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PubMedDate not supplied

Community pharmacy managers' perception of computerized drug-drug interaction alerts.

OBJECTIVE: To examine community pharmacists' attitudes toward computerized drug-drug interaction (DDI) alerts and identify factors associated with more favorable perceptions of these alerts. DESIGN: Cross-sectional postal survey. SETTING: 18 metropolitan statistical areas (MSAs) in the United States. PARTICIPANTS: 3000 community pharmacy managers. INTERVENTIONS: 34-item survey instrument designed to collect data about the pharmacy including demographics, workload issues, handling of DDIs, and pharmacists' attitudes toward computerized DDI alerts. MAIN OUTCOME MEASURE: Responses to items concerning community pharmacy managers' attitudes toward DDI alerts and factors associated with more favorable attitudes toward these alerts. RESULTS: A total of 736 usable surveys were returned (25.3% response rate). Pharmacy managers generally disagreed that DDI alerts were a waste of time (mean +/- SD, 2.1 +/- 1.1 on a scale of 1, strongly disagree, to 6, strongly agree). However, they were not completely confident that their computer systems provided them with meaningful DDI alerts (mean +/- SD, 4.5 +/- 1.2). They were confident in their ability to identify DDIs (mean +/- SD, 4.9 +/- 0.9) and discuss DDIs with physicians (mean +/- SD, 5.2 +/- 0.7). Pharmacy software that provided detailed DDI information as well as the ability to customize DDI alerts were associated with more favorable perceptions of DDI alerts. CONCLUSION: Despite being presented with a large proportion of clinically unimportant alerts, community pharmacy managers did not believe DDI alerts were meaningless or a waste of time. Incorporation of features that streamline DDI alerts may improve their effectiveness in community pharmacy practice.

Attitude to Computers↗
PubMedDate not supplied

Effect of attitudes and perceptions of independent community pharmacy owners/managers on the comprehensiveness of strategic planning.

OBJECTIVE: To assess the attitudes and perceptions of independent community pharmacy owners/managers about the comprehensiveness of strategic planning conducted for their pharmacies. DESIGN: Cross-sectional study. SETTING: United States. PARTICIPANTS: Nationwide random sample of 1,250 owners/managers of independent community pharmacies. INTERVENTION: Mailed survey. MAIN OUTCOME MEASURES: Comprehensiveness of strategic planning conducted; components used in the strategic planning process. Attitudes and perceptions of owners/managers of independent community pharmacies toward strategic planning. RESULTS: A total of 527 (42.1%) usable questionnaires were returned. Of the 141 (26.8%) respondents who indicated that they conduct strategic planning, most components of the process were used. However, only 78 (55.3%) of those respondents conducted a review of pharmacy systems, and only 60 (42.6%) periodically evaluated implemented strategies. Approximately 88% of the variance in comprehensiveness was accounted for by 12 variables identified as significantly associated with the comprehensiveness of strategic planning conducted by owners/managers of independent community pharmacies. These included factors such as favorable cost-benefit relationship, impact of the Medicare Modernization Act of 2003, and remaining competitive in the pharmacy marketplace. CONCLUSION: While a minority of the survey population, respondents who reported conducting strategic planning used a reasonably comprehensive process. Further, several variables were identified as significant factors associated with comprehensiveness of strategic planning conducted.

Attitude↗
PubMed2003

Pharmacy practitioners' views on computerized documentation of drug-related problems.

OBJECTIVE: To evaluate the practice by community pharmacy practitioners of computerized documentation of drug-related problems (DRPs) and pharmacy interventions in nonprescription drug consumers. METHODS: A questionnaire was administered in December 1999 to pharmacy practitioners in 45 community pharmacies of different sizes and locations across Sweden to survey their attitudes and experiences after participation in a 10-week period of computerized DRP documentation. RESULTS: The participants (n = 376, response rate 84%) found the development of computerized documentation of DRPs and pharmacy interventions to be very important. The instrument was perceived as easy to learn and to work well in daily practice. The documentation made many practitioners more attentive to the drug-related needs of self-care consumers and changed their perception of good quality in self-care counseling. The weighted multiple linear regression analysis showed no correlation between the proportion of practitioners experiencing time constraints and the DRP documentation rate of their work site. However, the magnitude of interest in the documentation practice had a significant effect on the documentation rate, regardless of the extent of the time constraints experienced (p = 0.004). CONCLUSIONS: The positive findings of the evaluation speak in favor of an expanded implementation of computerized documentation of DRPs and pharmacy interventions. Commitment among participating pharmacy practitioners to the new practice is essential and appears to overcome possible time constraints.

