Implementation of the VancomycIn per Pharmacy Education tRaining (VIPER) program for pharmacists at a children’s hospital

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Abstract
Purpose: Pharmacists play a vital role in supporting the safe and efficacious use of vancomycin in children. However, vancomycin dosing in children is challenging, and recent recommendations for implementation of 24-hour area under the curve (AUC24)–based dosing and model informed precision dosing (MIPD) approaches introduce additional complexity. Herein, we describe the development and implementation of a “VancomycIn per Pharmacy Education tRaining” (VIPER) program that supports a pharmacy-led vancomycin therapeutic drug monitoring (TDM) service at a children’s hospital. Summary: Our children’s hospital implemented a formal VIPER program to educate and evaluate the competency of pharmacists on vancomycin therapeutic principles in children, including AUC24-based dosing and use of a commercially available MIPD tool. Pharmacists were required to complete the VIPER core program prior to managing TDM independently in children. VIPER maintenance programs were delivered annually to sustain and expand knowledge. Pharmacists’ perceptions of VIPER were captured annually via survey. Since implementation of VIPER in 2020, over 100 pharmacists have received training. Overall, pharmacists rated the VIPER program highly, with 89% (96/108) agreeing or strongly agreeing that VIPER was an effective strategy for delivering institutional guideline updates and 84% (91/108) agreeing or strongly agreeing they felt more confident in vancomycin dose adjustments in children after VIPER. Competency assessment also demonstrated that pharmacist postcourse knowledge was high (a median score of ≥85% for each year). Conclusion: VIPER, a formal, yearly educational program, was successfully implemented at our hospital to help support a pharmacist-led vancomycin TDM service in children. The pharmacists reported high satisfaction with VIPER and agreed the program was a successful format for delivering education and improving skills.

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