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PubMedDate not supplied

Pharmacy teaching for family practice residents.

Because undergraduate training in pharmacology is insufficient preparation for prescribing drugs appropriately, comprehensive systematic education in clinical pharmacy is essential for family practice residents. A pharmacy curriculum could contribute to improved treatment of disease, decreased health care costs, decreased iatrogenicity and morbidity, lower risk of litigation, and better communication among physicians, pharmacists, and patients. The pharmacy curriculum which has been developed at the family practice residency program in Little Rock, Ark. focuses on problem-solving activities in the clinical setting, primarily utilizing problems from the residents' patient caseloads. A long-term plan of the department is to follow residents into practice in order to examine utilization of what they learned from the pharmacy curriculum.

Curriculum↗
PubMed1985

Clinical pharmacy services in Florida hospitals--1984.

To ascertain the progress made in the implementation of clinical services in Florida hospitals, a survey conducted in 1977 was readministered in 1984. Questionnaires were sent to the directors of pharmaceutical services of all 256 Florida hospitals. Nine questions on clinical services were identical to the 1977 survey and two additional questions were included on nutritional support services and pharmacokinetic dosing consultations. The directors were also asked if they had conducted studies to document the cost-effectiveness of their clinical pharmacy services. Questionnaires were returned by 75% of the directors. As in the 1977 survey, approximately half of the hospitals had less than 200 beds. Slightly more than 82% of the hospitals had total unit dose systems and about 7% had partial systems, which was considerably higher than the 58% with either total or partial systems found in the 1977 survey. Services such as patient monitoring, inservice education, and drug-use review were being offered substantially more than in 1977. Conducting patient medication histories, attending rounds with physicians, and providing discharge consultations were the least-performed clinical services. The reasons given for not implementing these services were similar in both surveys. However, while the lack of adequately trained pharmacists was frequently cited in 1977, very few respondents cited it as an obstacle in 1984. Several respondents indicated that they had documented cost savings attributable to their clinical pharmacy services. Clinical pharmacy programs are continuing to grow in Florida hospitals; however, pharmacy administrators appear to be having some of the same problems implementing these services as they did previously.

Costs and Cost Analysis↗
PubMed1979

Administrative approach to disaster preparedness in the pharmacy.

Disaster planning for a hospital pharmacy department is discussed. During a crisis, the type of behavior exhibited by hospital personnel and the community can be used to predict the situation's severity and to prepare a response. During disasters, it is important to focus on accomplishing tasks by defining employees' roles, establishing chains of communication, delegating authority to competent persons, limiting decision-making by persons other than those in command and defining the boundaries of pharmacy's involvement in the disaster. A case study of pharmacy operations during a crisis is presented, with guidelines for assessing the situation, establishing priorities, identifying resources and executing a response. Hospital pharmacy administrators must display a high degree of creativeness and responsibility during disasters, but training in the principles of disaster management can be helpful.

Behavior↗
PubMed1979

Decentralization of pharmaceutical services without satellite pharmacies.

The decentralization of pharmaceutical services without the addition of pharmacy satellites is described. Mobile, master medication carts are used by pharmacy personnel in the patient-care areas to fill the unit dose carts used by nurses. A combination medication administration record and patient profile eliminates duplication of effort by pharmacy and nursing. Responsibilities of pharmacists and technicians, the process of hospital-wide implementation of the system, current levels of service, and a clerkship designed to improve staff pharmacists' clinical abilities are described. The ratio of the number of drug doses administered to the number of drug doses handled per patient-day increased after the implementation of the new system. This indicated that individual doses were handled fewer times by pharmacy personnel. This method of decentralization permitted integration of distributive and clinical pharmaceutical services with a minimal personnel cost increase, no additional space requirements nor expenditures for renovation, and only a small cost for master medication carts. Because the pharmacists work in the patient-care areas, they are in more frequent contact with nurses, physicians and patients.

Costs and Cost Analysis↗
PubMed1984

The pharmacy computer system at The Ohio State University hospitals.

The pharmacy computer system designed, developed, and implemented at The Ohio State University Hospitals is described. The computer system was developed to make more efficient use of hospital facilities and professional staff time. The pharmacy system operates on the mainframe hospital system using computer terminals with light-pen and keyboard access. Current online applications include order entry, patient profiles, pharmacokinetic calculations, and preparation of unit dose cart fill lists. Batch processing functions include drug-use review, drug-drug interactions, and financial management reports. Approximately 95% of unit dose orders and 20% of i.v. orders are conditionally entered by pharmacy technicians for subsequent verification by pharmacists. The system saves considerable staff time in the i.v. admixture and billing areas and has relieved pharmacists from performing many clerical and repetitive tasks. Disadvantages of the system include (1) its dependence on another department for patient admission, transfer, and discharge information and (2) delays in obtaining approval for program modifications and new applications. The advantages of the pharmacy computer system lie in its ability to access information from other computerized databases in the hospital. Future modifications and enhancements to the system are discussed.

Computers↗
PubMed1984

Managing training programs for pharmacy employees.

