal DESCRIPTION:Purpose: The purpose of this research project is to determine lorazepam-equivalent usage with a gabapentin taper compared to no gabapentin taper in the inpatient management of alcohol withdrawal syndrome. \;\n\n\nMethods: This was a retrospective chart review that was approved by the Jefferson Health Institutional Review Board and conducted from January 1\, 2024 to December 31\, 2024. Patients were identified by initiation on the alcohol withdrawal scale (AWS) protocol. The study was divided into 2 groups: gabapentin and benzodiazepine or benzodiazepine-only. The primary endpoint was lorazepam-equivalent usage with a gabapentin taper compared to no gabapentin taper. Secondary outcomes included time from admission to AWS protocol initiation\, time from AWS protocol initiation to gabapentin start\, time to resolution of AWS symptoms\, and length of stay in days from admission to discharge. A subgroup analysis of the primary endpoint was conducted among patients who received the appropriate gabapentin taper according to the AWS protocol.  \;\n\n\nResults: A total of 400 patients were screened for study inclusion\, 70 patients met criteria for evaluation\, and 35 patients were included in each group. The median lorazepam-equivalent usage (mg) during the withdrawal period was statistically significantly higher in the gabapentin and benzodiazepine group than in the benzodiazepine-only group (20 vs 3.10\; p = 0.020). Among the 23 patients who received the appropriate gabapentin taper\, the median lorazepam-equivalent usage (mg) was statistically significantly higher in the gabapentin and benzodiazepine group than in the benzodiazepine-only group (18 vs 3.10\; p = 0.032). None of the secondary endpoints in the primary or subgroup analyses were statistically significant. \;\n\n\nConclusion: Benzodiazepine utilization in the management of alcohol withdrawal syndrome was not reduced by the addition of a gabapentin taper. Further research is needed to fully evaluate the benzodiazepine-sparing potential of gabapentin and to develop a standardized regimen for alcohol withdrawal management.\n CATEGORIES:CRITICAL CARE LOCATION:a.Pavilion Hub WEST\, Center City\, Philadelphia SEQUENCE:0 UID:65758ab0fc6135df889d02bcfefd49a5 URL:http://pshp2026residencyconference.sched.com/event/65758ab0fc6135df889d02bcfefd49a5 END:VEVENT BEGIN:VEVENT DTSTAMP:20260520T135913Z DTSTART:20260518T182000Z DTEND:20260518T184000Z SUMMARY:Review of Institutional Emergency Medicine Pharmacotherapy to Acute Agitation and Violent Patients DESCRIPTION:Purpose: Evaluate the impact of provider education on the initial selection of medications used to treat patients with escalating agitation in acute care settings to ensure staff and patient safety.\nMethods: A two-phase retrospective chart review study evaluated the impact of provider education on medication selection for agitated patients aged 18 and older who required an institutional agitation alert and received stat medications for agitation. Phase one retrospectively identified these patients during a six-month period prior to the intervention. In phase two\, providers received an educational presentation detailing the recommendations from an algorithm collaboratively created by clinical pharmacists and psychiatric providers for treatment of acutely agitated and violent patients. Post-education in phase two\, a second retrospective chart review was conducted. The primary endpoint was the percentage of administered medications that were adherent to the algorithm. Secondary endpoints included percentage of medications considered first-line and second-line agents\, and percentage of patient encounters that required a repeat agitation alert.\nResults: A total of 88 agitation alerts from phase one and 30 from phase two were included in this study. The percentage of medications administered that were adherent to the institution’s guideline was 85.2% (109/128) in phase one and 89.5% (34/38) in phase two. In phase one\, 63.3% (69/109) of these adherent medications were considered first line recommended agents\, and 61.8% (21/34) in phase two. Of the medications that were adherent to the algorithm\, 36.7% (40/109) were considered second line recommended agents in phase one\, and 38.2% (13/34) in phase two. The percentage of repeat agitation alerts that met inclusion criteria per patient encounter in phase one was 20.5% (18/88) and 3.3% (1/30) in phase two.\nConclusion: Provider education did not affect the percentage of medications administered adherent to the algorithm or on medications considered first or second line. The percentage of repeat agitation alerts decreased following provider education. The findings are limited by minimal direct pharmacist input on medication selection. Future studies may explore the impact that pharmacists can make by providing real-time interventions during agitation alerts. CATEGORIES:EMERGENCY MEDICINE LOCATION:a.Pavilion Hub EAST\, Center City\, Philadelphia SEQUENCE:0 UID:75fc3c8d6bf69ae84978c52875b5aeb1 URL:http://pshp2026residencyconference.sched.com/event/75fc3c8d6bf69ae84978c52875b5aeb1 END:VEVENT BEGIN:VEVENT DTSTAMP:20260520T135913Z DTSTART:20260518T182000Z DTEND:20260518T184000Z SUMMARY:Real-World Implementation of Long-Acting Injectable Antiretroviral Therapy for HIV Treatment and Pre-Exposure Prophylaxis: Adherence\, Retention\, And Outcomes DESCRIPTION:Purpose: \;To evaluate \;real-world implementation of long-acting injectable cabotegravir \;(CAB)-based \;regimens for HIV treatment and \;Pre-Exposure \;Prophylaxis (PrEP) \;assessing \;adherence\, \;retention\, and outcomes.\n\n\nMethods: \;This retrospective \;study \;evaluated patients initiating \;long-acting \;cabotegravir (CAB) \;based \;injectable therapy at Temple University Health System \;in Philadelphia\, PA \;between FDA approval and \;September 1st \;2025. Primary endpoints were \;adherence \;(defined by \;injections \;received \;within the FDA-approved ±\;7-day window) and retention in care. Secondary endpoints included \;continued \;viral suppression (HIV RNA <\;200 copies/mL) in the treatment group and all-cause discontinuation across both groups. \;Demographics\, comorbidities\, \;prior \;antiretroviral regimens\, and \;associated \;laboratory values \;were collected.\n\n\nResults: 200 patients received CAB/RPV for \;HIV \;treatment\, \;median injections were 11 (5&ndash\;16)\, and total injections given were 2121. \;24 patients on CAB \;PrEP\, median number of injections was 4.5 (3&ndash\;11). \;In \;the \;treatment \;group\, 45.5% of injections were within the ±\;7-day window\; 67% \;required \;reinitiation (>\;30-day gaps). Overall\, 72% remained on therapy. \;PrEP \;adherence was 79.2% within \;the window. At \;study \;end\, 82.1% (46/56) of treatment discontinuations remained suppressed and 5.4% (3/56) had detectable HIV RNA\; resistance occurred in \;10.7% \;(6/56) \;of cases. Treatment discontinuation was 28%\, driven by patient preference (28.6%) \;and CATEGORIES:INFECTIOUS DISEASES LOCATION:Broad Hub EAST\, Center City\, Philadelphia SEQUENCE:0 UID:ef89acf015b6e1465b7302eb8c251bdb URL:http://pshp2026residencyconference.sched.com/event/ef89acf015b6e1465b7302eb8c251bdb END:VEVENT BEGIN:VEVENT DTSTAMP:20260520T135913Z DTSTART:20260518T182000Z DTEND:20260518T184000Z SUMMARY:Evaluation of RSV Prevention Equity DESCRIPTION:Purpose: Respiratory Syncytial Virus (RSV) is a leading cause of infant morbidity and mortality. The purpose of this study was to identify barriers to timely and equitable uptake of RSV prevention and evaluate their clinical impact. \;\n\n\nMethods: This was an IRB-exempted\, single-center\, retrospective chart review of infants born at Penn State Health Golisano Children&rsquo\;s Hospital from September 1\, 2024 &ndash\; March 31\, 2025\, with a first newborn follow up-visit post-hospital discharge within our system. The primary outcome was the percentage of mother-infant pairs who received RSV prophylaxis of any kind. Secondary outcomes included timing of infant RSV prophylaxis (age at administration of nirsevimab)\, time from discharge to first outpatient follow-up\, and incidence of RSV infection and resulting hospitalization.\n\n\nResults: 1364 infants were screened\, and 946 met inclusion criteria. Of these\, 76.7% of infants received RSV prophylaxis\; 41.6% received nirsevimab\, 35.1% with maternal vaccination\, and 23.2% received no prophylaxis. Among prophylaxis recipients\, 56.6% were White\, 82.9% were not Hispanic\, Latino\, or Spanish origin\, and 88.6% noted English as the preferred maternal language. Overall\, 99.6% of infants who received RSV prophylaxis also received hepatitis B vaccine at a median age of 1 day of life\, compared to 77.7% without RSV prophylaxis. Median time to outpatient follow-up post-hospital discharge was 2 days\, with the median age of nirsevimab administration at 12 days (range 2-262). Commercial insurance was most common across groups.  \;\n\n\nConclusion: RSV prophylaxis uptake was lower than hepatitis B vaccine administration (76.7% vs 94.5%) in our study cohort. Hepatitis B vaccine is given inpatient at our health system\, while nirsevimab is deferred to the outpatient setting. Given high hepatitis B vaccine uptake\, lower nirsevimab use likely reflects access barriers rather than hesitancy. These findings highlight gaps in equitable access and the need to improve timely provision of RSV prevention.  \;\n\n\n CATEGORIES:PEDIATRICS LOCATION:Broad Hub WEST\, Center City\, Philadelphia SEQUENCE:0 UID:5da481fde31850d65c6e64f33eeee34d URL:http://pshp2026residencyconference.sched.com/event/5da481fde31850d65c6e64f33eeee34d END:VEVENT BEGIN:VEVENT DTSTAMP:20260520T135913Z DTSTART:20260518T184000Z DTEND:20260518T190000Z SUMMARY:Fixed Dose versus Titratable Vasopressin in Septic Shock: A Retrospective Chart Review DESCRIPTION:Evaluate the safety and efficacy of fixed dose versus titratable vasopressin infusions in critically ill patients with septic shock by comparing rebound hypotension when stopping fixed dose vs. weaning titratable vasopressin infusions. \;\n\n\nThis retrospective cohort study reviewed patients in a medical/surgical ICU at a community hospital from October 1\, 2023 to October 1\, 2024 and January 1\, 2025 to January 1\, 2026. Adults with septic shock who received vasopressin and norepinephrine were included. Exclusion criteria included use of other catecholamines at wean\, vasopressor withdrawal due to death or comfort care\, mechanical circulatory support\, or non-adherence to vasopressin orders. The primary endpoint was rebound hypotension defined as MAP &le\; 60 mmHg with an intervention to improve blood pressure within six hours of vasopressin discontinuation or dose reduction. Secondary endpoints included MAP changes after vasopressin discontinuation\, vasopressor duration\, time to vasopressor wean\, time on mechanical ventilation\, and ICU length of stay. Exploratory endpoints compared rebound hypotension when vasopressin or norepinephrine was discontinued first. \;\n\n\nA total of 78 patients were included in the analysis\, with 43 in the fixed‑dose (FD) group and 35 in the titratable (TD) group. The primary outcome was met by 20 (47%) patients in the FD group and 23 (61%) patients in the TD group. There was no significant difference in rebound hypotension between groups (OR\, 0.82\; 95% CI\, 0.45&ndash\;2.01\; p = 0.666). When comparing FD vs. TD vasopressin\, there was no difference in rebound hypotension based on the order of vasopressor discontinuation\, whether vasopressin (p = 0.524) or norepinephrine (p = 0.747) was stopped first. Patients in the TD group demonstrated significantly shorter time to vasopressor wean (p &le\; 0.001)\, duration of mechanical ventilation (p = 0.010)\, and ICU length of stay (p = 0.006). \;\n\n\nOverall\, there was no difference in the incidence of rebound hypotension in patients who underwent abrupt discontinuation of vasopressin and those who were down-titrated off the infusion. The order of vasopressor discontinuation did not affect the likelihood of rebound hypotension. These findings suggest that titratable vasopressin strategies may support more efficient critical care management with similar hemodynamic outcomes in septic shock. \;\n CATEGORIES:CRITICAL CARE LOCATION:a.Pavilion Hub WEST\, Center City\, Philadelphia SEQUENCE:0 UID:3b1b229f7b28f8e5efe02e29bd9b1d53 URL:http://pshp2026residencyconference.sched.com/event/3b1b229f7b28f8e5efe02e29bd9b1d53 END:VEVENT BEGIN:VEVENT DTSTAMP:20260520T135913Z DTSTART:20260518T184000Z DTEND:20260518T190000Z SUMMARY:Evaluation Of Ketamine-Propofol Versus Propofol Alone For Procedural Sedation In Orthopedic Reductions DESCRIPTION:Purpose: \;This study aims to evaluate the effectiveness \;and safety \;of \;ketamine-propofol compared with propofol alone for procedural sedation in adult patients undergoing orthopedic reductions.\nMethods: \;This \;single-center retrospective observational study \;included \;adults (≥18 years) undergoing \;orthopedic reductions with \;ketamine-propofol \;or propofol in the emergency department \;between \;September 2024 to September 2025. \;Patients were \;identified \;via electronic medical \;records. \;The primary endpoint was sedation efficacy\, defined as \;successful first-attempt reduction confirmed by imaging without \;additional \;sedation. \;Secondary endpoints included \;site-specific \;reduction \;success\, recovery time\, emergency department length of stay\, total weight-based sedative dose\, and incidence of respiratory\, cardiovascular\, and rescue interventions. Continuous variables were analyzed using t-test or Mann-Whitney U test\; categorical variables using chi-square or Fisher’s exact test (α=0.05).