Attitude of Health Personnel↗
PubMed2005

Including the assessment of nontraditional factors in pharmacy school admissions.

OBJECTIVE: To review the relevant literature regarding the predictive ability of cognitive measures (ie, Pharmacy College Admissions Test [PCAT] scores and prepharmacy grade point average [GPA]) on both academic and clinical performance and discuss the inclusion of nontraditional assessment during the admissions process. DATA SOURCES: Articles were identified through searches of International Pharmaceutical Abstracts (1970-April 2004), MEDLINE (1966-January 2004), and ERIC (1966-April 2004) using the key words admissions variables, predictors of success, Pharmacy College Admissions Test, grade point average, cognitive variables, and noncognitive variables. STUDY SELECTION AND DATA EXTRACTION: Cross-sectional, longitudinal, and retrospective studies, as well as reviews, regarding pharmacy school and other higher education admissions' variables were included in this review. DATA SYNTHESIS: Many pharmacy school admissions committees give a majority weight to the traditional cognitive markers of prepharmacy GPA and PCAT scores when selecting viable applicants. Doing so may be problematic due to the magnitude of the relationship between traditional cognitive predictors and pharmacy school performance. CONCLUSIONS: Based on this review, a cogent argument is advanced for the need to examine, in addition to PCAT scores and GPAs, such nontraditional factors as empathy, citizenship, and ethical behavior. This may increase the predictive ability of preadmission factors on pharmacy school didactic and clinical performance. Schools of pharmacy can do this through questionnaires and interviews designed to assess nontraditional variables.

Humans↗
PubMed2005

Assessing the utility of a community pharmacy refill record as a measure of adherence and viral load response in patients infected with human immunodeficiency virus.

STUDY OBJECTIVE: To assess the utility of a community pharmacy refill record as a measure of adherence to antiretroviral agents and as a predictor of viral load response. DESIGN: Retrospective review of laboratory and community pharmacy records. SETTING: University-based human immunodeficiency virus (HIV) clinic and local community pharmacy. PATIENTS: Ninety-four patients with HIV or the acquired immunodeficiency syndrome (AIDS) who visited both settings and had retrievable pharmacy and laboratory records. MEASUREMENTS AND MAIN RESULTS: Community pharmacy records were compiled and screened for antiretroviral agent refill histories. The continuous, multiple-interval measure of medication gaps (CMG), a measure of drug nonadherence, was calculated for each antiretroviral agent. Viral load information was retrieved from the clinic records of patients who had a community pharmacy refill record documenting the previous 2 years. As refill nonadherence increased, viral load response increased, following an approximately sigmoid relationship. When the CMG score was less than 0.10, the viral load response did not change appreciably. The steepest rise in viral load response occurred with a CMG score ranging from 0.10-0.19. For values of 0.20 or greater, the viral load response was less sensitive to adherence performance. The probability (i.e., sensitivity) of having at least a 10% nonadherence record given a viral load greater than 1000 copies/ml was 80%. CONCLUSION: The community pharmacy refill record is a convenient, accessible, and useful tool for assessing adherence and predicting viral load outcomes in patients with HIV and AIDS.

Adult↗
PubMed2001

Interrelationships among mortality rates, drug costs, total cost of care, and length of stay in United States hospitals: summary and recommendations for clinical pharmacy services and staffing.

