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PubMed1986

A drug distribution system to supply a detached ambulatory surgery center from the main hospital's central pharmacy.

Ambulatory surgery centers (ASCs) and other outpatient service facilities are becoming more prevalent throughout the country. The development and implementation of a drug distribution system to supply a detached ambulatory surgery center is described. The method proposed to provide all the medication needed for the ASC uses a unit-dose cart with lockable doors. The cart is delivered to the ASC each morning by nonpharmacy hospital transportation personnel. A locked case method similar to the system described by McClure-Zola et al. is employed for schedule II controlled substances. Specific formularies were developed for the anesthesia and the operating/recovery rooms. Medications for both areas are arranged separately in the cart. The cart is returned to the pharmacy at the end of each ASC day to be replenished on the night shift by the pharmacy staff. Additional full-time equivalents are not required in the pharmacy budget to provide this service. The system described provides a simple method for efficiently and effectively meeting the medications needs of a free-standing satellite of the hospital.

Centralized Hospital Services↗
PubMed1990

Therapeutic drug monitoring in a community hospital.

This study describes an aminoglycoside dosing service in a community hospital. Between 95 and 98% of all aminoglycoside doses are calculated by staff pharmacists using traditional pharmacokinetic equations. All patients dosed by the pharmacy are then monitored by clinical pharmacists who make necessary dosage modifications following serum peak and trough levels. After the first year of this service, it was determined that a slight change in the volume of distribution equation would allow the pharmacy to calculate maintenance doses that would more accurately result in estimated serum peak and trough levels. Physicians are pleased with this service and professional job satisfaction is experienced by the pharmacists. Therapeutic drug monitoring is an important component of patient care and can be implemented in community hospitals. Other pharmacy departments are encouraged to establish similar services.

Aminoglycosides↗
PubMed1976

Comprehensive pharmacy services in an 85-bed hospital.

The development of a unit dose drug distribution system, centralized intravenous admixture program and clinical pharmacy services in a small hospital is discussed. The steps taken to implement and justify the programs and an outline of procedures followed is included.

Costs and Cost Analysis↗
PubMed1986

Strategic planning for clinical services: Hamot Medical Center.

As a result of a two-day strategic-planning program, a hospital pharmacy department developed a five-year plan for addressing seven critical issues facing the department. The pharmacy department at a large nonprofit community hospital began a formal planning process in 1981 after concluding that the existing clinical services had been implemented in a haphazard fashion and had mixed results. The planning process began with a two-day planning program aimed at identifying issues facing the department, followed by the development of consensus about the most important issues and the development of action plans for dealing with these. The planning program consisted of four parts: presentations by hospital administrators, nurses, and the medical staff on future directions in their respective areas and pharmacy's potential input; presentations on the future of pharmacy from the perspectives of the pharmacy director and the responsible hospital administrator; preliminary recommendations related to drug distribution services and clinical services by two pharmacy consultants; and discussions of departmental management issues and key points identified in previous sessions. The department's progress in addressing each of the seven critical issues is described; most of the action plan has been completed. The consensus-building planning process allowed the department to focus on the most important issues, identify support and possible conflicts from others, and obtain administrative approval of the department's focus on patient-oriented services.

Cost-Benefit Analysis↗
PubMed1980

Effects of primary nursing on pharmaceutical services.

The effects of primary care nursing on the provision of pharmaceutical services are discussed. Primary care nursing poses advantages and disadvantages for pharmacy. It makes communications and distribution more complex, except when pharmaceutical services are decentralized. Introduction of innovative patient care pharmaceutical services has been made more difficult. Solutions to these problems include assigning pharmacist/technician teams to specific patient-care areas, orienting nursing staff to the pharmacy department, and establishing committees to handle potential problems.

Medication Systems, Hospital↗
PubMed1977

Integration of pharmacy into the computerized problem-oriented medical information system (PROMIS)--a demonstration project.

The integration of pharmacy into the computerized problem-oriented medical information system (PROMIS) at the Medical Center Hospital of Vermont is discussed. Practioners who generate and retrieve information communicate directly with the computer without intermediary personnel. Touch-screen cathode-ray tube terminals are used for data input. Under PROMIS, the pharmacist has two new resources which better integrate his services into total patient care: (1) the ability to directly access online patient data in the pharmacy, and (2) the ability to directly couple online current drug information to a specific patient's computerized medical record in the pharmacy. The PROMIS solutions to pharmacy problems in drug ordering, drug distribution and drug therapy audit are discussed; In a demonstration project on a 20-bed unit, PROMIS made the medical record readily available to all health care providers, reduced reliance on memory, preserved the logic of medical action, and provided feedback loops for corrective action in everyday medical practice. Also discussed are user acceptance of the system, effect on pharmacy staffing, and implications for pharmacy.