\nResults: A \;total \;of \;72 \;patients \;were included \;(ketamine-propofol n=14\; propofol n=58). \;Propofol was associated with a higher first-attempt reduction success rate compared with ketamine-propofol (89% vs 64%\, p=0.01). Site-specific reduction success was similar for \;shoulder (66.7% vs 88.0%\, p=0.35)\, hip (66.7% vs 100%\, p=0.33)\, or ankle reductions (100% vs 100%\, p>\;0.9). \;Emergency department length of stay \;did \;not \;differ \;between \;groups \;(562 vs \;429 minutes\, p=0.26). Ketamine–propofol \;required \;a higher total sedative dose (2.3 vs 1.5 \;mg/kg\, p=0.04). Procedural success rat CATEGORIES:EMERGENCY MEDICINE LOCATION:a.Pavilion Hub EAST\, Center City\, Philadelphia SEQUENCE:0 UID:801458d990b99921cb06429eed91863c URL:http://pshp2026residencyconference.sched.com/event/801458d990b99921cb06429eed91863c END:VEVENT BEGIN:VEVENT DTSTAMP:20260520T135913Z DTSTART:20260518T184000Z DTEND:20260518T190000Z SUMMARY:Evaluation of Antimicrobial Therapy and Clinical Outcomes for Patients with Streptococcus pneumoniae Bacteremia or Pneumonia with and without β-lactam Allergies DESCRIPTION:Purpose: \;To evaluate the likelihood of receiving guideline-concordant \;antimicrobial therapy among patients with \;S. pneumoniae \;bacteremia or pneumonia with and without a documented β-lactam allergy.\nMethods: \;This retrospective cohort study included adults admitted to \;3 \;academic medical \;centers \;in a single health system \;from January 2021 to May 2025 with \;S. pneumoniae \;bacteremia \;or pneumonia. Patients were \;identified \;via positive blood or respiratory cultures and included if ≥ \;18 years old and \;received \;systemic antimicrobials. Exclusions were polymicrobial infections or \;infectious complications including \;empyema\, endocarditis\, bone/joint\, or \;CNS. \;Patients were stratified by documented β-lactam allergy at admission (1:3 allergy to non-allergy). \;Data \;was \;collected using \;REDCap™. Patients were treated \;in accordance with \;institutional Antimicrobial Guidelines\, ensuring therapy aligned with established recommendations. The primary outcome was the receipt of guideline-directed therapy\, which was analyzed using the chi-square test. Secondary outcomes were summarized descriptively\, and statistical significance was defined as a p-value<\;0.05.\nResults: \;Of 64 patients\, 16 (25%) had a documented β-lactam \;allergy. Guideline-concordant \;therapy was received by \;12 \;(75.0%) with an allergy and \;26 \;(54.2%) \;without. \;Patients with documented β-lactam allergy were more likely to receive guideline-directed therapy\, but this difference was not statistically significant (χ² = \;1.38\, \;p = 0.24). \;Among cases of non-concordant therapy\, the most common reason in patients with β-lactam allergy was prolonged duration (54.5%)\, \;switching \;to an oral fluoroquinolone (36.4%) and inappropriate oral therapy (9.1%). In patients without \; CATEGORIES:INFECTIOUS DISEASES LOCATION:Broad Hub EAST\, Center City\, Philadelphia SEQUENCE:0 UID:2634b90f09054c61a5ee3e43cbfcbd82 URL:http://pshp2026residencyconference.sched.com/event/2634b90f09054c61a5ee3e43cbfcbd82 END:VEVENT BEGIN:VEVENT DTSTAMP:20260520T135913Z DTSTART:20260518T184000Z DTEND:20260518T190000Z SUMMARY:Retrospective Review of a Neonatal Hypoglycemia Management Protocol Prior to Implementation of Oral Dextrose Gel DESCRIPTION:This study aimed to assess the rate of neonatal intensive care unit (NICU) admissions prior to addition of oral dextrose gel (ODG) to an internal treatment protocol for neonatal hypoglycemia. This was a single center retrospective review assessing the protocol without ODG. Inclusion criteria were gestational age &ge\; 35 weeks\, birth weight >\; 2 kg\, and no other indication for NICU admission\, pertinent exclusion criteria included receiving ODG. The primary outcome assessed was rate of NICU admission for neonatal hypoglycemia treatment and was descriptively compared to previously reviewed data for an internal treatment protocol with ODG. Secondary outcomes were resolution of hypoglycemia &le\; 60 minutes\, length of stay (LOS) (hospital and NICU if applicable)\, and IV dextrose boluses administered. Additionally\, data on maternal and fetal risk factors for severe hypoglycemia were collected. Data were extracted from the institutional electronic medical record (EMR) and REDCap was used for data storage. Statistical analysis utilized descriptive statistics. In the group without ODG\, 285 charts were reviewed\, 274 were excluded and 11 were included. Primary exclusion reason was an institutional EMR change limiting access to data needed to review eligibility criteria (n=157). In the protocol without ODG\, 100% of patients were admitted to the NICU for hypoglycemia management with IV dextrose. In comparison\, review of the protocol with ODG had a NICU admission rate of 27% (n=166). Total LOS in the without ODG protocol was a median (IQR) of 7 (6-13) days and NICU LOS was a median (IQR) of 7 (5-13) days. Three (27%) of 11 received dextrose boluses\, none had resolution of hypoglycemia &le\; 60 minutes\, and all received IV dextrose infusions. Results of this review demonstrated NICU admissions were frequent with the prior protocol and numerically higher compared to review done of the protocol with ODG. When not using ODG\, feeds and dextrose boluses were unable to prevent IV dextrose infusions. Interpretation of results were limited by small sample size and access to data due to EMR change but will be useful for improving institutional management practices of neonatal hypoglycemia.\n CATEGORIES:PEDIATRICS LOCATION:Broad Hub WEST\, Center City\, Philadelphia SEQUENCE:0 UID:9b06244a4935b2671904fc9bd1c64159 URL:http://pshp2026residencyconference.sched.com/event/9b06244a4935b2671904fc9bd1c64159 END:VEVENT BEGIN:VEVENT DTSTAMP:20260520T135913Z DTSTART:20260518T190000Z DTEND:20260518T192000Z SUMMARY:Clinical Pearl: Making Enterprise-wide Medication-use Information More Widely Available DESCRIPTION:0.25 contact hour continuing education CATEGORIES:SESSION LOCATION:a.Pavilion Hub EAST\, Center City\, Philadelphia SEQUENCE:0 UID:7de46c023dca97bc63b43b59b6d500bc URL:http://pshp2026residencyconference.sched.com/event/7de46c023dca97bc63b43b59b6d500bc END:VEVENT BEGIN:VEVENT DTSTAMP:20260520T135913Z DTSTART:20260518T190000Z DTEND:20260518T192000Z SUMMARY:Preceptor Pearl: Successful Failure in Precepting DESCRIPTION:0.25 contact hour continuing education CATEGORIES:SESSION LOCATION:a.Pavilion Hub WEST\, Center City\, Philadelphia SEQUENCE:0 UID:323dc17380259aac9ba592bdc189ed37 URL:http://pshp2026residencyconference.sched.com/event/323dc17380259aac9ba592bdc189ed37 END:VEVENT BEGIN:VEVENT DTSTAMP:20260520T135913Z DTSTART:20260518T192000Z DTEND:20260518T194000Z SUMMARY:Clinical Pearl: Current Concepts in Heart Failure DESCRIPTION:0.25 contact hour continuing education CATEGORIES:SESSION LOCATION:a.Pavilion Hub EAST\, Center City\, Philadelphia SEQUENCE:0 UID:7eb5d1c0de85e0087520357d522cc4d9 URL:http://pshp2026residencyconference.sched.com/event/7eb5d1c0de85e0087520357d522cc4d9 END:VEVENT BEGIN:VEVENT DTSTAMP:20260520T135913Z DTSTART:20260518T192000Z DTEND:20260518T194000Z SUMMARY:Preceptor Pearl: Small Patients\, Big Learning. Precepting in Pediatric Pharmacy DESCRIPTION:0.25 contact hour continuing education CATEGORIES:SESSION LOCATION:a.Pavilion Hub WEST\, Center City\, Philadelphia SEQUENCE:0 UID:2786d833c1383df3cb3f6f62fdb7255b URL:http://pshp2026residencyconference.sched.com/event/2786d833c1383df3cb3f6f62fdb7255b END:VEVENT BEGIN:VEVENT DTSTAMP:20260520T135913Z DTSTART:20260518T194000Z DTEND:20260518T200000Z SUMMARY:Clinical Pearl: From Genotype to Guideline: Oncology Pharmacogenomics DESCRIPTION:0.25 contact hour continuing education CATEGORIES:SESSION LOCATION:a.Pavilion Hub EAST\, Center City\, Philadelphia SEQUENCE:0 UID:a7745c4d86a2cf260b2cd8f69e6cc890 URL:http://pshp2026residencyconference.sched.com/event/a7745c4d86a2cf260b2cd8f69e6cc890 END:VEVENT BEGIN:VEVENT DTSTAMP:20260520T135913Z DTSTART:20260518T194000Z DTEND:20260518T200000Z SUMMARY:Preceptor Pearl: Supporting Professional Identity Formation in Pharmacy Trainees DESCRIPTION:0.25 contact hour continuing education CATEGORIES:SESSION LOCATION:a.Pavilion Hub WEST\, Center City\, Philadelphia SEQUENCE:0 UID:aa9ebf821444a874c1e0c766fde8a94d URL:http://pshp2026residencyconference.sched.com/event/aa9ebf821444a874c1e0c766fde8a94d END:VEVENT BEGIN:VEVENT DTSTAMP:20260520T135913Z DTSTART:20260518T200000Z DTEND:20260518T210000Z SUMMARY:Resident Phamily Feud DESCRIPTION:Cheer on your program and win prizes! Open to all residents and preceptors. CATEGORIES:GENERAL SESSION LOCATION:Forum (13th Floor Downstairs)\, Center City\, Philadelphia SEQUENCE:0 UID:7e0d2814f56a763dd60c8cbf254edcec URL:http://pshp2026residencyconference.sched.com/event/7e0d2814f56a763dd60c8cbf254edcec END:VEVENT BEGIN:VEVENT DTSTAMP:20260520T135913Z DTSTART:20260518T210000Z DTEND:20260518T220000Z SUMMARY:Optional Offsite Event Now at Walnut Garden *VENUE CHANGE* 1708 Walnut St. DESCRIPTION:\n CATEGORIES:EVENT LOCATION:Walnut Garden\, 1708 Walnut Street\, Philadelphia\, PA\, USA SEQUENCE:0 UID:3ef95f598beca2fcfa04ad869d862a4f URL:http://pshp2026residencyconference.sched.com/event/3ef95f598beca2fcfa04ad869d862a4f END:VEVENT BEGIN:VEVENT DTSTAMP:20260520T135913Z DTSTART:20260519T120000Z DTEND:20260519T124500Z SUMMARY:Networking Breakfast DESCRIPTION: CATEGORIES:EVENT LOCATION:Franklin Square (13th Floor Downstairs)\, Center City\, Philadelphia SEQUENCE:0 UID:e786a6f92ad39376c42c733e43f030fb URL:http://pshp2026residencyconference.sched.com/event/e786a6f92ad39376c42c733e43f030fb END:VEVENT BEGIN:VEVENT DTSTAMP:20260520T135913Z DTSTART:20260519T125000Z DTEND:20260519T130000Z SUMMARY:Announcements & Updates DESCRIPTION:\n CATEGORIES:RESIDENT PLATFORMS LOCATION:a.Pavilion Hub EAST\, Center City\, Philadelphia SEQUENCE:0 UID:9e712805573b90645915048bed14f1b3 URL:http://pshp2026residencyconference.sched.com/event/9e712805573b90645915048bed14f1b3 END:VEVENT BEGIN:VEVENT DTSTAMP:20260520T135913Z DTSTART:20260519T125000Z DTEND:20260519T130000Z SUMMARY:Announcements & Updates DESCRIPTION:\n CATEGORIES:RESIDENT PLATFORMS LOCATION:Broad Hub EAST\, Center City\, Philadelphia SEQUENCE:0 UID:ec6721b15736bb5998a93d597d8f1a10 URL:http://pshp2026residencyconference.sched.com/event/ec6721b15736bb5998a93d597d8f1a10 END:VEVENT BEGIN:VEVENT DTSTAMP:20260520T135913Z DTSTART:20260519T125000Z DTEND:20260519T130000Z SUMMARY:Announcements & Updates DESCRIPTION:\n CATEGORIES:RESIDENT PLATFORMS LOCATION:a.Pavilion Hub WEST\, Center City\, Philadelphia SEQUENCE:0 UID:f8fe98f9a6a034c6926ed11db17d397b URL:http://pshp2026residencyconference.sched.com/event/f8fe98f9a6a034c6926ed11db17d397b END:VEVENT BEGIN:VEVENT DTSTAMP:20260520T135913Z DTSTART:20260519T125000Z DTEND:20260519T130000Z SUMMARY:Announcements & Updates DESCRIPTION:\n CATEGORIES:RESIDENT PLATFORMS LOCATION:Broad Hub WEST\, Center City\, Philadelphia SEQUENCE:0 UID:fdd914b8a33d70bc6981ec46379fc9aa URL:http://pshp2026residencyconference.sched.com/event/fdd914b8a33d70bc6981ec46379fc9aa END:VEVENT BEGIN:VEVENT DTSTAMP:20260520T135913Z DTSTART:20260519T130000Z DTEND:20260519T132000Z SUMMARY:Evaluation Of Universal Low-Intensity Pravastatin Therapy In De Novo Kidney Transplant Recipients DESCRIPTION:Purpose: The purpose of this retrospective study is to evaluate the appropriateness and effectiveness of low-intensity pravastatin 20 mg daily in statin-naï\;ve\, kidney transplant recipients\, according to the estimated baseline ASCVD risks.\nMethods: The study includes a chart review of 296 subjects who underwent kidney transplants between September 1\, 2023\, and September 1\, 2024\, with at least 12 months of post-transplant follow-up. Baseline demographics that are pertinent to estimate ASCVD risk are included. Transplant data was collected\, including transplant indication\, lipid profiles\, and incidence of delayed graft function. Goal statin intensity was extrapolated based on age\, history of diabetes mellitus\, chronic kidney disease\, tobacco use\, coronary calcium scores (when available)\, and calculated ASCVD scores. ASCVD risk scores were assessed using the American College of Cardiology online calculator. Pravastatin initiation and monthly continuation were recorded. If pravastatin discontinuation occurred within 12 months\, timing\, reason for discontinuation\, and intensity changes were further assessed. Information on immunosuppressive therapy was also collected.