We evaluated interrelationships and associations among mortality rates, drug costs, total cost of care, and length of stay in United States hospitals. Relationships between these variables and the presence of clinical pharmacy services and pharmacy staffing also were explored. A database was constructed from the 1992 American Hospital Association's Abridged Guide to the Health Care Field, the 1992 National Clinical Pharmacy Services database, and 1992 Health Care Finance Administration mortality data. A severity of illness-adjusted multiple regression analysis was employed to determine relationships and associations. Study populations ranged from 934-1029 hospitals (all hospitals for which variables could be matched). The only pharmacy variable associated with positive outcomes with all four health care outcome measures was the number of clinical pharmacists/occupied bed. That figure tended to have the greatest association (slope) with reductions in mortality rate, drug costs, and length of stay. As clinical pharmacist staffing levels increased from the tenth percentile (0.34/100 occupied beds) to the ninetieth percentile (3.23/100 occupied beds), hospital deaths declined from 113/1000 to 64/1000 admissions (43% decline). This resulted in a reduction of 395 deaths/hospital/year when clinical pharmacist staffing went from the tenth to the ninetieth percentile. This translated into a reduction of 1.09 deaths/day/hospital having clinical pharmacy staffing between these staffing levels, or 320 dollars of pharmacist salary cost/death averted. Three hospital pharmacy variables were associated with reduced length of stay in 1024 hospitals: drug protocol management (slope -1.30, p=0.008), pharmacist participation on medical rounds (slope -1.71, p<0.001), and number of clinical pharmacists/occupied bed (slope -26.59, p<0.001). As drug costs/occupied bed/year increased, severity of illness-adjusted mortality rates decreased (slope -38609852, R(2) 8.2%, p<0.0001). As the total cost of care/occupied bed/year increased, those same mortality rates decreased (slope -5846720642, R(2) 14.9%, p<0.0001). Seventeen clinical pharmacy services were associated with improvements in the four variables.

Cost Savings↗
PubMed2006

Sleep and wakefulness disturbances in Swiss pharmacy customers.

BACKGROUND AND OBJECTIVE: Sleep disturbances are prevalent but often overlooked or underestimated. We suspected that sleep disorders might be particularly common among pharmacy customers, and that they could benefit from counselling. Therefore, we described the prevalence and severity of symptoms associated with sleep and wakefulness disorders among Swiss pharmacy customers, and estimated the need for counselling and treatment. METHODS: In 804 Swiss pharmacies (49% of all community pharmacies) clients were invited to complete the Stanford Sleep Disorders Questionnaire (SDQ), and the Epworth Sleepiness Scale (EPW). The SDQ was designed to classify symptoms of sleep and wakefulness into the four most prevalent disorders: sleep apnoea syndrome (SAS), insomnia in psychiatric disorders (PSY), periodic leg movement disorders/restless legs (RLS) and narcolepsy (NAR). Data were entered into an internet-linked database for analysis by an expert system as a basis for immediate counselling by the pharmacist. RESULTS: Of 4901 participants, 3238 (66.1%) were female, and 1663 (33.9%) were male. The mean age (SD) of females and males was 52.4 (18.05), and 55.1 (17.10) years, respectively. The percentages of female and male individuals above cut-off of SDQ subscales were 11.4% and 19.8% for sleep apnoea, 40.9% and 38.7% for psychiatric sleep disorders, 59.3% and 46.8% for restless legs, and 10.4% and 9.4% for narcolepsy respectively. The prevalence of an Epworth Sleepiness Scale score >11 was 16.5% in females, and 23.9% in males. Reliability assessed by Cronbach's alpha was 0.65 to 0.78 for SDQ subscales, and for the Epworth score. CONCLUSIONS: Symptoms of sleep and wakefulness disorders among Swiss pharmacy customers were highly prevalent. The SDQ and the Epworth Sleepiness Scale score had a satisfactory reliability to be useful for identification of pharmacy customers who might benefit from information and counselling while visiting pharmacies. The internet-based system proved to be a helpful tool for the pharmacist when counselling his customers in terms of diagnostic classification and severity of symptoms associated with the sleeping and waking state.

