Organizing a distribution system.
Explore the source record for details and available documents.
Central Supply, Hospital↗
SEARCH · Search PubMed
Results for “Hospital Distribution Systems”
Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
Patient's medicines brought to hospital: an overlooked resource?
AIM: To quantify potential cost advantages and identify practical safeguards required for utilising patients own medicines while in hospital, and returning them on discharge. METHODS: All medicines brought in by patients in two wards of a geriatric assessment and rehabilitation unit at Auckland Hospital were examined by the pharmacist, and their suitability for re-issue assessed. Medicines were regarded as suitable for use where they could be positively identified, had been dispensed within 3 months of admission, or if packed in foil, provided the expiry date and manufacturer identification were on the foil. RESULTS: Medicines (260 items) totalling $2,976, assessed over a 6 month period, were regarded as suitable for use by the patient, with a mean value of $11.36 per patient. CONCLUSIONS: Patients own medicines used within the hospital with a unit-of-issue distribution system, and taken home by them on discharge, would provide appreciable savings for the hospital medicine budget and reduction in waste of the overall health dollar.
Budgets↗
[Analysis of hospital mortality in the Croatian Republic using selected indicators].
Mortality trends and distribution in a system of 32 general and teaching hospitals in the Republic of Croatia for the years 1966 through 1989, separately for 1986/1987, were evaluated as a possible informational support to the national policies regarding developing of health care system. By means of 13 elaborated and/or selected indicators, using hospital health statistics as a data base, we measured the changes in the dynamics, structure and level of death at institutions, individual medical departments and among patients. Hospitals mortality statistics was found to offer a good informational orientation for monitoring realization of the hospital's restructuring activities envisaged under the Aim 29 of the Croatian strategy Health for All by the Year 2000 as well as for planning technical surveillance and streamlining the special statistical studies on inpatient health care. It can also provide a solid base for the evaluation of the quality of inpatient medical care, if the diagnosis of causes of death is improved, methodology for sentinel-health-events adopted, commissions for the evaluation of inpatient health care organized, medical registration units established and the National Register of Autopsy begun.
Adult↗
Nosocomial transmission of Legionella pneumophila to a child from a hospital's cold-water supply.
Human Legionella infections mainly consist of community-acquired and nosocomial pneumonia and rarely affect children. We describe a nosocomial infection with Legionella pneumophila, serogroup 1, subgroup OLDA, in an immunocompromized 2-y-old girl at a paediatric clinic. L. pneumophila identical to that of the patient was found in the hospital's cold-water but not in the hot-water distribution system. Transmission of Legionella to the girl most probably occurred by Legionella-contaminated cold water mixed and heated by water from the hot-water system. Mixing of hot and cold water probably occurred through thermostatic water mixing valves connected to showers regulated by a handle at the shower head. Nosocomial Legionella infection might thus have occurred, although circulating hot water temperatures never dropped below 53 degrees C and cultures for surveillance of Legionella from central parts of the hot-water system have been consistently negative. Legionellae were successfully eliminated from the hospital's cold-water distribution system by hot water flushing at 73 degrees C for 1h.
Child, Preschool↗
Pharmacy practice in the United States Navy.
The current status of pharmaceutical services in the United States Navy Medical Department is described. The mission of the Navy Medical Department is to provide comprehensive health care to the more than 2.7 million active-duty and retired Navy personnel and their dependents. A total of 144 Navy pharmacy officers, 50 civilian pharmacists employed by the Navy, and 650 Navy-trained technicians practice in 32 Naval hospitals. All Naval hospitals have unit dose drug distribution systems and complete i.v. admixture services as well as an extensive series of ambulatory-care clinics. Clinical pharmaceutical services provided in these facilities vary depending upon the size and purpose of the facility. Pharmaceutical services are supported by the TRIPHARM computer system. Navy pharmacy officers may choose to pursue full-time graduate studies or may follow career paths outside of pharmacy. Navy pharmacists currently serve in a variety of administrative positions, as instructors and curriculum directors in the two Navy technician training schools, and as commanding officers of drug screening laboratories. In times of combat, Navy pharmacists may be assigned to hospital ships or to medical facilities near the line of combat. The ability of Navy pharmacists to respond to innovations in pharmacy practice will be the key to the future success of Navy pharmacy practice. One of the major challenges facing Navy pharmacy in the next few years is the recruitment of qualified pharmacy officers.