\nResults: A total of 296 patients were evaluated\, and 60 patients were included for analysis. The 10-year ASCVD risk was estimated for 24 (40%) patients. Low-intensity pravastatin was appropriate in 35 (58%) patients. The median changes in LDL\, HDL\, and total cholesterol levels from day 30 to 365 post-transplant were 7.5 mg/dL\, 1.5 mg/dL\, and 10 mg/dL\, respectively (all p-value>\;0.05). Approximately 51 (85%) patients continued pravastatin throughout one year post transplant. Four (6.7%) discontinued pravastatin due to reported intolerance or self-discontinuation\; no patients met clinical criteria for hepatoxicity and rhabdomyolysis. One (1.7%) experienced non-fatal myocardial infarction (MI)\; however\, no patients experienced ischemic stroke. \;\nConclusion: We estimated that more than a third of patients might be considered for a higher intensity statin based on baseline characteristics\, estimated risk assessment\, and ASCVD risk enhancers. Most patients remained on low-intensity pravastatin for up to one-year post-transplant. Changes in lipid profile from 30 days to 365 days were not significant. No major safety issues were observed\, except for non-fatal MI. \;\n CATEGORIES:AMBULATORY CARE LOCATION:Broad Hub EAST\, Center City\, Philadelphia SEQUENCE:0 UID:b4445c538134c2fbd455e9dfc2916332 URL:http://pshp2026residencyconference.sched.com/event/b4445c538134c2fbd455e9dfc2916332 END:VEVENT BEGIN:VEVENT DTSTAMP:20260520T135913Z DTSTART:20260519T130000Z DTEND:20260519T132000Z SUMMARY:Risk Factors for PTT Prolongation in Patients Receiving Continuous Heparin DESCRIPTION:Purpose\n \;Evaluate the characteristics of patients started on intravenous heparin for a thrombotic indication that experienced PTT prolongation at Jefferson Einstein Philadelphia Hospital.\n \;\nMethods\nThis study included patients at least 18 years old that received heparin for a thrombotic indication and had at least 48 hours of PTTs available in their chart. Prolonged PTT was defined by two or more PTT values greater than 112 seconds within 48 hours of heparin. If patients experienced a prolonged PTT\, they were evaluated to determine if a bleeding event had occurred within 48 hours of heparin. Patients were excluded if they were pregnant at data collection. The primary endpoint was a multivariable analysis of characteristics that predisposed patients to prolonged PTTs\, including hypertension\, abnormal renal and/or liver function\, previous stroke\, history of bleed\, baseline PTT 1.5 times the upper limit of normal\, age\, alcohol use disorder\, body mass index\, male sex\, bolus on initiation\, black race\, and thrombolytic or anticoagulant use within 48 hours of heparin initiation. The secondary endpoint was the incidence of bleeding with prolonged PTT.\n \;\nResults\nData was analyzed using GraphPad Prism 10.6.1. Out of 344 patients\, 58 (16.9%) did not experience PTT prolongation. Baseline characteristics between both groups were similar. PTT 1.5 times the upper limit of normal (5.8\, 95% CI [1.1-107]\, p=0.04) was the only variable associated with PTT prolongation. All other variables were considered statistically nonsignificant. Among the 286 patients \;(83.1%) that experienced PTT prolongation\, 65 patients (22.7%) experienced a bleeding event within 48 hours of heparin initiation.\n \;\nConclusion/Summary\nThis study with 344 patients found that a baseline PTT 1.5 times the upper limit of normal is associated with PTT prolongation. Limitations include single-center\, retrospective nature\, and small sample size. Future steps include conducting a study using a nomogram with conservative heparin dosing in this cohort of patients with PTT prolongation at baseline and more frequent monitoring to prevent adverse outcomes.\n CATEGORIES:CARDIOLOGY LOCATION:Broad Hub WEST\, Center City\, Philadelphia SEQUENCE:0 UID:a2254c7904209a168217789e33c37b76 URL:http://pshp2026residencyconference.sched.com/event/a2254c7904209a168217789e33c37b76 END:VEVENT BEGIN:VEVENT DTSTAMP:20260520T135913Z DTSTART:20260519T130000Z DTEND:20260519T132000Z SUMMARY:Comparing Fentanyl Infusion Dosing Before and After Implementation of a Non-Weight-Based Approach in the Critical Care Unit DESCRIPTION:Purpose: Evaluate the overall impact of transitioning from a weight-based to non-weight-based fentanyl infusion dosing strategy in critically ill\, mechanically ventilated patients in the critical care unit.\nMethods: \;Through a retrospective electronic medical record chart review\, adult patients who were admitted to the critical care unit\, were mechanically ventilated and receiving a fentanyl infusion were identified for inclusion. Exclusion criteria included patients not admitted to the critical care unit\, not mechanically ventilated\, did not receive a fentanyl infusion for more than 24 hours\, received concomitant neuromuscular blockers and patients who underwent targeted temperature management. The patient population was characterized using descriptive statistics. Students&rsquo\; T-test or Mann-Whitney U tests were used for continuous variables\, and Chi-squared was used to measure the association between categorical variables. Power calculation determined that 100 patients would be included to evaluate study outcomes.\nResults: \;One hundred patients were included in the final analysis. For daily fentanyl dose\, there was no statistically significant difference between pre- and post-implementation groups (p-value: 0.391). There was a statistically significant difference between groups for the maximum fentanyl infusion dose (p-value = 0.007). The subset of patients with BMI 30 or greater showed no difference between groups for daily fentanyl dose (p-value: 0.411). The difference between subset groups for maximum fentanyl infusion dose was statistically significant (p-value: 0.006). For length of stay in the critical care unit and total time spent on mechanical ventilation\, there was not a statistically significant difference between groups (p-value: 0.139).\nConclusion: \;Implementation of a non-weight-based fentanyl infusion dosing strategy did not significantly reduce mean daily fentanyl dose compared to weight-based dosing. However\, it significantly reduced maximum infusion doses\, including in patients with a BMI &ge\;30. No significant differences were observed in ICU length of stay or duration of mechanical ventilation. These findings suggest non-weight-based dosing may reduce peak opioid exposure without compromising clinical outcomes.\n CATEGORIES:CRITICAL CARE LOCATION:a.Pavilion Hub EAST\, Center City\, Philadelphia SEQUENCE:0 UID:4ea39407b7899c1751a8cf1d863646ed URL:http://pshp2026residencyconference.sched.com/event/4ea39407b7899c1751a8cf1d863646ed END:VEVENT BEGIN:VEVENT DTSTAMP:20260520T135913Z DTSTART:20260519T130000Z DTEND:20260519T132000Z SUMMARY:Evaluating Early Transition from Intravenous to Oral Antibiotics for Adult Patients with Community Acquired Pneumonia DESCRIPTION:Purpose:\nTo evaluate early transition (at day 3 or less) compared to late transition (after day 3) of intravenous (IV) to oral (PO) antibiotics on clinical outcomes. \;\n\n\nMethods:\nThis study utilized retrospective chart review of patients treated for CAP within Lankenau Medical Center (LMC). Adult patients were included if they met CAP criteria published in the IDSA guidelines and received at least 3 days of antibiotic therapy. Patients were excluded if they did not meet criteria for transition to oral therapy in IDSA CAP guidelines\, transferred from another inpatient facility\, had concomitant infection treatment\, or admitted to an intensive care unit on the day of antibiotic initiation. The primary outcome compared 30-day readmission rates between patients transitioned to PO before and after day 3 of antibiotics. Key secondary outcomes were compared between these groups and included 90-day all-cause mortality\, hospital length of stay\, total antibiotic days of treatment\, and Clostridium difficile \;infection at day 90. \;\n\n\nResults:\n676 patients were screened for meeting criteria\, of which 50 met inclusion criteria. Six of these patients met early transition criterion\, with 44 qualifying for late transition. Baseline characteristics across the two treatment groups were similar in Charlston Comorbidity Index and Pneumonia Severity Index scores. Thirty-day readmission occurred in 8 (18.2%) of the late transition group\, with no readmissions in the early transition group. One patient within the late transition group did have mortality at 90 days\, while no patients within the early transition group met this criterion. Both treatment groups had a median length of hospital stay of 5 days. \;\n\n\nConclusion:\nFor patients meeting IDSA criteria\, early transition to oral antibiotics in CAP patients was associated with decreased 30-day readmission rates as compared to late PO transition.\n CATEGORIES:INFECTIOUS DISEASES LOCATION:a.Pavilion Hub WEST\, Center City\, Philadelphia SEQUENCE:0 UID:06d123b288295f3f1aa2eff64d38f13a URL:http://pshp2026residencyconference.sched.com/event/06d123b288295f3f1aa2eff64d38f13a END:VEVENT BEGIN:VEVENT DTSTAMP:20260520T135913Z DTSTART:20260519T132000Z DTEND:20260519T134000Z SUMMARY:Assessing the Effect of Pharmacist Intervention on Inappropriate Beta-Blocker Prescribing for Essential Hypertension DESCRIPTION:Purpose\nTo evaluate the impact of a pharmacist-led intervention on inappropriate beta-blocker prescribing in adults with essential hypertension (HTN) without compelling indications\nMethods\nA prospective cohort study of adults with essential HTN who were prescribed a beta-blocker without a compelling indication was conducted across eight family medicine practices at our institution. A randomized convenience sample (N&asymp\;120) was identified from a prior medication use evaluation. After chart review\, recommendations were sent to the primary care practitioner (PCP) to deprescribe the beta-blocker or switch to a guideline-preferred agent. Patients were excluded for resistant HTN\, documented ASCVD\, heart failure\, recent myocardial infraction\, arrhythmias\, migraine\, hyperthyroidism\, intolerance to first-line agents\, or cardiology-managed HTN. The primary endpoint was the recommendation acceptance rate. Secondary outcomes were absolute change in inappropriate beta-blocker use\, time to implementation\, predictors of acceptance\, and documented adverse drug events. Descriptive statistics were used.\nResults\nA total of 25 patients met inclusion criteria. Eleven (44%) recommendations to deprescribe were accepted. Among accepted recommendations with follow-up (n = 6)\, 3 were implemented. Twelve (48%) recommendations were refused\, and 2 (8%) received no response. The most common reason for refusal was that the beta-blocker had been initiated by a specialist (n = 11). Reported adverse drug reactions potentially related to beta-blockers (N = 26) consisted of fatigue (n = 14)\, bradycardia (n = 4)\, and sleep disturbances (n = 8). Male sex was associated with lower odds of recommendation acceptance (OR\, 0.14\; 95% CI\, 0.02&ndash\;0.84\; P = 0.032).\nConclusion: to be presented at the conference\n CATEGORIES:AMBULATORY CARE LOCATION:Broad Hub EAST\, Center City\, Philadelphia SEQUENCE:0 UID:bd5fe8b67766ca8d6aeeb498221cf98b URL:http://pshp2026residencyconference.sched.com/event/bd5fe8b67766ca8d6aeeb498221cf98b END:VEVENT BEGIN:VEVENT DTSTAMP:20260520T135913Z DTSTART:20260519T132000Z DTEND:20260519T134000Z SUMMARY:Comparing The Safety and Effectiveness of Venous Thromboembolism Prophylaxis with Unfractionated Heparin Versus Enoxaparin in Patients with Cirrhosis and Chronic Liver Disease DESCRIPTION:Purpose: To compare the safety and efficacy of enoxaparin versus unfractionated heparin for venous thromboembolism prophylaxis in hospitalized patients with chronic liver disease by evaluating in-hospital bleeding and thromboembolic events.\nMethods: This retrospective\, single-center cohort study included adult patients (>\; 18 years) with a documented diagnosis of cirrhosis or chronic liver disease as identified by relevant ICD-10 codes from January 2020 to June 2025 that have received VTE prophylaxis with UFH or enoxaparin during hospitalization. The data collected includes baseline patient characteristics\, admission diagnosis\, prior to admission medications\, important baseline laboratory values\, MELD score\, Child-Pugh score\, VTE and bleed risk assessment tools\, and VTE prophylaxis administered. The primary endpoint is the incidence of in-hospital bleeding events. Secondary endpoints include incidences of in-hospital International Society on Thrombosis and Haemostasis (ISTH) major and minor bleeding\, in-hospital VTE events\, drug discontinuations due to thrombocytopenia or anemia\, and mortality. Data analysis was completed using descriptive statistics.\nResults: A total of 82 patients were included (enoxaparin n=46\; UFH n=36). Baseline demographics\, laboratory values\, and liver disease severity were similar\, with median age 60 years and most patients classified as Child-Pugh C. All patients were high VTE risk by PADUA and IMPROVE scores. New bleeding events occurred in 8.6% with enoxaparin and 5.6% with UFH. Major bleeding occurred only with UFH (5.6%)\, while minor bleeding occurred only with enoxaparin (8.6%). VTE events were rare and comparable (2.2% vs 2.7%). Therapy discontinuation for non-bleeding events was more frequent with enoxaparin (32.6% vs 22.2%). In-hospital mortality was numerically lower with enoxaparin (6.5% vs 13.8%).\nConclusion: In hospitalized patients with cirrhosis requiring VTE prophylaxis\, enoxaparin demonstrated similar efficacy to UFH in preventing thromboembolic events. Although bleeding occurred more often with enoxaparin\, events were minor and did not require discontinuation of therapy\, whereas fewer but more severe bleeding events were seen with UFH. These findings suggest that enoxaparin may be a safe alternative\, though larger prospective studies are needed.