Adult↗
PubMed2006

The impact of problem-based learning on students' perceptions of preparedness for advanced pharmacy practice experiences.

OBJECTIVES: To evaluate graduating pharmacy students' perceptions of their preparedness for advanced pharmacy practice experiences and the effectiveness of problem-based learning in their preparation. METHODS: A survey instrument was administered anonymously in May 2004 and May 2005 to graduating pharmacy students of the University of Mississippi School of Pharmacy. RESULTS: Students reported that the areas in which problem-based learning prepared them most effectively for advanced pharmacy practice experiences were retrieval of medical information (80%), discussion of disease states and drug therapies at the basic science level (56%), and evaluation of the appropriateness of a medication regimen based on patient specific information (50%). Areas in which students reported being inadequately prepared included identifying and utilizing drug assistance programs (42%) and processing prescriptions/hospital orders (40%). CONCLUSION: Data from 2 consecutive graduating classes supports that problem-based learning is an effective format for preparing pharmacy students for advanced pharmacy practice experiences in a variety of areas.

Curriculum↗
PubMed1993

Survey of sterile product compounding practices in Canadian hospital pharmacies.

Improper preparation of sterile products by hospital or community pharmacies may have serious consequences. Recent reports of deaths or injury to patients as a result of receiving products that were contaminated during their preparation in a pharmacy have highlighted the importance of maintaining good sterile compounding practices. Efforts are now underway to develop revised guidelines for the compounding of sterile products in order to minimize the potential for future recurrence of similar incidents. This survey study was undertaken to provide background data on current sterile products compounding practices and procedures in Canadian hospital pharmacies. It was also anticipated that these data would be helpful in identifying issues that needed to be addressed in the new guidelines. Surveys were distributed to 700 Canadian hospitals with 50 or more beds. Responses from returned surveys were entered into and analyzed using the database program RBase. A total of 306 hospital pharmacies responded, with 200 indicating that sterile products were compounded within their department. The information provided by respondents provides insight into the types of sterile products being prepared in Canadian hospitals, the training background of staff involved in sterile product preparation, the type of facilities and equipment used for compounding these preparations, and the quality control/quality assurance procedures that are in place in hospital pharmacies. The information arising from this survey underscores the need for comprehensive guidelines or standards with respect to sterile product compounding, and the need for improved training of personnel involved in sterile product compounding. The results should be of interest to hospital pharmacy administrators, pharmacy regulatory bodies, and government agencies responsible for assuring the safety of pharmaceutical products used in patient care.

Canada↗
PubMed1987

OR satellite pharmacies: demographics, services, and implementation.

OR satellite pharmacies are a relatively new addition to a system of pharmacy-coordinated drug distribution. The institution of a pharmacy branch to service the operating room is hypothesized to have a number of advantages over a centralized pharmacy system including improved service, reduced inventory, increased charge capture, better narcotic control, and more efficient drug delivery. Hospital Pharmacy and the OR Satellite Pharmacy Bulletin published a questionnaire to obtain information on OR satellite pharmacies from those actively involved in their planning, implementation, and operation. The questionnaire covered three major areas: demographics, functions and services, and implementation. This article summarizes the results.

Medication Systems, Hospital↗
PubMed1993

[Examples of pharmacies founded in Istanbul at the beginning of the twentieth century].

In this issue we presented five more pharmacies which have historical collections. Infortunately those pharmacies have lost their historical atmosphere, while they have some historical collections. We can find some old books about pharmacy, diploma written in Ottoman language, pharmacy licence, registration note-book, etc. among them. We also noticed some glass, porcelain and brass mortars and pestles in different diameters, weights, portable boxed scales which were the most common ones, cobalt blue syrup bottles which protect the contents from the light, gold gilded porcelain extract and essence bottles with golden gildedor written with golden gild labels, glass funnels, essence oil bottles, cork presser in the shape of a crocodile. Moreover we can see some drugs in their original cartons, which are imported from London, Paris, New York, Leverkusen, Mannheim and Budapest; lamplight, oil paintings of famous Turkish physician Ibn-i Sina, and old Venetian pharmacy, a mythological figure personality in Turkish medical folklore, Lokman Hekim. We can give the following books as examples of rare books which can be seen in those pharmacies: Pathologie speciale, 1888, Paris; Dorvault L'Officine 1910, 1928, 1948, Paris; Dictionnaire Tefeyuz Français-Ottoman 1911, Constantinople; First Turkish Pharmacopoeia, 1930; formulaire Pratique de Therapeutique et de Pharmacologie, 1955. some of the retired pharmacists also keep some historical instruments in their personal collection. We wish sincerely that those collections, also, will take their place in the pharmacy museums soon.