Ambulatory Care↗
The importance of pharmacist surveillance in a unit dose drug distribution system.
A study was conducted at a Public Health Service Hospital to determine if the pharmacist could provide important services to patient care while simultaneously performing the repetitious acts involved in unit dose drug distribution. During two five-week periods, the pharmacist actively questioned requests by the nursing staff for additional doses of medication to determine why these additional doses were needed. Also, during these periods the pharmacy actively questioned all doses returned in the dose medication carts which, according to doctor's orders, should have been administered to the patient. Results of these studies included the detection of some potentially dangerous deviations from accepted medication administration times (i.e., "twice" a day order given only four hours apart) as well as other problems, such as missed orders, medication "borrowing" which sometimes magnified errors, and underdosing. The conclusions from the studies are that the pharmacist can provide essential services while simultaneously performing the repetitious tasks of filling, checking, and exchanging unit dose medication cassettes.
Boston↗
Dialysis staff influence patients in formulating their advance directives.
Patients on chronic dialysis were surveyed to determine the degree to which completion of advance directives (ADs) was influenced by personal factors that patients bring to their dialysis situation (eg, demographic characteristics or personal preferences) and by environmental factors that are not under their control (eg, interaction with dialysis staff or hospital system). Of the 113 questionnaires distributed to the population of 40 hemodialysis and 73 peritoneal dialysis patients, 90 (80%) were completed. Although only 17% of the respondents had actually completed written ADs previously, respondents seemed to have a good general understanding of ADs, as evidenced by the 80% overall accuracy on a 19-question portion of the survey that tested knowledge regarding ADs. While a few personal factors, such as gender, dialysis, modality, perceived quality of life, and attitude toward death, were associated with completion of ADs, most other demographic variables, including age, marital status, religion, work status, number of years of education, disability status, locus of control, renal diagnosis, and number of years on dialysis, were not correlated. More prominently correlated with completion of ADs were environmental factors, such as having dialysis staff discuss ADs with patients, patients being asked to complete ADs at the time of hospitalization, and perception of staff as being comfortable discussing ADs with patients. The overall results of the survey suggest that discussing ADs as an ongoing activity may have been positively influenced by the Federal Patient Self-Determination Act of 1991.(ABSTRACT TRUNCATED AT 250 WORDS)
Adult↗
[Hypothesis on generating and tracer gas study regarding transmission of severe acute respiratory syndrome through ventilation system in a general hospital].
OBJECTIVE: By measuring airflow and ventilation distribution of ward building, to explore and verify the hypothesis of airborne transmission and risk factor of severe acute respiratory syndrome (SARS) nosocomial infection. METHODS: Tracer gas (perfume of plant oil) was emitted to the bathroom of wards when SARS index patient lived. Six different experimental situations were designed to control the status of exhaust fan in bathrooms, exhaust fan in the top of building and fresh air exchange system. The concentration of perfume was separately measured by 4 groups of lab workers and recorded blindly by the scores of "tenth degree". RESULTS: Tracer gas was detected from the wards of 8th to 13th floor. CONCLUSION: Architecture and ventilation system of the inpatient building in the hospital contributed to the aerodynamic condition of SARS nosocomial infection through airborne transmission. The distribution of tracer gas in the wards was associated with SARS patients in this building. It was possible that SARS could have been transmitted to for distance by aerosol or other carriers.
Air Microbiology↗
Health care and hospital pharmacy in Sweden.
Health care and hospital pharmacy in Sweden are discussed. The system of drug distribution in Sweden is reviewed, and the following functions of hospital pharmacies are discussed; drug and hygiene committees, inspection activities, drug information and educational services, radiopharmacy, and research activities. Pharmacy education, drug manufacturing, and Apoteksbolaget--The National Corporation of Swedish Pharmacies--are also discussed. Future developments in hospital pharmacy are expected to include increased sales to outpatients, a restructuring of the drug supply within outpatient care and recommendations from the hospital drug committees on outpatient care.
Delivery of Health Care↗
Program to disseminate information on new hospital pharmacy practices.