\n CATEGORIES:CARDIOLOGY LOCATION:Broad Hub WEST\, Center City\, Philadelphia SEQUENCE:0 UID:f9b3eee3c5250693adad75d4f61a39c0 URL:http://pshp2026residencyconference.sched.com/event/f9b3eee3c5250693adad75d4f61a39c0 END:VEVENT BEGIN:VEVENT DTSTAMP:20260520T135913Z DTSTART:20260519T132000Z DTEND:20260519T134000Z SUMMARY:Trends in Sedative and Paralytic Exposures in Critically Ill Pediatric Patients During Three Different Time Periods DESCRIPTION:Purpose: This study compared the trends of total daily dose (TDD) of sedation and paralytic medications in intubated pediatric patients prior to and after the implementation of the State Behavioral Scale (SBS) and Cornell Assessment of Pediatric Delirium (CAPD). \;\n\n\nMethods: This was an IRB-exempt single center retrospective chart review taking place during three different time periods in the pediatric intensive care unit (PICU) at Penn State Health Golisano Children&rsquo\;s Hospital (PSHGCH). Study periods were defined as follows: Stage 1\, (January 1\, 2017-December 31\, 2018) prior to the implementation of both SBS and CAPD\; Stage 2 (March 5\, 2024-January 31\, 2025)\, following SBS but prior to CAPD implementation\; and Stage 3 (February 1\, 2025-August 31\, 2025)\, after implementation of both SBS and CAPD. In each cohort\, TDD was calculated for all sedative\, paralytic\, and delirium agents. Daily sedation burden was calculated using the Pediatric Normalized sedation Index (PNSI)\, which provides an objective measure of sedation burden for the patient. The primary outcome of this study is to compare sedative and paralytic use before and after the implementation of SBS and CAPD. Data analysis was done using the Kruskal-Wallis test. \;\n\n\nResults: 526 patients were screened with the inclusion of 134 patients in the final analysis. Baseline characteristics were well balanced across groups\, with no meaningful differences observed except length of intubation (p = 0.0496).  \;PNSI differed overall across all time points combined and changed differently overtime with an apparent increase in sedation use during Stage 2 and subsequent decrease in sedation use during Stage 3 (Group p <\;0.001\; Interaction p <\;0.0010). PNSI on each individual day was not statistically significant except for day 1 (p <\; 0.001). Vecuronium use differed across all time points combined but did not distinctly change over time (Group p <\; 0.001\; Interaction p = 0.1008). \;\n\n\nConclusion: Sedation use increased during Stage 2 following implementation of SBS scoring and subsequently decreased during Stage 3 with the implementation of CAPD scoring. Trends in paralytic use remained inconclusive and limited clinical interpretation. Larger future studies are needed to better evaluate these patterns and determine the clinically meaningful impact of SBS and CAPD on both sedation and paralytic use. \;\n CATEGORIES:CRITICAL CARE LOCATION:a.Pavilion Hub EAST\, Center City\, Philadelphia SEQUENCE:0 UID:61bc68e5312e205940476bbe62ff415c URL:http://pshp2026residencyconference.sched.com/event/61bc68e5312e205940476bbe62ff415c END:VEVENT BEGIN:VEVENT DTSTAMP:20260520T135913Z DTSTART:20260519T132000Z DTEND:20260519T134000Z SUMMARY:Impact of Preoperative Antibiotic Timing on Odds of Surgical Site Infection DESCRIPTION:Purpose: Ideal timing of preoperative antibiotic administration in relation to incision time remains unclear. This study aims to evaluate optimal timing of preoperative antibiotic administration to mitigate the risk of surgical site infection (SSI). \n\n\nMethods: This study was a retrospective\, case-control trial evaluating 993 adult patients admitted to St. Luke&rsquo\;s University Health Network for a surgical procedure between January 2022 and December 2024. Patients were included at a 1:4 case-to-control\, with cases defined as patients who developed a SSI\, and controls defined as patients without subsequent SSI. Patients were excluded if they did not receive preoperative antibiotics\, received preoperative antibiotics >\; 120 minutes prior to incision\, underwent more than one procedure during index hospitalization\, or had a preexisting infection at time and anatomical site of index procedure. The primary outcome was SSI rate by preoperative antibiotic administration time. Secondary outcomes included admission for SSI\, hospital length of stay\, readmission for SSI\, and mortality at 30 and 90 days post-operation. SSIs were categorized based on National Healthcare Safety Network (NHSN) definitions.\n\n\nResults: Cefazolin was the most frequent preoperative antibiotic administered (863 of 993 cases). Preoperative administration time was evaluated at 15-minute intervals\, with time 0 being start of procedure. The SSI rate when cefazolin was administered before or at 45 minutes prior to procedure was significantly lower than the SSI rate when cefazolin was administered beyond 45 minutes (18.5% vs 44.4%\, P = 0.005). The majority of patients presenting with a SSI were admitted for inpatient management (67.6%). In the subgroup analysis\, cefazolin was associated with a significantly lower rate of SSIs compared to clindamycin (P = 0.013).\n\n\nConclusion: Cefazolin should be administered within 45 minutes of procedure initiation to best mitigate the risk of SSIs. Cefazolin was associated with a lower rate of SSIs compared to clindamycin\, supporting its use as the preoperative antibiotic of choice.\n\n\nIRB approval: yes \;\n CATEGORIES:INFECTIOUS DISEASES LOCATION:a.Pavilion Hub WEST\, Center City\, Philadelphia SEQUENCE:0 UID:574660951b59ff34eb5062bc72cc0f21 URL:http://pshp2026residencyconference.sched.com/event/574660951b59ff34eb5062bc72cc0f21 END:VEVENT BEGIN:VEVENT DTSTAMP:20260520T135913Z DTSTART:20260519T134000Z DTEND:20260519T140000Z SUMMARY:Characterization of Semaglutide and Tirzepatide Prescribing and Tolerability After Therapy Lapse DESCRIPTION:Purpose: \;\nThis retrospective cohort study characterized approaches for resuming semaglutide or tirzepatide after at least two consecutive missed doses and evaluated tolerability in outpatient clinics at Penn Presbyterian Medical Center (PPMC).\n\n\nMethods: \;\nThis study included adults who missed at least two consecutive doses of semaglutide or tirzepatide between October 2024 and November 2025 and reinitiated therapy at a non-starting dose. Exclusion criteria included patients who resumed at the lowest dose\, those switching medications (except brand substitutions)\, or without follow-up data. Chart review captured demographics\, indication\, therapy duration before lapse\, prior and resumed doses\, and number of missed doses. The primary outcome was the tolerability associated with the dose step changes related to missed doses. Tolerability was defined as no patient-reported adverse drug reactions (ADRs)\, a dose increase or continuation. Intolerance was defined as any patient-reported ADR\, a dose reduction\, or discontinuation. Secondary outcomes included reasons for lapse and months saved by avoiding restart at the initial dose. Descriptive statistics were used.\n\n\nResults:\nAmong 65 patients\, the mean age was 46 years and 76.9% were female. Most were prescribed tirzepatide (46.2%) or semaglutide (38.5%) for weight loss. The median number of missed doses was 3 (IQR\, 2 to 4)\, with a median dose step change of -1 (IQR\, -2 to 0). A dose reduction occurred in 37 patients (57%)\, 24 patients (36.9%) had no change\, and 4 patients (6.2%) had a dose increase. Overall\, 95.4% of patients tolerated reinitiation. Access-related issues accounted for 87.7% of lapses. The median months saved by avoiding restart at the initial dose was 2 (IQR\, 1 to 3). Additionally\, tolerability remained high across missed-dose subgroups.\n\n\nConclusion: \;\nResuming semaglutide or tirzepatide at a non-starting dose after at least two missed doses was well-tolerated in most patients. Dose reductions were common with high rates of tolerability. This approach prevented titration delays typically caused by missed doses. Further studies should prospectively evaluate optimal reinitiation strategies\, including the impact on long-term weight loss and glycemic control.\n CATEGORIES:AMBULATORY CARE LOCATION:Broad Hub EAST\, Center City\, Philadelphia SEQUENCE:0 UID:d89ec3d597b21eb58b74fc0a40e28619 URL:http://pshp2026residencyconference.sched.com/event/d89ec3d597b21eb58b74fc0a40e28619 END:VEVENT BEGIN:VEVENT DTSTAMP:20260520T135913Z DTSTART:20260519T134000Z DTEND:20260519T140000Z SUMMARY:Assessing Inpatient Pharmacist Role In Optimizing Sodium-Glucose Cotransporter-2 (SGLT2) Inhibitor Use In Patients With Heart Failure Prior To Discharge DESCRIPTION:Purpose: \;Evaluate the impact of inpatient pharmacist interventions on SGLT2 inhibitor initiation in hospitalized heart failure patients and compare pre- and post-intervention rates\, pharmacist involvement\, barriers\, and 30-day readmissions. \;\n \;\nMethods: \;This retrospective\, pre- and post-quality improvement study included adult patients hospitalized with heart failure over two six-week periods. Data collected included demographics\, heart failure classification\, laboratory values\, guideline-directed medical therapy (GDMT)\, pharmacist interventions\, and 30-day readmissions. The intervention consisted of increased inpatient pharmacist involvement through chart review\, documentation\, medication recommendations\, discharge counseling\, and assistance with medication access. Statistical analyses included chi-square tests for categorical variables and t-tests for continuous variables.\n \;\nResults: \;A total of 164 pre- and 170 post-intervention patients were included. Baseline demographics and clinical characteristics were similar between groups. Pharmacist interventions significantly increased from 7.3% pre-intervention to 21.3% post-intervention (p<\;0.001).\n \;\nSGLT2 inhibitor use at discharge remained similar between groups (28.0% vs 27.2%\, p=0.866)\, and initiation rates during hospitalization did not significantly change (12.2% vs 12.4%\, p=0.949). Other GDMT utilization also showed no statistically significant differences.\nHowever\, 30-day readmission rates increased from 34.8% pre-intervention to 48.5% post-intervention (p=0.011). Barriers to SGLT2 inhibitor initiation were similar between groups (32.9% vs 30.8%).\n \;\nConclusion: \;Inpatient pharmacist involvement significantly improved documentation and intervention rates but did not result in increased SGLT2 inhibitor initiation. Despite enhanced pharmacist engagement\, no reduction in 30-day readmissions was observed. These findings show persistent barriers to therapy initiation suggesting additional strategies beyond pharmacist intervention may be necessary to improve clinical outcomes in heart failure patients.\n \;\nAuthorship: \;\nKatherine Ghattas\, PharmD\; James Helms\, PharmD\, BCPS\; Bonny Brownstein\, PharmD\, BCPS\, BCPPS CATEGORIES:CARDIOLOGY LOCATION:Broad Hub WEST\, Center City\, Philadelphia SEQUENCE:0 UID:6cb263e8cb47b4de717fc78aafa6ce14 URL:http://pshp2026residencyconference.sched.com/event/6cb263e8cb47b4de717fc78aafa6ce14 END:VEVENT BEGIN:VEVENT DTSTAMP:20260520T135913Z DTSTART:20260519T134000Z DTEND:20260519T140000Z SUMMARY:Comparison of Heparin versus Bivalirudin Therapy for Anticoagulation in Patients Receiving Extracorporeal Membrane Oxygenation DESCRIPTION:PURPOSE: The purpose of this study is to evaluate the safety and efficacy of bivalirudin versus heparin as anticoagulation for patients receiving either VA or VV ECMO. \;\n \;\nMETHODS: This single center\, retrospective chart review evaluated patients at Temple University Hospital between June 1st\, 2019 to June 30th\, 2025 who were placed on either VA or VV ECMO and received anticoagulation with either heparin or bivalirudin for at least 72 hours. The primary composite endpoint for the efficacy of bivalirudin in the use of ECMO compared to heparin was the overall incidence of thrombosis occurrences including venous and arterial \;thromboembolism and/or circuit related thrombotic event \;occurring after anticoagulation initiation. Secondary outcomes included bleeding occurrences while on anticoagulation and ECMO and the average volume of blood products received. Data collection included patient demographics\, baseline characteristics\, and anticoagulant used while on ECMO. \;Demographic data was analyzed using descriptive statistics\, categorical data was analyzed using Chi- square test\, and \;continuous data was analyzed by Student T-test. \;\n \;\nRESULTS: A total of 78 patients were included: median age 59\, 69% male\, and 60% received VV ECMO. The incidence of thrombotic events was similar between heparin and bivalirudin (10.2% versus 12.5%\, p = 0.754). More patients who received heparin experienced a major bleeding event compared to those who received bivalirudin (28.2% versus 2.6%\, p <\; 0.001). Additional analysis is ongoing.\n \;\nCONCLUSION: Patients receiving bivalirudin for systemic anticoagulation on extracorporeal membrane oxygenation did not have an increased incidence of thrombotic events and had a significantly lower incidence of major bleeding events compared to heparin.  \; CATEGORIES:CRITICAL CARE LOCATION:a.Pavilion Hub EAST\, Center City\, Philadelphia SEQUENCE:0 UID:abeb5775960e2c20be1beaa9cfff9ab4 URL:http://pshp2026residencyconference.sched.com/event/abeb5775960e2c20be1beaa9cfff9ab4 END:VEVENT BEGIN:VEVENT DTSTAMP:20260520T135913Z DTSTART:20260519T134000Z DTEND:20260519T140000Z SUMMARY:Effect of Inhaled Amikacin Liposome Dose Adjustments on Treatment Outcomes in Pulmonary Non-Tuberculous Mycobacteria Infections DESCRIPTION:Purpose:\nThis study evaluates the impact of reduced-dose amikacin liposome inhalation suspension (ALIS) on treatment outcomes in patients with pulmonary nontuberculous mycobacteria (NTM) infections who may experience treatment intolerance. \;\n\n\nMethods:\nThis was a retrospective\, descriptive study. Eligible patients started ALIS therapy from September 1\, 2018-June 30\, 2024\, and filled ALIS through the health system specialty pharmacy. Patients must have completed at least 6 months of ALIS therapy by June 30\, 2025. Data was sourced through the pharmacy software system\, and data collection was conducted through chart review. Patient adherence was quantified by a percentage of days covered (PDC)\, calculated based on refill history. The primary outcome was prevalence of negative cultures with various dosing strategies. Secondary outcomes included the incidence of culture reconversion up to one year after the first negative culture conversion or at the end of the study period\, new culture resistance\, number of patients with reduced ALIS dosing strategies\, reasons for ALIS dose adjustments\, and total duration of ALIS treatment.  \;Descriptive statistics were used to report outcomes. \;\n\n\nResults:\n30 patients were included in this study and 17 (56%) were considered adherent to daily dosing based on a PDC of >\;80%. Overall\, 24 (80%) patients achieved culture conversion\, with 12 of 17 patients in the >\;80% PDC group and 12 of 13 in the <\;80% PDC group. Median time to culture conversion was 178.5 (117-216.5) days. Median time to culture conversion in the >\;80% PDC group was 201 (105-247.25) days vs.146 (122.5-210.75) days in the <\;80% PDC group. There were 12 (20%) patients with culture reconversion\, with 6 of 17 patients in the >\;80% PDC group and 6 of 13 in the <\;80% PDC group. One patient (3.3%) developed new resistance to amikacin. There were several reasons for dose adjustment\, with the most frequent reason being adverse effects. \;\n\n\nConclusion:\nDose adjustments of ALIS did not appear to influence the rate of culture conversion in this study. There was a limited impact on resistance or duration of ALIS treatment. This suggests dose adjustment strategies may be an option for patients with adverse effects\; however\, further research is needed.\n CATEGORIES:INFECTIOUS DISEASES LOCATION:a.Pavilion Hub WEST\, Center City\, Philadelphia SEQUENCE:0 UID:d770d12b3bae6aa90fb89dceeb06e5cc URL:http://pshp2026residencyconference.sched.com/event/d770d12b3bae6aa90fb89dceeb06e5cc END:VEVENT BEGIN:VEVENT DTSTAMP:20260520T135913Z DTSTART:20260519T140000Z DTEND:20260519T142000Z SUMMARY:Comparison of Appropriate Lipid Panel Monitoring in Patients Managed by Pharmacists and Non-Pharmacists at Temple University Health System (TUHS) DESCRIPTION:Purpose:\nThe purpose of this study was to compare the number of patients who had appropriate lipid panel follow-up/monitoring at TUHS divided by management type: managed by pharmacy (Rx-managed) and not managed by pharmacy (Non-Rx-managed).\n\n\nMethods:\nThis study was conducted at the Temple Internal Medicine Associates (TIMA) clinic at TUHS from 07/01/2024 to 06/30/2025. Inclusion criteria were age ≥18 years\, TIMA patients\, ≥2 in-person visits (≥3 months apart)\, and ≥1 lipid panel during the study period. Exclusion criteria included ESRD\, palliative care\, pregnancy\, TSH >\;4.5 mIU/L\, or TG >\;400 mg/dL. Patients were categorized as Rx-managed (≥2 pharmacist visits) or Non-Rx-managed (managed exclusively by non-pharmacist clinicians). The primary endpoint was the number of lipid panels. Secondary endpoints included mean LDL-C\, number of patients achieving LDL-C <\;100 mg/dL and <\;70 mg/dL\, and number of patients receiving lipid-lowering therapy. Due to group size differences\, 1:4 propensity score matching was performed using age\, sex\, race\, T2DM\, and ASCVD. Continuous variables were analyzed using the Wilcoxon rank-sum test\, and categorical variables using Fisher’s exact or Chi-square tests.\n\n\nResults:\nBaseline characteristics were similar between groups after 1:4 matching. A greater proportion of patients in the Rx-managed group had more than one lipid panel compared with the Non-Rx-managed group (39.7% vs 27.1%\, p=0.006). Mean LDL-C was numerically lower in the Rx-managed group (86.6 vs 88.4 mg/dL)\, though not statistically significant. The proportion of patients achieving LDL-C goals was similar between Non-Rx-managed and Rx-managed groups (<\;100 mg/dL: 67.1% vs 70.2%\; <\;70 mg/dL: 34.3% vs 38.8%). Use of lipid-lowering therapy was comparable between groups. This study used real-world data and propensity matching to improve comparability\; however\, it was limited by its retrospective\, single-center design and lack of baseline lipid values.\n\n\nConclusion: \;\nPatients in the Rx-managed group were more likely to receive additional lipid monitoring than those in the non-Rx- managed group. Although not statistically significant\, the Rx-managed group showed trends toward lower LDL-C and greater goal attainment. Future studies with longer follow-up and baseline lipid values are needed to better evaluate longitudinal lipid outcomes and the clinical impact of pharmacist-led management in lipid management. CATEGORIES:AMBULATORY CARE LOCATION:Broad Hub EAST\, Center City\, Philadelphia SEQUENCE:0 UID:a0ffd2b52cf86c9d092a59a0a532ca4c URL:http://pshp2026residencyconference.sched.com/event/a0ffd2b52cf86c9d092a59a0a532ca4c END:VEVENT BEGIN:VEVENT DTSTAMP:20260520T135913Z DTSTART:20260519T140000Z DTEND:20260519T142000Z SUMMARY:Evaluation of Initial Management for Acute Blood Pressure Control in Intracerebral Hemorrhage DESCRIPTION:Purpose:\nTo evaluate the proportion of patients with spontaneous intracerebral hemorrhage (ICH) achieving institutional systolic blood pressure (SBP) targets within 60 minutes of head computed tomography (HCT).\n\n\nMethods:\nThis retrospective cohort study included adult patients with spontaneous ICH admitted to entities within the University of Pennsylvania Health System between January 1\, 2025\, and November 30\, 2025. Patients were stratified by presenting SBP (<\;220 mmHg vs >\;220 mmHg)\, corresponding to institutional protocol targets. For patients presenting with SBP greater than 220 mmHg\, the initial goal is to reduce SBP to less than 180 mmHg within the first hour. For patients presenting with SBP between 180&ndash\;220 mmHg\, the target range is 130&ndash\;150 mmHg. The  \;primary outcome was achievement of protocol-defined SBP target within 60 minutes of HCT confirmation. Secondary outcomes included antihypertensive medication regimen\, time to target SBP\, SBP variability during the first six hours after HCT \, neurologic outcomes \, incidence of hematoma expansion or ischemic stroke\, mortality\, and safety outcomes including hypotension and bradycardia. \;\n\n\nResults: \;\nA total of 39 patients met inclusion criteria (SBP <\;220 mmHg: n=23\; SBP >\;220 mmHg: n=16). \;Achievement of target SBP within 60 minutes occurred more frequently in patients presenting with SBP >\; 220 mmHg (39.1% vs 93.8%\, p<\;0.01).  \;Nicardipine was utilized in all patients and was initiated within 30 minutes of HCT confirmation in 69.6% and 75% of patients with SBP <\;220 mmHg and >\;220 mmHg\, respectively. In-hospital mortality occurred in 8.7% of patients with SBP <\;220 mmHg and 6.3% with SBP >\;220 mmHg (p=1.00). The incidence of ischemic stroke was 8.7% versus 25.0%\, respectively (p=0.21). Hypotension occurred in one patient (4.3%) in the SBP <\;220 mmHg group (p=1.00).  \;No  \;cases of bradycardia were observed.\n\n\nConclusion: \nPatients with SBP >\;220 mmHg were more likely to achieve protocol-defined SBP targets within 60 minutes compared with those <\;220 mmHg. Despite rapid blood pressure reduction\, rates of hypotension and bradycardia were low. These findings suggest that early SBP control in patients with moderately elevated SBP may reflect differences in clinical attention and management intensity\, highlighting a potential need for more optimized titration strategies.\n\n\n CATEGORIES:CRITICAL CARE LOCATION:a.Pavilion Hub EAST\, Center City\, Philadelphia SEQUENCE:0 UID:2fbbf6ae815bf59a07bc164eef0652e5 URL:http://pshp2026residencyconference.sched.com/event/2fbbf6ae815bf59a07bc164eef0652e5 END:VEVENT BEGIN:VEVENT DTSTAMP:20260520T135913Z DTSTART:20260519T140000Z DTEND:20260519T142000Z SUMMARY:Treatment Outcomes in Patients with Fungal Infections After Implementation of Weight Based Micafungin Dosing at a Large Academic Medical Center DESCRIPTION:Purpose: \;Given the opportunity to optimize micafungin therapy in obese patients\, our institution established a new protocol that recommends high doses for patients >\; 125 kg. We aimed to evaluate the outcomes associated with this new protocol.\n \;\nMethods: \;This is a retrospective cohort study of patients at Thomas Jefferson University Hospital Inc locations from December 2024 to March 2026. Patients were included if they were 18 years or older\, had documented invasive candidiasis\, and received micafungin for 3 or more days. Patients were excluded if they had a concomitant infection within 7 days\, were given empiric combination antifungal therapy\, or had \;Candida species isolated from the genitourinary tract. Outcomes will be compared between patients weighing &le\; 125kg\, patients weighing >\; 125kg on standard dose micafungin\, and patients weighing >\; 125kg on high dose micafungin. The primary outcome is a composite of all&ndash\;cause 90-day mortality\, microbiologic and clinical cure\, and incidence of recurrent infections within 30 days. The secondary outcomes are 30-day infection related readmission\, duration of micafungin treatment\, hospital and ICU length of stay and duration of candidemia.\n \;\nResults: \;A total of 318 positive Candida cultures were identified and of those\, 271 patients were removed to meet the exclusion criteria. Therefore\, the study cohort included a total of 42 patients with 40 patients in the &le\; 125kg group\, 1 patient in the >\; 125kg with standard micafungin dose group\, and 1 patient in the >\; 125kg with high micafungin dose group. No difference was seen with the primary composite outcome between the cohorts (p=0.448). Due to low enrollment\, exploratory analysis was performed utilizing binomial linear regression. When including mg/kg dosing as a continuous variable and analyzed it with other impactful and confounding variables\, we did not find that it added significantly to the model. \;\n \;\nConclusion: \;Our results from a very limited data set suggest that increased micafungin dosing in obese patients was not associated with improved clinical outcomes for invasive candidiasis. Exploratory analysis did not suggest that higher micafungin dosing (measured in mg/kg) provided additional benefit. Our institution will continue to collect data\, in hopes of generating a greater sample size. Larger studies are required to confirm these results. \;\n CATEGORIES:INFECTIOUS DISEASES LOCATION:a.Pavilion Hub WEST\, Center City\, Philadelphia SEQUENCE:0 UID:3fa6ea76ed9bc0a2ac91c89d94994e6d URL:http://pshp2026residencyconference.sched.com/event/3fa6ea76ed9bc0a2ac91c89d94994e6d END:VEVENT BEGIN:VEVENT DTSTAMP:20260520T135913Z DTSTART:20260519T143000Z DTEND:20260519T145000Z SUMMARY:Safety and Efficacy of Alpha-2 Agonists in the Setting of Fentanyl and Medetomidine Withdrawal DESCRIPTION:Purpose\nThe purpose of this study was to characterize and assess the safety and efficacy of alpha-2 agonist utilization in the setting of fentanyl and presumed medetomidine withdrawal at a tertiary academic medical center in Philadelphia\, PA.\n \;\nMethods\nThis retrospective\, single-center chart review evaluated patients admitted to an academic medical center between 1/1/2025 and 10/31/2025 with fentanyl and suspected medetomidine withdrawal and received an alpha-2 agonist(s) for withdrawal management. Patients were excluded if they received mechanical ventilation or vasopressors\, experienced severe alcohol withdrawal\, or underwent surgery during their withdrawal management. The primary objective was to characterize alpha-2 agonist use\, including agent\, dose\, frequency\, and route. Secondary objectives assessed safety and efficacy. Safety endpoints included incidence of hemodynamic instability and ICU disposition. Efficacy endpoints included incidence of ICU escalation and patient-directed discharge and the change in maximum Clinical Opiate Withdrawal Scale (COWS) scores within 72 hours of admission. \;\n\n\nResults\nThere were 100 included patients: 53 in the ICU and 47 on general medicine floors. All patients received clonidine\, largely as oral tablets\; 18% received tizanidine and 52% dexmedetomidine. The \;median maximum total daily dose of clonidine was 1.2 mg [IQR 1-1.6] for a median duration of 108.9 hours [IQR 72.7-159.7]. Dexmedetomidine had a median maximum infusion rate of 1.2 mcg/kg/hr [IQR 1-1.5] and a median of 27.3 hours [IQR 18.6-42]. Clonidine was held in 65% of patients (bradycardia). A heart rate <\;60 bpm occurred in 51% and a systolic blood pressure <\;90 mmHg in 5% of patients. The median COWS by day 2 had decreased from 22 [IQR 16.5-26] to 6 [IQR 4-8]. Many patients (58%) were discharged on clonidine\, and 27% had self-directed discharge.