History, 20th Century↗
PubMed2003

Community pharmaceutical care: an 8-month critical review of two pharmacies in Kampala.

BACKGROUND: The concept of pharmaceutical care is neither well developed nor adequately documented in Uganda. OBJECTIVES: This study is therefore an attempt to identify and quantify the various service components of community pharmacy practice in Kampala, Uganda's capital city. SETTING: Two pharmacies operating retail outlets were chosen out of about 110 in Kampala. The city itself is fairly small with a rather congested population. It is Uganda's economic hub with the greatest number of private sector health facilities and pharmacy outlets. METHODS: This study involved an 8-month observation period at the two pharmacies, combined with a data collection form to record demographic characteristics of respondents and parameters such as self-medication, pharmacy initiated therapy, prescription filling, patient/non-patient clients and treatment received. RESULTS: 567 observations were made. Missing data for parameters studied were omitted during analysis, thus yielding different totals for the various sets of variables. Just less than half of 564 respondents (44.3%), were females compared to males (55.7%). The study found that clients over the age of 12 years seeking pharmaceutical services were 8-fold (93.1%) more likely to be the very patients compared to children (OR = 8.3; 95% CI, 3.7-18.7). Slightly over thirty percent of respondents (32.3%) were third party patients. About fifteen percent (14.7%) of respondents came to fill prescriptions, 28.8% to receive pharmacy-initiated therapy and 56.5% came for self-medication with all drugs including antibiotics at 22.4%. Most clients (75.2%) received treatment. The availability of a drug at the pharmacy was found to be a significant predictor of whether treatment was received, with the client age acting as a confounding variable (OR = 59.7; 95% CI 25.9-137.6).

Adolescent↗
PubMed2003

[Availability of antidotes in hospital pharmacies in the Czech Republic].

Availability of antidotes in the Czech Republic (CR) is insufficient. Many antidotes are not approved in CR, so their obtaining is problematic. The purpose of this study is to examine the real availability of antidotes in Czech hospital pharmacies and to assess the influence of hospital size, hospital localisation, antidote cost, and the fact of antidote approval in CR on antidote availability. Finally, some proposals for the solution of the situation are mentioned. A structured questionnaire was constructed and mailed to 85 hospital pharmacies. A total of 46 hospital pharmacies sent back completely answered questionnaires and they were statistically assessed. The questionnaire included a summary of poisonings and usable antidotes. The recommended quantity of each antidote was included. Availability of antidotes (D) and sufficient availability of antidotes (DD) were calculated for each answering hospital pharmacy as a ratio of poisonings for which the antidote was available or available in a sufficient quantity, to all poisonings mentioned in the questionnaire. The other calculated parameter was the availability of an individual antidote (d) and the sufficient availability of an individual antidote (dd)--they were calculated as a ratio of pharmacies stocking the antidote, or stocking the antidote in a sufficient quantity, to evaluated pharmacies. Availability of 23 different antidotes for 20 poisonings was assessed. Antidotes for roughly one half of assessed poisonings are available (D 55.69 +/- 12.42%) and for about one third of poisonings the antidotes are available in a sufficient quantity (DD--37.23 +/- 14.10%). The D and DD have been dependent on hospital size (measured as the number of beds). D and DD have not been dependent on the localisation of the hospital (measured as a period of transport time to the hospital of higher type of care), d and dd ranged between 0-100% and were dependent on the antidote cost. There were significant differences between d and dd of antidotes approved (R) and unapproved (NR) in CR (d(R)--70.51 +/- 33.26%, d(NR)--10.19 +/- 9.26%, p < 0.001; dd(R)--47.55 +/- 29.94%, dd(NR)--6.93 +/- 7.76%, p < 0.001). The results of the study confirm a very unsatisfactory situation in antidote availability in Czech hospital pharmacies. Hospital stocks of many antidotes are inadequate. Often, the antidotes are available, but their quantity is insufficient. The worst situation is in small hospitals, in the very costly antidotes, and in the antidotes not registered in CR.