Computers↗
PubMed1995

University-based sports pharmacy program.

Ways for pharmacists to become involved in sports pharmacy are discussed, and a university-based sports pharmacy program is described. Sports pharmacy encompasses treating athletic injuries, distributing drugs and sports-related supplies, counseling patients, and monitoring therapeutic outcomes, along with educating athletes, trainers, and others about drug use and abuse. Pharmacists can contribute their expertise by presenting information at schools, health clubs, and other exercise-related organizations. They can serve on drug-testing crews at collegiate athletic events. Pharmacists can also provide supplies and services to schools or athletic facilities; ideally, this could be a contractual arrangement to provide comprehensive pharmaceutical care. A sports pharmacy program was implemented at the University of North Carolina at Chapel Hill in 1980. Pharmacists provide drug therapy monitoring and patient education to all patients at the school; patients' level of athletic activity is taken into consideration. Pharmacists also ensure proper use, storage, and distribution of drugs kept in clinics, training rooms, and sports medicine travel bags, as well as identifying and providing drugs and supplies that might be needed at an off-campus event. They provide inservice education to athletic trainers and physicians. The program has improved patient outcomes and helped to ensure adequate drug supplies and minimum waste. There are numerous opportunities for practitioners to become involved in sports pharmacy. A university-based sports pharmacy program improved the care of student athletes and helped contain drug costs.

Athletic Injuries↗
PubMed1986

Justifying a pediatric critical-care satellite pharmacy by medication-error reporting.

As a part of an evaluation of the need for a satellite pharmacy to serve two pediatric critical-care units, an observational study was conducted to determine the incidence of medication errors in the units. A pharmacist observed nurses preparing and administering medications in 18 12-hour shifts. Of the nine shifts observed in each unit, five were day shifts and four were night shifts. Five nurses were observed per shift in the intensive-care nursery (ICN) and three nurses per shift in the pediatric intensive-care unit (PICU). The classification of errors was based on the definitions established by the American Society of Hospital Pharmacists. The total error rate was 17.4% in the ICN and 38.0% in the PICU. When the error rates were calculated excluding wrong-time errors, they were 7.1% in the ICN and 11.7% in the PICU. Of 147 errors, 124 (84.4%) occurred with medications with a high potential for serious consequences. The error rates were similar on the day and night shifts in the PICU (42.1% and 31.3%, respectively), but they were significantly higher on the day shifts than the night shifts in the ICN (24.5% and 8.4%, respectively). The number of medication errors in the two units was substantial, and steps were taken to implement a 24-hour pediatric critical-care satellite pharmacy with unit dose drug distribution to reduce the incidence of errors.

Centralized Hospital Services↗
PubMed1986

Strategic planning for clinical services: St. Joseph Hospital and Health Care Center.

A pharmacy department at a 340-bed community hospital based its strategic plan for developing patient-oriented services on a sound drug distribution system, a credible work-measurement program, and fiscal responsibility. In 1982 the department of pharmacy and i.v. therapy implemented a strategic plan for improving pharmaceutical services. The plan involved developing goals and objectives for the department; marketing the department's services and fiscal management to hospital administrators, medical staff, and nursing staff; building teamwork among the pharmacy staff; and improving the drug distribution system before instituting clinical services. Hiring of additional pharmacy staff was justified on the basis of work-measurement data. By adjusting staffing levels every two weeks based on work-measurement data, the department increased the efficiency of drug distribution activities; the pharmacy also implemented cost-saving programs like selection of therapeutic alternates and formulary restrictions. The savings were then reinvested in labor-intensive patient-oriented pharmaceutical services. A staff development program using staff pharmacists as preceptors expanded the breadth and depth of pharmacists' clinical skills. The planning efforts were successful because the needs of hospital administrators, the pharmacy department, and staff members were addressed.

Hospital Bed Capacity, 300 to 499↗
PubMed1986

Decentralization of pharmaceutical services in a large hospital complex.