A five-year program to stimulate interest in contemporary pharmacy practices and disseminate information to pharmacists and other health professionals in community hospitals throughout the State of Maine is described. Pharmacists from the New England Medical Center in Boston and the Maine Medical Center in Portland conducted a program from 1973 to 1978 that included consultative services, drug information, and continuing-education components. Pharmacy consultants visited about 50% of the hospitals in the state and met with the director of pharmacy, administrator, and director of nursing who received written reports of all findings and suggestions. Most frequently, hospitals requested recommendations on drug-distribution systems, design and use of medical profiles, and design of physician order forms. Surveys at the beginning and at the end of the program indicated that the number of hospitals with unit dose systems and i.v. admixture programs increased during the life of the program; pharmacy staffing levels also increased. The program successfully brought consultative services, drug information, and educational programs to pharmacists and other health professionals in community hospitals in Maine.
Boston↗
A prototype generalized network technology for hospitals: initial implementation.
A demonstration implementation of a distributed data-processing hospital information system using an intelligent local area communications network (LACN) technology is described. This system is operational at the UCSF Medical Center and integrates four heterogeneous, stand-alone minicomputers. The applications systems are PID/Registration, Outpatient Pharmacy, Clinical Laboratory, and Radiology/Medical Records. Functional autonomy of these systems has been maintained, and no operating system changes have been required. The LACN uses a fiber-optic communications medium and provides extensive communications protocol support within the network, based on the ISO/OSI Model. The architecture is reconfigurable and expandable. This paper describes system architectural issues, the applications environment, and the local area network.
California↗
Emergency response to an anthrax attack.
We developed a mathematical model to compare various emergency responses in the event of an airborne anthrax attack. The system consists of an atmospheric dispersion model, an age-dependent dose-response model, a disease progression model, and a set of spatially distributed two-stage queueing systems consisting of antibiotic distribution and hospital care. Our results underscore the need for the extremely aggressive and timely use of oral antibiotics by all asymptomatics in the exposure region, distributed either preattack or by nonprofessionals postattack, and the creation of surge capacity for supportive hospital care via expanded training of nonemergency care workers at the local level and the use of federal and military resources and nationwide medical volunteers. The use of prioritization (based on disease stage andor age) at both queues, and the development and deployment of modestly rapid and sensitive biosensors, while helpful, produce only second-order improvements.
Anthrax↗
Testing for neutral-to-ground connections in new construction.
A study was performed to seek out inadvertent connections between neutral and ground in the power distribution system of a newly constructed hospital, prior to occupancy. Such connections are not only violations of code but could cause medical device problems. Ground wires are not intended to carry load currents except during faults. When currents do flow in grounds, medical device chassis voltages are elevated and some devices may respond unpredictably. Suitable acceptance testing is not commonly done. In this study, a simple test method was developed that helped reveal and correct many neutral-ground misconnections. The authors advocate incorporating such a test into building construction contract specifications.
Electric Power Supplies↗
Analysis of missing medication episodes in a unit dose system.
The unit dose drug distribution system at The Buffalo General Hospital in Buffalo, New York, was evaluated by an analysis of cases in which doses of medication were missing from the unit dose administration cart. When a dose was missing, the medication administration nurse reported the occurrence to the pharmacy. When time permitted, the cause of the missing dose was determined and recorded. Thirty causes for missing doses are cited. The causes were found to arise from misuse of the unit dose system by nurses, misunderstandings between the Nursery and Pharmacy Departments, or from oversights on the part of nurses or pharmacy personnel. Missing doses can be prevented in the future by instructing nurses in the use of the system, improving communication between the Departments of Pharmacy and Nursing concerning the needs of the patients, and being aware of mistakes that can occur so care can be taken to prevent them in both departments.
Evaluation Studies as Topic↗
[The surgical record in a computerized hospital environment].
The author describes the architecture and functions of a distributed real-time hospital information system (MIRAM). Based on a microcomputer star network, this system gives a response to the informational needs of the clinical physicians. Specifically, the surgical computerized file description during patient hospitalisation enlightens on the medico-administrative duality of these file elements.
Confidentiality↗
Economic evaluation of Viaflex with vial adapter in a unit-dose drug distribution system.