Antidotes↗
PubMed2003

[Functional characteristics of pharmacy services related to home care--results from two pharmaceutical association surveys in suburban and old town areas].

In order to investigate the implementation about pharmacy services focusing on home care and to identify differences in functional characteristics in accordance with pharmacy location, questionnaire surveys were conducted on all 75 pharmacies belonging to T-City Pharmaceutical Association in a suburban area and on all 161 belonging to K-Ward Pharmaceutical Association in a central downtown district. Using data, a principal component analysis was performed. The following services were investigated: medication guidance for patients and their families; provision of drug information to patients; management of patients' drug history; dispensing; advice to physicians; inquiries; management of prescriptions for home infusion services; sales of items such as over-the-counter [OTC] drugs [commercially available drugs that do not require a physician's prescription]; display and catalogue sales of nursing items; consultation on home care; holding events such as health education programs; guidance for drug management by home visits; and information exchange with other medical professionals and social workers. The results of these surveys were as follows. (1) The following services were regularly performed in both urban and suburban areas: medication guidance for patients and their families; provision drug information to patients; management of patients' drug history; dispensing; advice to physicians; inquiries; and sales of OTC drugs. (2) The following services were not difficiently regularly performed in both areas: display and catalogue sales of nursing items; consultation on home care; holding events such as health education programs; guidance for drug management by home visits; and information exchange. (3) As to principal component analysis, pharmacy functions were divided into 3 components and the dispensing service strongly influenced the functional characteristics in T-City. Whereas, in K-Ward, pharmacy functions were divided into 4 components and consultation and information exchange were strong influences. (4) Home care-relate pharmacy services were closely associated with information exchange on both areas. This implies that enforcing information exchange among pharmacists and other health practitioners and social welfare practitioners is an essential factor to expand implementation of home-care related pharmacy services.

Community Pharmacy Services↗
PubMed2004

Training pharmacy workers in recognition, management, and prevention of STDs: district-randomized controlled trial.

OBJECTIVES: To determine the effectiveness of an intervention for pharmacy workers in improving their recognition and management of sexually transmitted disease (STD) syndromes. METHODS: We randomly selected 14 districts (total population nearly 4 million) from the 24 districts of low socioeconomic status in Lima, Peru. We randomly assigned paired districts to receive training and support for management and prevention of STDs or a control intervention about management of diarrhoea. The STD intervention included interactive luncheon seminars on recognition and management of four STD syndromes (urethral discharge, vaginal discharge, genital ulcers, and pelvic inflammatory disease) and STD/HIV prevention counselling; monthly pharmacy visits by "prevention salespersons" who distributed materials that included "STD/HIV prevention packets" containing information, condoms, and cards given to patients for referral of their sex partners; and workshops for physicians on managing patients with STD syndromes referred from pharmacies. Standardized simulated patients visited pharmacies in intervention and control districts at one, three, and six months after training to assess outcomes. FINDINGS: Standardized simulated patients reported significantly better recognition and management (appropriate antimicrobial regimens provided for discharge syndromes and referral to specially trained physicians for genital ulcers or pelvic inflammatory disease) by pharmacy workers of all four STD syndromes. They also reported significantly more frequent recommendations for use of condoms and treatment of partners at pharmacies in intervention districts than in control districts (by "intention-to-train" analyses, P<0.05 for 47/48 primary outcome comparisons). CONCLUSION: Training was feasible and effectively improved pharmacy workers' practices.