The decentralization of pharmaceutical services to two patient-care areas remote from the central pharmacy in a large hospital complex is described. The addition of a fifth building to a large hospital complex led to problems with drug distribution and interprofessional communication, since the pharmacy that provided services to the 120 beds in the new building was located in a building some distance away. Decentralization of pharmaceutical services to a 24-bed surgical intensive-care unit and a 48-bed surgical patient-care unit in the new building was accomplished through a satellite pharmacy located on the intensive-care unit with support from a mobile medication cart located on the surgical unit. The satellite is staffed from 0700 to 2200 each day by one pharmacist and one technician per eight-hour shift. Evaluations of medication turnaround time, number of interactions with nurses and physicians, efficiency of the drug distribution system, quantity of floor stock maintained on the units, and productivity performed before and after the implementation of decentralized services indicated improvements in all areas. A survey of the nursing staff indicated that nurses were very satisfied with the improvements in pharmaceutical services. The implementation of decentralized pharmaceutical services in two patient-care areas remote from the central pharmacy was successful in improving services to these areas.

Centralized Hospital Services↗
PubMed1990

The challenge of health care developments for hospital pharmacy.

The traditional role of hospital pharmacists in drug analysis and drug compounding broadened to a patient-oriented approach during the sixties and seventies. The clinical pharmacy concept was adopted. This practice includes daily-prepared total parenteral nutrition and chemotherapy, sophisticated analgesic systems, individualized drug distribution and specific information. The hospital pharmacy provides aseptic procedures as well as specialized logistics. Clinical pharmacy practice concentrates on tailor-made pharmaceutical care. As home health care usually deals with therapeutic modalities, this approach offers great possibilities for highly skilled out-patient care. Financial and legal interferences and the traditional gap between in-patient care and out-patient care must be removed. Home health care challenges the hospital pharmacists to place his knowledge and abilities at the disposal of this new type of patient care.

Delivery of Health Care↗
PubMedDate not supplied

[Hospital pharmacy and clinical trials. Requirement of procedures and protocol of administration and distribution of drug].

Law established a holding and a distribution, by the hospital pharmacist, of the clinical trial drugs. These operations can only be achieved with written procedures. Two sorts of procedures are required: general procedures for the whole of trials and special procedures for each of them. In that setting, a protocol for administration and distribution of drug involved in one study is established. It is intended for the three partners of the trial: sponsor, clinical investigator, and pharmaceutical department itself. It gives to these partners all the relevant informations so as to lead the operations and their chronology. This system has been acting in the hospital for a year. It appeared reliable for the three partners in about thirty trials. So, it can be considered as validated.

Clinical Trials as Topic↗
PubMed2006

Influence of attitudes toward curriculum on dishonest academic behavior.

OBJECTIVES: The objective of this study was to examine possible associations between students' self-reported behaviors and opinions towards academic dishonesty, and their attitudes towards curriculum, assessment, and teaching within the pharmacy program. METHODS: A questionnaire was developed and distributed to undergraduate (pre-licensure) students at 4 schools of pharmacy in Canada, including students enrolled in the international pharmacy graduate program. RESULTS: More than 80% of respondents indicated they had participated in one or more of the act of academic dishonesty described in the questionnaire. A weak to moderate correlation was found between students' attitudes towards pharmacy education and their self-reported behaviors related to academic dishonesty. CONCLUSIONS: This study confirmed previous findings suggesting widespread academic dishonesty as well as a hierarchy of values with respect to students' perceptions regarding severity and importance of academic dishonesty. Despite methodological limitations inherent in examining academic dishonesty, there is a definite need to continue to examine this important issue. While this study indicated only a moderate correlation between attitudes towards curriculum and dishonest behaviors, the problem of academic misconduct is multifactorial and will require ongoing study.

Attitude↗
PubMed2006

[Survey of the attitude of master course students of clinical pharmacy toward clinical trials].

To obtain basic data on the introductory lecture on clinical trials in a School of Pharmacy, we carried out an attitude survey among master course students in the School of Pharmacy of our University. We distributed two types of questionnaire, one before and one after a lecture on the outline of clinical trials and the role of pharmacists in the performance of clinical trials. In the first questionnaire, 67% of respondents were interested in clinical trials, and 89% stated that they had obtained information on clinical trials from lectures at the University. On the other hand, over 92% thought that pharmacists should manage investigational drugs and provide information on those drugs for the rational conduct of clinical trials. Over 80% of respondents hoped that they would receive education on clinical trials in the third or fourth year of study, since that is when basic education ends and clinical education starts. After the first questionnaire and student attendance at an introductory lecture on clinical trials, second questionnaire was distributed. Based on the results of the second questionnaire, almost all of the students hoped to learn more about the actual conduct of clinical trials.

Attitude of Health Personnel↗