The cost of parenteral admixtures has an important impact on the hospital budget. Recently, a Viaflex with vial adapter (named 'minibag plus' in some countries) has been commercialized in order to facilitate parenteral admixture preparation. In the present study a preparation using Viaflex with a vial adapter has been economically compared with a preparation with a traditional Viaflex (without adapter) in a centralized unit or in nursing wards in a unit-dose drug distribution system. A cost-analysis was conducted from the hospital point of view. Direct costs were considered: these included supplies and human resources. Differences in the whole process between the two types of Viaflex were analysed. The process included: purchasing, reception, storage, medical order record, preparation in the Pharmacy Service (PS), delivery from the PS to the nursing unit, preparation by the nurse, return of unused material to the PS. Human resource costs were estimated by time counting and multiplying by the average salary. To estimate wasted material, drug and supplies delivered from the PS and returned to the PS were counted during 26 days. With the new Viaflex costs are reduced by 30% in comparison with drug dilution using the traditional Viaflex in a centralized unit of the PS, and by 13.4% in comparison with preparation with the traditional Viaflex in the nursing ward. In addition it can be estimated that contamination risk with the new Viaflex is lower than preparation in the nursing ward with the traditional Viaflex. Therefore, owing to its lower cost we recommend the use of Viaflex with vial adapter for drug dilution for those vials that are compatible with the system.
Costs and Cost Analysis↗
Description of an experimental hospital pharmacy management information system.
The objectives, characteristics, and uses of hospital pharmacy work-measurement systems are discussed, and the development and operation of an experimental hospital pharmacy management information system (HPMIS) is described. Hospital pharmacy work-measurement systems are designed to measure and evaluate the productivity of a hospital pharmacy or group of pharmacies. Previous work-measurement systems used by hospital pharmacies have been too time consuming or imprecise for widespread use. A national hospital pharmacy work-measurement system known as HPMIS was developed to provide comprehensive and widely applicable information on pharmacy expenses, personnel use, and productivity. HPMIS converts data from participating hospitals into 17 indicators that enhance the comparability of the information between the hospitals. The 17 indicators relate to pharmacy production, clinical services, and administrative functions; also included are several gross department indicators that combine elements of all three areas. After analysis and categorization of the data according to characteristics such as bed size, geographical location, and type of drug-distribution system, results are reported to individual hospitals. A national work-measurement system such as HPMIS should enable hospitals to evaluate their pharmacy operations in relation to those of other hospitals and to track their department's relative management performance over time.
Efficiency↗
Pharmaceutical services in rural hospitals in Illinois--1991.
The results of a 1991 survey of pharmaceutical services in rural hospitals in Illinois are reported and compared with the results of previously published national and regional surveys. A questionnaire was developed and mailed to the director of pharmacy at each hospital in the study population (n = 95 rural hospitals in Illinois) to obtain information about inpatient drug distribution services, ambulatory-care services, clinical services, and human resources. The response rate was 81% (77 usable responses). Respondents reported a mean hospital size of 115.5 licensed beds. The mean average daily census was 51.2. Drug distribution systems appear similar to those reported in the 1990 ASHP survey, with complete unit dose drug distribution systems existing in 90.1% of respondent rural Illinois hospitals and complete and comprehensive i.v. admixture services in 71.2%. The percentage of pharmacy departments that are decentralized is lower among rural Illinois hospitals than among previous survey populations. Respondents indicated that they provided the following clinical pharmacy services: drug therapy monitoring (73%), patient rounds (12.2%), nutritional support (37.8%), pharmacokinetic consultations (32.4%), and patient education and counseling (24.3%). These results are comparable to those reported in previous surveys. Respondents reported an average of 5.9 full-time equivalents per hospital pharmacy department. The pharmacist vacancy rate and the total vacancy rate per department were reported as 10% and 5.3%, respectively, with vacant positions taking an average of 15 months to fill. The pharmacist vacancy rate is markedly higher than that reported in the 1990 ASHP survey. Rural Illinois hospitals are comparable to other U.S. hospitals in the provision of most pharmaceutical services.(ABSTRACT TRUNCATED AT 250 WORDS)
Ambulatory Care↗