\n\n\nConclusions\nAlpha-2 agonists improved COWS scores over 72 hours and were well tolerated\, with bradycardia being the most common adverse effect. Clonidine was the most frequently used alpha agonist\, with dexmedetomidine reserved for ICU-level patients. Overall\, these findings support the use of alpha-2 agonists for fentanyl with presumed medetomidine withdrawal management with careful hemodynamic monitoring and individualized dosing and tapering strategies.\n\n\nThis study was approved by the University of Pennsylvania Institutional Review Board (Protocol #859692).\n CATEGORIES:ADDICTION MEDICINE/PAIN MANAGEMENT LOCATION:Broad Hub WEST\, Center City\, Philadelphia SEQUENCE:0 UID:fea88161f0a6067bb9814697a1bd3949 URL:http://pshp2026residencyconference.sched.com/event/fea88161f0a6067bb9814697a1bd3949 END:VEVENT BEGIN:VEVENT DTSTAMP:20260520T135913Z DTSTART:20260519T143000Z DTEND:20260519T145000Z SUMMARY:Evaluation of Guideline-Recommended Weight-Based Initial Vancomycin Dosing in Septic Patients and the Effects on Therapeutic Level Achievement and Clinical Outcomes DESCRIPTION:Abstract Title: \;Evaluation of Guideline-Recommended Weight-Based Initial Vancomycin Dosing in Septic Patients and the Effects on Therapeutic Level Achievement and Clinical Outcomes\nPurpose: \;This study was designed to evaluate guideline-recommended weight-based initial vancomycin dosing of 25 mg/kg in septic patients and the effects on therapeutic level achievement and clinical outcomes. \; \;\nMethods: \;Institutional Review Board approval was obtained for this retrospective observational chart review. Patients were identified based on the order set utilized by providers for vancomycin loading dose. The \;order set used prior to September 2023 allowed providers to order a maximum loading dose of 1\,500 mg\, while the new sepsis order set guides providers to order 25 mg/kg loading doses with a maximum dose of 3\,000 mg. \;Data was collected from March 1st 2023\, through March 31st\, 2025. The primary outcome is to determine if sufficient loading doses of vancomycin in septic patients result in faster achievement of therapeutic levels. Secondary outcomes include the rate of patients who experienced nephrotoxicity\, time to administration of loading doses\, length of stay\, 30-day mortality\, critical care admission\, and the rate of MRSA bacteremia. Data analysis was completed with descriptive statistics\, Wilcoxon Sum Rank test and Chi-squared test. \;\nResults: \;Initial vancomycin doses of 25 mg/kg\, based on total body weight\, in septic patients results in faster therapeutic achievement (p-value 0.000004) and lower rates of acute kidney injuries (p-value 0.005). The time from order to administration of initial vancomycin doses in the post-implementation group was about 25 minutes faster than the pre-implementation group and was almost one day shorter for the average length of stay compared to the pre-implementation group. In the pre-implementation group\, the average loading dose was 15.5 (SD of 3.1) and the average AUC was 365.3 mg/h/L (SD of 122.6). In the post-implementation group\, the average loading dose was 20.1 (SD of 4.4) and the average AUC was 419.9 (SD of 95.2).\nConclusion: \;Increased initial vancomycin doses resulted in faster therapeutic achievement and lower rates of acute kidney injury. There were no statistically significant differences between 30-day mortality\, admission to critical care unit\, MRSA bacteremia\, time from order to administration and length of stay. Results support updating non-sepsis vancomycin order sets to increase the initial dose\, as well as promoting batching larger vancomycin doses. \;\nAuthorship: \;Paige de Fremery\, PharmD\; Miranda Cason\, PharmD\, BCPS\; Troy Albrecht\, PharmD\, BCPS\, BCIDP\n CATEGORIES:CRITICAL CARE LOCATION:a.Pavilion Hub WEST\, Center City\, Philadelphia SEQUENCE:0 UID:4f4090e70889edc98107be50ffb12113 URL:http://pshp2026residencyconference.sched.com/event/4f4090e70889edc98107be50ffb12113 END:VEVENT BEGIN:VEVENT DTSTAMP:20260520T135913Z DTSTART:20260519T143000Z DTEND:20260519T145000Z SUMMARY:Implementation of a Pharmacist-Driven Protocol for Ceftriaxone IV to PO Step-down in Hospitalized Patients with an Uncomplicated or Complicated Urinary Tract Infection DESCRIPTION:Purpose: \;To implement a pharmacist-driven protocol which allows for the step-down of IV \;ceftriaxone \;to PO antibiotics for hospitalized patients with uncomplicated and complicated urinary tract infections to help improve transition time. \; \;\nMethods: \;A prospective study will be conducted from February 23\, \;2026 \;to \;May \;12\, 2026\, using data collected from EPIC. \;The included patients \;will be age 18 and older with a UTI \;diagnosis\, \;presence \;of \;stones\, obstruction\, strictures\, TURP\, prostatitis\, stents\, associated bacteremia\, indwelling urinary catheters\, \;pregnancy \;and before/after genitourinary procedure. Patients will be excluded if they have asymptomatic bacteriuria\, secondary diagnosis for another infection\, renal abscess\, or are immunocompromised. \; \;\nThe primary endpoint is transition time from IV to PO antibiotics. Secondary endpoints include length of stay\, 30-day \;UTI \;readmission \;rates\, \;total length of therapy\, antibiotic \;selection \;and dosing. \;The endpoints will be compared to a retrospective analysis from May 1\, 2025\, to June 30\, 2025\, to assess if a pharmacist-driven protocol allowed for \;a \;timely \;transition \;to oral antibiotics and/or a reduction in any of the secondary endpoints.\nResults: \;TBD \;\nConclusion: \;TBD \;\nIRB Approval: \;IRB approval is \;not \;required \;as this research is categorized as a process improvement project. \; \; CATEGORIES:INFECTIOUS DISEASES LOCATION:a.Pavilion Hub EAST\, Center City\, Philadelphia SEQUENCE:0 UID:2a733e6db426b6fb59494db1dbd3bdcb URL:http://pshp2026residencyconference.sched.com/event/2a733e6db426b6fb59494db1dbd3bdcb END:VEVENT BEGIN:VEVENT DTSTAMP:20260520T135913Z DTSTART:20260519T143000Z DTEND:20260519T145000Z SUMMARY:Evaluation of Implementation of an Agitation Protocol in an Emergency Department DESCRIPTION:Purpose \;\nThis study evaluates the implementation of an ED agitation protocol on the reduction of repeat sedative doses within 1 hr in agitated adults\, leading to safer\, more effective agent selection and evidence-based pharmacologic management.\nMethods \;\nThis multi-center retrospective chart review evaluated electronic medical records of adult ED patients across all LVHN sites who were treated with at least one dose of sedative medication for agitation. Patients treated from 7/1/2022&ndash\;7/1/2023 and 10/1/2023&ndash\;10/1/2024 were identified\, stratified by study period\, and randomly selected to be included for analysis. Patients who were not treated for acute agitation\, had alternative indications for benzodiazepines\, (Ex. CIWA benzodiazepines)\, or had a pre-administration SPO2<\;92% or SBP<\; 90 were excluded from analysis. Variables collected included medication selection\, times of medication administration\, ED LOS\, patient disposition\, and safety data. A sample size of 169 patients per group was calculated to detect 15% differences in repeat sedative use (49% vs 34%) using a two-tailed chi-square test (&alpha\;=0.05\, power=80%).\nResults \;\nBaseline characteristics were similar amongst groups. Agent treatment selection was similar pre- and post-protocol implementation. The proportion of patients requiring an additional sedative within 1 hour significantly decreased post-protocol implementation (8.9% vs 17%\, p=0.025). ED length of stay was significantly reduced (20 h vs 25 h\, p=0.00006). The proportion of patients requiring 1:1 monitoring before and after implementation was (31% vs 39%\, p=0.096)\, a reduction in 8%. Restraint use decreased by 13% post-implementation (31% vs 43%). ICU admission rates did not differ between groups (p=0.769). Adverse events were infrequent\, limiting conclusions. Diphenhydramine use was not associated with ED LOS. \;\nConclusion \;\nAdoption of a standardized ED agitation protocol was associated with fewer repeat sedative doses within one hour and a reduction in emergency department length of stay. These improvements occurred without increases in ICU admission\, monitoring needs\, or adverse events. Protocol-driven\, evidence-based medication selection enhances initial agitation control\, reduces restraint use\, improves patient safety\, and promotes more efficient care delivery. \;\n CATEGORIES:MEDICATION SAFETY/QUALITY IMPROVEMENT LOCATION:Broad Hub EAST\, Center City\, Philadelphia SEQUENCE:0 UID:9956f9c58db1c421d7ff8cf60944db83 URL:http://pshp2026residencyconference.sched.com/event/9956f9c58db1c421d7ff8cf60944db83 END:VEVENT BEGIN:VEVENT DTSTAMP:20260520T135913Z DTSTART:20260519T145000Z DTEND:20260519T151000Z SUMMARY:Assessment of Pharmacy Resident Education on Opioid with Suspected Adulterants Withdrawal Clinical Practice DESCRIPTION:\nPurpose:  \;The purpose of this project is to evaluate the current treatment practices in the critical care units for complex withdrawal and organize formal education surrounding a high priority clinical topic.\n\nMethods: The study will use a newly implemented protocol in the medical intensive care unit and pharmacy resident education to screen current treatment practices and assess gaps in knowledge. An anonymous survey was developed and consisted of questions regarding experience treating complex withdrawal and self-reported confidence in the management in clinical practice. Data will be collected including the attendees professional practice setting. The education and the survey will be presented to the appropriate departments and afterwards survey results will be used to assess changes in knowledge and confidence with future adherence to the implemented protocol. The primary endpoint is the improvement in healthcare professional knowledge regarding the management of complex withdrawal\, measured by completed survey results. Secondary endpoint includes change in confidence pre and post-educational sessions.  \;\n \;\nResults: Approximately ~75 healthcare professionals were given formal education\, and a total of 40 were able to complete the survey due to access at time of presentation. Self-reported confidence in the treatment of opioid with suspected adulterant withdrawal increased from 42% to 78% after education was given. Two clinical questions regarding the presentation of medetomidine withdrawal were asked and 30% and 63% of responders were &ldquo\;not confident&rdquo\; in their answer choices. When asked to report confidence in using the presented material 78% and 96% of responders were confident in applying the material to clinical practice. Even though not every participant was able to take the pre- and post-surveys the reminders for close monitoring and proactive care has reinforced different specialties their importance in managing complex withdrawal. \;\n \;\nConclusion: Implementation of a standardized complex withdrawal management protocol\, along with educational sessions was found to improve self-reported confidence and knowledge in managing complex withdrawal. Ongoing monitoring of protocol use and interdisciplinary support to promote long-term adherence to the newly implanted protocol. Future evaluation may include clinical outcomes\, such as length of hospital stay\, length of intensive care unit stay and incidence of withdrawal-related complications \;\n\n CATEGORIES:ADDICTION MEDICINE/PAIN MANAGEMENT LOCATION:Broad Hub WEST\, Center City\, Philadelphia SEQUENCE:0 UID:1a0561d9028a23572d9fc7c30cef4fae URL:http://pshp2026residencyconference.sched.com/event/1a0561d9028a23572d9fc7c30cef4fae END:VEVENT BEGIN:VEVENT DTSTAMP:20260520T135913Z DTSTART:20260519T145000Z DTEND:20260519T151000Z SUMMARY:Evaluation of the impact of anti-Xa monitoring for the prevention of venous thromboembolism (VTE) in trauma patients DESCRIPTION:Purpose: \; \;\nThe purpose of this study \;is \;to evaluate the impact of \;prophylactic \;anti-Xa monitoring on rates of venous thromboembolism (VTE) events and bleeding \;in \;trauma \;patients \;at a level one trauma center. \; \;\n \;\n \;\nMethods: \; \;\nThis retrospective cohort study \;includes \;patients \;admitted to the trauma surgery service from January 2019 \;&ndash\; July 2025 \;treated with \;enoxaparin for VTE prophylaxis. \;Exclusion criteria \;includes \;patients \;who spent \;48 hours \;or more at a referring facility before \;transfer \;or \;an \;anti-Xa level \;collected \;before 3.5 hours of after 6.5 hours \;from last enoxaparin \;dose. \;Patients were \;identified \;via an \;Enterprise Information Management \;report\, data was extracted from the electronic health record \;using \;REDCap\, \;and statistical analysis was \;completed \;using Microsoft \;Excel. The primary outcome is rate of thromboembolic events\, and secondary \;outcomes include \;rates \;of bleeding\, \;units of red blood cells transfused\, ICU \;and hospital \;length of stay \;(LOS). Categorical data is compared using a chi-squared \;test\, \;and continuous data \;is reported \;using descriptive statistics. The study \;is \;IRB \;exempt by the institutional review board at the study site. \; \;\n \;\nResults: \; \;\nA total of 196 patients \;are \;included in the study\; \;91 received anti-Xa monitoring and 105 patients did not. No statistically significant differences \;in rates of VTE events were \;observed \;between patients who received anti-Xa monitoring compared with those who did not (9.9% vs 7.6%\, p-value 0.573). Rates of bleeding were higher in the anti-Xa monitoring \;group \;(44.0% vs 26.7%\, p-value 0.01). \;Patients who received anti-Xa monitoring were more likely to have missed doses of enoxaparin (56.0% vs 41.0% p-value 0.03) and had a longer median ICU \;LOS \;(13.6 days \;vs 6.3 days). \;In \;patients \;receiving \;anti-Xa \;monitoring\, \;48/91 (52.7%) \;patients \;had \;an \;initial \;anti-Xa within the goal range\, and only \;3/91 (2.2%) had an anti-Xa above the goal range. \; \;\n \;\n \;\n \;\nConclusion: \;\nAnti-Xa monitoring did not result in a difference in VTE events and was associated with higher bleeding rates. However\, the anti-xa monitoring group had more missed doses of enoxaparin and longer ICU length of stay\, which are risk factors for VTE events. This suggests that patients who received anti-xa monitoring likely had a greater severity of illness\, leading to higher rates or bleeding\, despite not having supratherapeutic anti-xa levels.  \;\n CATEGORIES:CRITICAL CARE LOCATION:a.Pavilion Hub WEST\, Center City\, Philadelphia SEQUENCE:0 UID:b68d58fe192edf4828a948403b89a153 URL:http://pshp2026residencyconference.sched.com/event/b68d58fe192edf4828a948403b89a153 END:VEVENT BEGIN:VEVENT DTSTAMP:20260520T135913Z DTSTART:20260519T145000Z DTEND:20260519T151000Z SUMMARY:Incidence of Piperacillin/Tazobactam Reactions in Patients with Reported Beta-Lactam Reactions in a Community Hospital Setting DESCRIPTION:Purpose: \;Despite structural dissimilarity between penicillins and piperacillin/tazobactam (P/T)\, the incidence of cross-reactivity is unknown. This project evaluated the incidence of P/T reaction in patients with documented β-lactam reactions.\n\n\nMethods: \;This was a retrospective single-center cohort analysis evaluating patients with reported β-lactam reactions who received P/T from July 2022 to June 2025. Patients were included if they received at least one dose of P/T during this time and had a previously reported β-lactam reaction. Patients were excluded if they were less than 18 years old\, the P/T order was not administered\, or there was insufficient quality of data. The primary outcome was the compared incidence of P/T reactions between patients with documented penicillin class reactions versus patients with reactions to all other β-lactams and β-lactamase inhibitors. Secondary outcomes were the incidence of P/T reactions in the following subgroups: subclass of previous β-lactam reaction\, previous reaction type classification\, P/T duration\, and number of previously reported reactions. Results were analyzed using a Chi-squared analysis and descriptive statistics.\n\n\nResults: \;Of 183 patients screened for analysis\, 164 were included. Previously reported β-lactam reactions were classified as IgE-mediated (30%)\, non-IgE-mediated (18%)\, adverse reactions (23%)\, and unknown (29%). There were 21 (13%) patients with multiple β-lactam allergies. Potential reaction to P/T occurred in 0/87 (0%) patients with penicillin class reactions and 1/77 (1.3%) patients with non-penicillin β-lactam reactions (p=0.286). The patient with a documented reaction to P/T had a history of developing hives to cefuroxime. The median [IQR] length of treatment for patients who received multiple doses in an encounter was 2 [1-3.5] days\, with the most common reason for discontinuation being targeted antimicrobial therapy (47%). \;\n\n\nConclusion: \;In patients labeled with a β-lactam reaction\, there was minimal incidence of P/T reactions\, with 1/164 patients (0.6%) experiencing a documented reaction. These results support the hypothesis that cross-reactivity would be low based on structural dissimilarity\, including penicillin class allergies. Further research is warranted to further elucidate the safety of administering P/T in this patient population. CATEGORIES:INFECTIOUS DISEASES LOCATION:a.Pavilion Hub EAST\, Center City\, Philadelphia SEQUENCE:0 UID:8d1839fd99145d60c17b5ee140261d42 URL:http://pshp2026residencyconference.sched.com/event/8d1839fd99145d60c17b5ee140261d42 END:VEVENT BEGIN:VEVENT DTSTAMP:20260520T135913Z DTSTART:20260519T145000Z DTEND:20260519T151000Z SUMMARY:Assessing High-Risk Behaviors in Veterans at the CMCVAMC through a Behavioral Health Initiative for Distributing Fentanyl Test Strips DESCRIPTION:Purpose: \;\nHarm reduction minimizes negative outcomes associated with substance use. \;Fentanyl \;test strips are distributed \;as a strategy \;due to its presence in local supply. \;The primary \;goal \;is to assess impact of \;test \;strips on \;high-risk \;behaviors.\n \;\nMethods:\nRetrospective chart reviews were conducted using the Veterans Health Administration (VHA) Computerized Patient Record System (CPRS) to collect data on 129 veterans who received fentanyl test strips from behavioral health teams between 10/02/2024 to 09/08/2025. Veterans receiving outpatient care aged 18 and older with active opioid and/or stimulant use disorder were included in our review. Veterans with significant cognitive impairments or acute psychiatric instability that prevent informed consent were excluded. A prospective component was planned but will not be reported due to insufficient enrollment.  \;\n \;\nResults:\nAmong veterans offered fentanyl test strips\, the majority accepted\, with only a small percentage declining. A subset of veterans accepted additional fentanyl test strip kits when re-offered.  \;Additionally\, many veterans who accepted the fentanyl test strips already had naloxone on hand\, or received it concurrently. \;\n \;\nConclusion:\nFentanyl test strip acceptance\, including repeated offer acceptances\, suggest potential utilization and perceived benefits by veterans. However\, further evaluation is warranted to determine whether use leads to reduction in high-risk behaviors. Additionally\, ensuring naloxone access alongside fentanyl test strip distribution further supports harm-reduction efforts to protect veterans who are at risk for opioid overdose. \;\n \;\n CATEGORIES:MEDICATION SAFETY/QUALITY IMPROVEMENT LOCATION:Broad Hub EAST\, Center City\, Philadelphia SEQUENCE:0 UID:7ab3891ccb73a3db272bdffa2b9b606f URL:http://pshp2026residencyconference.sched.com/event/7ab3891ccb73a3db272bdffa2b9b606f END:VEVENT BEGIN:VEVENT DTSTAMP:20260520T135913Z DTSTART:20260519T151000Z DTEND:20260519T153000Z SUMMARY:Impact of a Two-Part Training Program to Support Naloxone Education and Community Outreach: Outcomes of the NAME Initiative DESCRIPTION:Purpose: \;\nNorth Philadelphia is disproportionately affected by opioid use disorder and related deaths. The objective of this study is to evaluate the effectiveness of a community-centered opioid harm reduction education program for pharmacy students.\n\n\nMethods:\nThis is a prospective\, quasi-experimental\, \;pilot \;study \;evaluating \;outcomes of \;the \;Naloxone Access and Medication Education (NAME) \;Initiative. The study was \;conducted at \;a single \;ACPE-accredited school of pharmacy in Philadelphia\, Pennsylvania. \;The \;program \;consisted of a \;two-hour training course followed by a two-hour community \;outreach Introductory Pharmacy Practice Experience \;(IPPE). Students completed pre- and post-surveys \;to assess their knowledge of opioid overdose recognition and response \;using \;the validated Opioid Overdose Knowledge Scale (OOKS) \;and confidence \;to \;engage meaningfully in community service \;using \;the validated \;Community Service Self-Efficacy Scale (CSSES). The primary \;endpoint \;was \;the change \;in OOKS \;scores \;pre- and post- \;didactic \;training. \;The secondary endpoint was \;the \;change in CSSES \;scores \;from pre- to \;post-IPPE. \;Pre- and post-survey \;data were \;analyzed using paired t-tests.\n\n\nResults:\nA statistically significant improvement of 0.91 points (SD ± 3.0) was seen in OOKS scores after students received didactic training (p=0.049). Significant improvement was primarily seen in the “Action” domain of the OOKS score (p=0.01). Seventy percent (31/44 students) completed the post-CSSES. Of those completed the survey\, an improvement of 3.5 points (SD± 8.4) was observed\; however\, this was not statistically significant (p=0.053).\n\n\nConclusions:\nUtilization of a didactic training program followed by a community outreach IPPE led to improvement in pharmacy student knowledge of opioid harm reduction \;and management and may increase perceived self-efficacy with educating community members.\n\n\n\n CATEGORIES:ADDICTION MEDICINE/PAIN MANAGEMENT LOCATION:Broad Hub WEST\, Center City\, Philadelphia SEQUENCE:0 UID:72193525b1acd9539d31f03c7dd6977a URL:http://pshp2026residencyconference.sched.com/event/72193525b1acd9539d31f03c7dd6977a END:VEVENT BEGIN:VEVENT DTSTAMP:20260520T135913Z DTSTART:20260519T151000Z DTEND:20260519T153000Z SUMMARY:Assessment of Bradycardia with Dexmedetomidine Use for Sedation in Non-Cardiac Intensive Care Units DESCRIPTION:PURPOSE: This study evaluates the incidence of bradycardia following dexmedetomidine initiation in critically ill patients and identifies clinical predictors and dosing patterns to inform monitoring and optimize sedation practices.\nMETHODS: This retrospective chart review included critically ill adult patients who received a dexmedetomidine infusion for greater than 2 hours admitted to a non-cardiac intensive care unit (ICU) from November 1st\, 2024 to November 1st\, 2025. The primary outcome was the incidence of bradycardia defined as less than 60 beats per minute (bpm) following dexmedetomidine initiation. Secondary outcomes included incidence of severe bradycardia (less than 40 bpm or requiring clinical action)\, incidence of hypotension\, time to first bradycardic event\, dose and duration of infusion\, liver function on ICU admission\, body mass index (BMI) at time of infusion initiation\, and concomitant use of vasoactive or rate-controlling medications. Descriptive statistics were used to summarize primary and secondary outcomes\, and a binary logistic regression was performed as an exploratory analysis to identify predictors of bradycardia.\nRESULTS: Seventy patients were included\, with bradycardia occurring in 25 patients (35.7%). Severe bradycardia occurred in 2 patients (2.9%). Median time to first bradycardic event was 6.33 hours [2.93\, 10.45]. Median infusion duration was 28.1 hours [14.6\, 72]\, and mean infusion rate was 0.99 ±\; 0.48 mcg/kg/hr. Hypotension occurred in 41 patients (58.6%)\, and vasopressor therapy was continued or initiated in a subset of patients during infusion. In a binary logistic regression\, higher heart rate on hospital admission was associated with increased odds of bradycardia [p=0.013\, (OR 1.046\, 95% CI 1.010-1.084)]\, while higher heart rate at dexmedetomidine initiation was associated with decreased odds of bradycardia [p=0.004 (OR 0.936\, 95% CI 0.896-0.979)].\nCONCLUSION: \;Bradycardia occurred in over one-third of critically ill patients receiving dexmedetomidine. Baseline heart rate predicted bradycardia risk\, with effects varying based on when it was measured\, as higher heart rate on hospital admission increased risk while higher heart rate at dexmedetomidine initiation was associated with lower risk. These findings highlight the need for patient-specific assessment and close monitoring during therapy.\nIRB Approval: iRISID-2026-0188\n CATEGORIES:CRITICAL CARE LOCATION:a.Pavilion Hub WEST\, Center City\, Philadelphia SEQUENCE:0 UID:6a9bbd0d288b68dc0c1206cf7bb78004 URL:http://pshp2026residencyconference.sched.com/event/6a9bbd0d288b68dc0c1206cf7bb78004 END:VEVENT BEGIN:VEVENT DTSTAMP:20260520T135913Z DTSTART:20260519T151000Z DTEND:20260519T153000Z SUMMARY:Evaluation of Carbapenem Therapy for Extended Spectrum β-Lactamase producing Enterobacterales (ESBL-E) Bloodstream Infections in Patients with and without Hypoalbuminemia DESCRIPTION:Purpose: \;\nThe aim of this study was to evaluate the impact of albumin status on clinical and microbiological outcomes of patients treated with ertapenem or meropenem for ESBL-E bacteremia\, and to identify factors associated with treatment failure.\n \;\nMethods:\nWe conducted a dual-center\, retrospective cohort study of adult patients admitted between October 1\, 2022\, and October 1\, 2025\, who received ertapenem or meropenem for the treatment of ESBL-E bacteremia (ceftriaxone-resistant Escherichia coli\, Klebsiella spp. (non-aerogenes)\, or Proteus spp.). Patients were stratified by albumin status (L-Alb: serum albumin <\; 2.5 mg/dL or N-Alb: serum albumin ≥ 2.5 mg/dL) and \;carbapenem selection. The primary outcome was a composite of treatment failure: death\, readmission for related infectious causes\, recurrent infection\, or absence of clinical improvement by day 14. Secondary outcomes included 30-day all-cause mortality and evaluation of clinical characteristics hypothesized to be associated with treatment failure. Categorical variables were compared using chi-square or Fisher’s exact tests. A multivariable logistic regression was performed to identify factors independently associated with outcomes.\n \;\nResults: \;\nAmong 203 patients with a median age of 63 years\, 23.6% had L-Alb\, and 49.8% were immunocompromised. Bacteremia was primarily caused by E. coli (57.6%) from urinary or intra-abdominal sources\, and the 30-day all-cause mortality rate was 14.3%. The primary outcome occurred in 24.6% of the cohort. Treatment failure was higher in patients with L-Alb versus N-Alb (47.9% vs 17.4%\, P <\; 0.01) and with ertapenem in relation to albumin status (42.3% vs 12.9%\, P <\; 0.01)\, but not with meropenem (54.5% vs 35.5%\, P = 0.17). On multivariable analysis\, L‑Alb (OR 2.76\, 95% CI [1.26-6.04]) and lack of source control (OR 4.45\, 95% CI [1.77-11.22]) independently predicted treatment failure\, while ertapenem did not appear to (OR 0.42\, 95% CI [0.19–0.93]).