Education, Pharmacy, Continuing↗
PubMed1990

Using pharmacists' perceptions in planning changes in pharmacy practice.

Pharmacists' perceptions of and goals for clinical pharmacy services, as well as the proportion of time devoted to clinical services, were studied at one hospital as part of the process for establishing departmental goals. Three methods were used in evaluating pharmacists' perceptions of clinical pharmacy services. The first was a departmental survey. Second, staff members were asked to generate and prioritize a list of goals for clinical pharmacy services; this was done by means of an interactive, small-group process. Finally, a work-sampling study was performed that indirectly measured use of staff pharmacist and technician time. Staff pharmacists perceived that clinical pharmacy services were being provided to individual patients; however, support for these services from upper management was perceived as inadequate. Staff development had the highest priority for the further development of clinical pharmacy services. Only 19.7% of pharmacists' time was devoted to clinical services. Data from all three studies were incorporated into the development of a strategic plan that set forth long-term departmental goals and objectives. The plan includes a statement of commitment to develop management systems to eliminate deficiencies identified in the study. Among the changes in pharmacy operations introduced as a result of the survey were (1) a career-ladder system, (2) new opportunities for staff development, and (3) improved documentation systems. Surveying staff perceptions of existing services, joint goal setting and prioritization, and work-sampling studies formed the basis for the development and implementation of a new model of integrated pharmacy services at this institution.

Attitude of Health Personnel↗
PubMed1989

Justification of an operating-room satellite pharmacy.

The pharmacy department's documentation of medication handling and control in a 24-suite operating room (OR) complex to justify implementation of an OR pharmacy satellite is described. At a 937-bed hospital, medication inventory, charge capture, and procedures for handling controlled substances were assessed to justify an OR pharmacy both financially and in terms of patient safety. Actual medication charges to patients using the OR billing system were compared with theoretical pharmacy charges based on medication administration records; results indicated that an OR pharmacy would increase gross revenue by $671,606 annually. New collectible revenue from increased charge capture was projected to be $71,926, considering payer mix, reimbursement rates, and current payment methods. The cost of medication inventory in the OR complex was $75,576; a $55,000 inventory reduction and $50,000 annual decrease in drug wastage was projected. First-year personnel costs associated with an OR pharmacy were estimated at $79,872 and equipment and renovation costs at $5,000. New collectible revenue to the institution, after expenses, was projected at $79,959 from the first year of operation and $277,569 after five years. Controlled-substance documentation was incomplete; 19% of fentanyl and 31% of sufentanil removed from inventory were not recorded as administered, returned, or wasted. The results indicated that, at this institution, approximately three OR complex full-time equivalents could be relieved from medication-related activities. Based on the potential for improved patient safety and new revenue generation, implementation of an OR satellite pharmacy was recommended to the hospital administration.

Cost-Benefit Analysis↗
PubMed1988

Impact of computerization on clinical pharmacy services in South Atlantic states.

The impact of computerization on clinical pharmacy services in the South Atlantic region was surveyed. Questionnaires were mailed to 350 hospital pharmacy directors in March 1987. The survey assessed type of computer system, degree of computerization, years computerized, hospital bed capacity, occupancy rate, staffing, presence of a clinical coordinator, and type of clinical services. For analysis of the relationship between clinical services and computerization, only responses indicating an increase in the number of clinical services since 1982 were used. Respondents were asked to rank, in order of importance, factors that they believed enabled clinical services to be increased. The survey response rate was 52.2%, with 179 of 343 usable replies received. The results indicate that there is a link between computerization and clinical services. Computerized pharmacies offered more services on average than did noncomputerized pharmacies. However, the differences in the types of services offered between computerized and noncomputerized pharmacies were not significant. Of the different means of increasing services, pharmacy directors ranked increasing professional staff the most important, followed by increased responsibility of technical staff, computerization, increasing technical staff, hiring a clinical coordinator, and other methods. Pharmacy directors interested in increasing the numbers of clinical services offered at their institutions should consider organizational factors such as departmental structure and number and types of personnel in conjunction with computerization.

Analysis of Variance↗