\n \;\nConclusion: \;\nOur study presents medically complex patients with ESBL-E bacteremia not limited by infectious source. While prior literature cautions against ertapenem in patients who are critically ill and/or with L-Alb\, our data suggests that poor ertapenem efficacy is multifactorial. Although failure rates were higher in patients with L-Alb receiving ertapenem\, ertapenem did not appear to be associated with increased failure after adjusting for confounders.\n \; CATEGORIES:INFECTIOUS DISEASES LOCATION:a.Pavilion Hub EAST\, Center City\, Philadelphia SEQUENCE:0 UID:0665e93151bbdf0451c3408aebbe42bc URL:http://pshp2026residencyconference.sched.com/event/0665e93151bbdf0451c3408aebbe42bc END:VEVENT BEGIN:VEVENT DTSTAMP:20260520T135913Z DTSTART:20260519T151000Z DTEND:20260519T153000Z SUMMARY:Impact of IV Push Antibiotics Administered in the Emergency Department in Patients with Sepsis and Septic Shock DESCRIPTION:Purpose: \;The primary objective was to compare administration times of intravenous push (IVP) compared to piggyback (IVPB) antibiotics in the emergency department (ED) in patients with sepsis and septic shock. \;\n\n\nMethods: \;This retrospective\, single-center\, IRB-exempt\, chart review conducted at Jefferson Einstein Philadelphia Hospital (JEPH) included ED patients with sepsis or septic shock who received either IVP or IVPB ceftriaxone or daptomycin. Patients with sepsis were identified by ICD-10 code and sepsis alert\, and septic shock patients had vasopressor requirements. Patients were excluded if transferred from outside hospital. To account for institution-wide process changes due to drug shortages\, IVPB antibiotics were evaluated from January 1\, 2024 to September 30\, 2024\, and IVP antibiotics were evaluated from November 1\, 2024 to July 31\, 2025.\n\n\nResults: Patients assessed for eligibility included 76 patients in the IVP group and 51 patients in the IVPB group. No patients who were administered daptomycin met inclusion criteria. There was no difference in median time to administration between the two groups (IVPB 40.8 min vs IVP 39.2 min. p=0.99). In patients with sepsis\, 34/46 patients (73.9%) and 51/72 patients (70.8%) in the IVPB and IVP group received antibiotics within 3 hours\, respectively. In patients with septic shock\, 1/5 patients (20%) and 2/4 patients (50%) in the IVPB and IVP group received doses within one hour\, respectively. Similar rates of in-hospital mortality were seen in septic shock patients\, and no patients experienced a type-1 hypersensitivity reaction.\n\n\n\nConclusion: \; Results showed no difference in administration times between IVP and IVPB ceftriaxone. Post-intervention IVP times to administration in prior studies were comparable to pre-intervention IVPB times to administration at JEPH. Future research should aim to evaluate potential factors that may contribute to delays in time to administration of antibiotics in sepsis and septic shock. \;\n CATEGORIES:MEDICATION SAFETY/QUALITY IMPROVEMENT LOCATION:Broad Hub EAST\, Center City\, Philadelphia SEQUENCE:0 UID:13b923106344c4b9eea29fb46c1da1a5 URL:http://pshp2026residencyconference.sched.com/event/13b923106344c4b9eea29fb46c1da1a5 END:VEVENT BEGIN:VEVENT DTSTAMP:20260520T135913Z DTSTART:20260519T153000Z DTEND:20260519T155000Z SUMMARY:Evaluation of a Pharmacist Driven Naloxone Protocol on Inpatient Naloxone Prescribing: A Retrospective Chart Review DESCRIPTION:Purpose: \;This study was designed to evaluate whether a standardized inpatient pharmacist-driven naloxone protocol increased the number of naloxone prescriptions dispensed to patients at risk for opioid induced respiratory depression (OIRD). \;\nMethods: \;This was a retrospective\, single-center\, cohort study where a pharmacist-driven naloxone protocol was implemented directing pharmacists to identify patients prescribed an opioid and at high risk for OIRD. A report was developed to standardize identification of at-risk patients from April 2025 to June 2025. Pharmacist then counseled on the importance and use of naloxone\, communicated with providers\, and pended naloxone prescriptions. Patients included were those at risk for OIRD and expected to take opioids at discharge or have a diagnosis of opioid use disorder. Patients excluded were those less than 18 years old and those discharged to a rehabilitation or skilled nursing facility. Patients were characterized into either a pre- or post-protocol group based off the discharge date. Dispensing of the naloxone prescription was then confirmed with the affiliated outpatient pharmacy. This study was approved by the institutional review board. \;\nResults: \;Those included in the pre- and post-protocol groups were 54 and 42\, respectively. The median age was 44 (range\, 39 to 55)\, median BMI was 24 (range\, 20 to 30) and median outpatient MME per day per patient was 180 (range\, 45 to 564) in the pre-protocol group. The median age was 42 (range\, 36 to 51)\, median BMI was 25 (range\, 22 to 34) and median outpatient MME per day per patient was 94 (range\, 46 to 360) in the post-protocol group. The total number of orders pended in the post-protocol group was 9 out of 42 (21%) and common reasons for not pending were either not documented (43%) or already had naloxone (28%). The number of naloxone prescriptions dispensed outpatient in the pre- and post-protocol groups are pending.  \;\nConclusion: \;The most common risk factors identified for OIRD were active smoking\, diagnosis of opioid use disorder\, and concomitant sedative/hypnotic use. The most common outpatient opioids prescribed were methadone\, oxycodone\, and buprenorphine/naloxone. Results on the impact on naloxone dispensing are pending. \;\n CATEGORIES:ADDICTION MEDICINE/PAIN MANAGEMENT LOCATION:Broad Hub WEST\, Center City\, Philadelphia SEQUENCE:0 UID:d01d1e93b284c66d062591b1bd73bfd7 URL:http://pshp2026residencyconference.sched.com/event/d01d1e93b284c66d062591b1bd73bfd7 END:VEVENT BEGIN:VEVENT DTSTAMP:20260520T135913Z DTSTART:20260519T153000Z DTEND:20260519T155000Z SUMMARY:Impact of a Pharmacist-Driven Antimicrobial Stewardship Initiative on Time to Targeted Therapy for Enterobacterales Bacteremia DESCRIPTION:Objective: \;The purpose of this study was to evaluate the impact of a pharmacist-driven antimicrobial stewardship (ASP) initiative using rapid diagnostic testing (RDT) on de-escalation of antipseudomonal antibiotic therapy for Enterobacterales bloodstream infections (BSIs).  \;\nMethods: \;This was a multi-center\, retrospective\, comparative cohort study was approved by the institutional review board review (IRB) and included a sample of adult patients with Enterobacterales bacteremia who received empiric antipseudomonal therapy. Treatment was compared pre- and post- implementation of RDT. The primary outcome was time (hours) to de-escalation of antipseudomonal coverage. Secondary outcomes included days of antipseudomonal antibiotic therapy\, 30-day mortality\, and incidence of Clostridioides difficile infection (CDI). A subgroup analysis was also conducted to evaluate the use of anti-methicillin resistant Staphylococcus aureus (MRSA) therapy. Antimicrobial stewardship activities were also evaluated in the post-implementation group. \;\nResults: \;This study included 44 patients in the pre-implementation group and 60 patients in the post-implementation group. Baseline characteristics were comparable between both groups. The median time (hours) to de-escalation of antipseudomonal coverage for Enterobacterales bacteremia was found to be significantly lower in the post-implementation group (9.3 vs 50.5\, p <\; 0.001). Median days of therapy was also found to be lower in the post-implementation group (2 vs 4 days\, p <\; 0.001). The 30-day mortality rate\, CDI events\, and days of anti-MRSA therapy were not statistically different between groups. \;\nConclusion: \;This study demonstrated that a pharmacist-driven antimicrobial stewardship initiative was successful in reducing time to targeted therapy in hospitalized patients receiving treatment for Enterobacterales bacteremia. CATEGORIES:INFECTIOUS DISEASES LOCATION:a.Pavilion Hub EAST\, Center City\, Philadelphia SEQUENCE:0 UID:35296a021e9ae27ba8fcd2b5c23243a0 URL:http://pshp2026residencyconference.sched.com/event/35296a021e9ae27ba8fcd2b5c23243a0 END:VEVENT BEGIN:VEVENT DTSTAMP:20260520T135913Z DTSTART:20260519T155000Z DTEND:20260519T170000Z SUMMARY:Lunch & Networking with Exhibitors DESCRIPTION:Grab your lunch and network with exhibitors CATEGORIES:EVENT LOCATION:Franklin Square (13th Floor Downstairs)\, Center City\, Philadelphia SEQUENCE:0 UID:f2312f2bac6c0a95d3e96f084c57ce54 URL:http://pshp2026residencyconference.sched.com/event/f2312f2bac6c0a95d3e96f084c57ce54 END:VEVENT BEGIN:VEVENT DTSTAMP:20260520T135913Z DTSTART:20260519T170000Z DTEND:20260519T180000Z SUMMARY:Panel Discussion: From Residency Training to Practice Success DESCRIPTION:Panel Discussion with Residency Program Directors & New Practitioners. Open to all attendees. Justin Miller (St. Luke's University Health Network)\, Jeff Sivik (Penn State Hershey)\, Emily Casey (Hospital of the University of Pennsylvania)\, Samantha Macko (Thomas Jefferson University Hospital)\, Matt Alspach (Tower Health)\, Anthony Trono (Main Line Health)\, Moderated by Jill Rebuck (PSHP) CATEGORIES:GENERAL SESSION LOCATION:Forum (13th Floor Downstairs)\, Center City\, Philadelphia SEQUENCE:0 UID:11ee17b47e70f20ed1d2d569ef008e0f URL:http://pshp2026residencyconference.sched.com/event/11ee17b47e70f20ed1d2d569ef008e0f END:VEVENT BEGIN:VEVENT DTSTAMP:20260520T135913Z DTSTART:20260519T180000Z DTEND:20260519T182000Z SUMMARY:Clinical Pearl: Emerging Therapies in Lipid Lowering DESCRIPTION:0.25 contact hour continuing education CATEGORIES:SESSION LOCATION:a.Pavilion Hub EAST\, Center City\, Philadelphia SEQUENCE:0 UID:d1f23c7a4f21459da07734479f1c9754 URL:http://pshp2026residencyconference.sched.com/event/d1f23c7a4f21459da07734479f1c9754 END:VEVENT BEGIN:VEVENT DTSTAMP:20260520T135913Z DTSTART:20260519T180000Z DTEND:20260519T182000Z SUMMARY:Preceptor Pearl: The Parfait Approach\, Layered Learning Without the Crunch DESCRIPTION:0.25 contact hour continuing education CATEGORIES:SESSION LOCATION:a.Pavilion Hub WEST\, Center City\, Philadelphia SEQUENCE:0 UID:91e1d7becb5006e62aca720562b2036b URL:http://pshp2026residencyconference.sched.com/event/91e1d7becb5006e62aca720562b2036b END:VEVENT BEGIN:VEVENT DTSTAMP:20260520T135913Z DTSTART:20260519T182000Z DTEND:20260519T184000Z SUMMARY:Clinical Pearl: All in Favor Say AI: Key Considerations in AI for Critical Care Medicine DESCRIPTION:0.25 contact hour continuing education CATEGORIES:SESSION LOCATION:a.Pavilion Hub EAST\, Center City\, Philadelphia SEQUENCE:0 UID:f4b80e8e007ed1959e5ccbf31c025495 URL:http://pshp2026residencyconference.sched.com/event/f4b80e8e007ed1959e5ccbf31c025495 END:VEVENT BEGIN:VEVENT DTSTAMP:20260520T135913Z DTSTART:20260519T182000Z DTEND:20260519T184000Z SUMMARY:Preceptor Pearl: Mapping It Out - Preceptor Readiness Program DESCRIPTION:0.25 contact hour continuing education CATEGORIES:SESSION LOCATION:a.Pavilion Hub WEST\, Center City\, Philadelphia SEQUENCE:0 UID:3d0a5261acae1fd213f1d2c45c3d4799 URL:http://pshp2026residencyconference.sched.com/event/3d0a5261acae1fd213f1d2c45c3d4799 END:VEVENT BEGIN:VEVENT DTSTAMP:20260520T135913Z DTSTART:20260519T184000Z DTEND:20260519T190000Z SUMMARY:Clinical Pearl: Pump It Up! Improving Patient Outcomes with Automated Insuin Delivery Systems for Type 2 Diabetes DESCRIPTION:0.25 contact hour continuing education CATEGORIES:SESSION LOCATION:a.Pavilion Hub EAST\, Center City\, Philadelphia SEQUENCE:0 UID:4171f6f6520dd6689ed010018804a20d URL:http://pshp2026residencyconference.sched.com/event/4171f6f6520dd6689ed010018804a20d END:VEVENT BEGIN:VEVENT DTSTAMP:20260520T135913Z DTSTART:20260519T184000Z DTEND:20260519T190000Z SUMMARY:Preceptor Pearl: Use of Custom Evaluations to Drive Consistent\, Timely and Structured Resident Feedback DESCRIPTION:0.25 contact hour continuing education CATEGORIES:SESSION LOCATION:a.Pavilion Hub WEST\, Center City\, Philadelphia SEQUENCE:0 UID:beb4e8b6d49b2c6bf298ce682b8c6d7f URL:http://pshp2026residencyconference.sched.com/event/beb4e8b6d49b2c6bf298ce682b8c6d7f END:VEVENT BEGIN:VEVENT DTSTAMP:20260520T135913Z DTSTART:20260519T190000Z DTEND:20260519T200000Z SUMMARY:Encore of Top 3 PGY1 Resident Platform Presentations DESCRIPTION:Voting for Top PGY1 Platform and PGY1/PGY2 Resident Award Announcements. Open to all preceptors and residents. CATEGORIES:GENERAL SESSION LOCATION:Forum (13th Floor Downstairs)\, Center City\, Philadelphia SEQUENCE:0 UID:15c5b6b4c3b640a8f03ea4ce3769f0a3 URL:http://pshp2026residencyconference.sched.com/event/15c5b6b4c3b640a8f03ea4ce3769f0a3 END:VEVENT BEGIN:VEVENT DTSTAMP:20260520T135913Z DTSTART:20260519T200000Z DTEND:20260519T201500Z SUMMARY:PGY1 & PGY2 Award Announcements / Closing Comments DESCRIPTION: CATEGORIES:GENERAL SESSION LOCATION:Forum (13th Floor Downstairs)\, Center City\, Philadelphia SEQUENCE:0 UID:4aaf03538871817cc2f5dfa344737804 URL:http://pshp2026residencyconference.sched.com/event/4aaf03538871817cc2f5dfa344737804 END:VEVENT END:VCALENDAR