Principles for managing training programs for supportive personnel and new pharmacist employees in hospital pharmacy departments are discussed, and ongoing staff development activities are described. General management objectives of training programs are outlined. Training programs for supportive personnel should include general theory, such as basic pharmacology and metric conversions, and practice in the specific skills required for the job. The practical component of the training program should be based on a job analysis, and behavioral objectives of the training program should be developed. Various approaches for structuring and monitoring training programs for supportive personnel are described. Besides mastering specific practice skills, new pharmacist employees must become thoroughly familiar with the pharmacy department's policy and procedure manual. Hospital pharmacy managers should implement ongoing activities for developing the decision-making, interpersonal, and practice skills of staff pharmacists. Well-organized training programs can effectively raise the performance standards of pharmacy departments and decrease the time spent in monitoring, evaluating, and correcting performance deficiencies of the staff.

Feedback↗
PubMed1983

Pharmacy program for improved handling of antineoplastic agents.

A pharmacy program to improve the handling of antineoplastic drug products in a pediatric hospital is described. To correct deficiencies in the preparation and administration of cancer chemotherapy, the pharmacy department in conjunction with pediatric hematology-oncology physicians prepared a cancer chemotherapy manual. Included in the manual were (1) policies and procedures for the ordering, preparation, delivery, administration, and disposal of chemotherapy; (2) a flow sheet to facilitate ordering of daily chemotherapy doses and allow pharmacists to double-check dosage calculations of physicians; (3) drug information monographs on various antineoplastic agents used in the hospital; and (4) a reference chart containing information about the reconstitution, dilution, stability, storage, administration, and special-handling precautions for chemotherapy. Upon the recommendation of the hematology-oncology staff and with the approval of the hospital administration, the pharmacy obtained a vertical laminar-airflow hood and expanded its services to include preparation of all cancer chemotherapy for inpatients. Procedures were implemented to document delivery of chemotherapy to the nursing unit and to ensure proper acquisition and charting of chemotherapy doses given by physicians. Pharmacy involvement has improved control of the handling and administration of cancer chemotherapy in the hospital and has increased the safety of patients and hospital personnel.

Antineoplastic Agents↗
PubMed1983

Improving a hospital pharmacy department's profitability.

Measures taken by a pharmacy department to increase its contribution to meeting hospital operating expenses are described. A pharmacy department in a 1000-bed university hospital used management techniques to help contain costs, maintain quality care, and meet short-term cash flow and long-range financial objectives. Overtime and differential hours, primarily caused by turnover and sick leave, were reduced by offering technicians opportunities for advancement and better scheduling. Drug costs were reduced through use of therapeutic equivalent bidding, formulary drug-class reviews, and reductions in drug inventory. Equipment and computer expenses were analyzed, and future applications that would result in substantial labor savings and more efficient billing were planned. Measures were taken to reduce lost charges, and the number of patient charge items was increased. Charge reimbursement versus cost reimbursement was studied; a pharmacy billing mix in which more dollars are billed by charge reimbursement was sought. A new satellite in the surgical intensive-care area reduced lost charges and converted cost transfers to patient charges. Implementation of these programs increased pharmacy department contributions to meeting hospital expenses by 96% in fiscal year 1981-82.

Computers↗
PubMed1982

Review of computer applications in institutional pharmacy--1975-1981.

A literature review of computer applications in institutional pharmacy, covering papers published from 1975 to 1981, is presented. Articles are categorized as computer concepts, applications to administrative functions, controlled substances, drug distribution systems (including on-line and off-line services, intravenous admixture services, and ambulatory services), drug information, clinical services (including drug-use review, drug interactions and therapeutic incompatibility surveillance, and pharmacokinetics), and pharmacy-related applications developed by nonpharmacists. Before 1975, computer applications in institutional pharmacy reported in the literature were largely single-use applications. After 1975, many reports described the integration of individual applications into sophisticated systems that supported many functions. There is still a need for good cost justification studies of computerization in pharmacy.

Computers↗
PubMed1982

Assessing whether a clinical pharmacy program is meeting its goals.

An assessment of whether the clinical pharmacy program at Memorial Hospital Medical Center (MHMC), Long Beach CA, was meeting its goals is presented. MHMC is a 858-bed, nonprofit teaching hospital that initiated a clinical pharmacy program in 1967. The program's three foremost goals were to: (1) establish cohesive and standardized clinical services, (2) promote the acceptance of the roles and functions of clinical pharmacists by physicians and nurses, and (3) assure the provision of good quality care. The evaluation data were collected over a six-week period using questionnaire surveys of approximately 28 pharmacists, 146 physicians, and 389 nurses; pharmacist service reports from 5991 drug monitorings; 228 medical record audits for six drugs; 68 guideline compliance records for three drugs; interviews with 131 users of the drug information services; abd logs of 3946 pharmacist encounters with other health-care providers. Generally, the clinical pharmacy program was found to be meeting its goals. Most of the monitorings (81.6%) were initiated by pharmacists, and 20% resulted in changes in drug therapy. The pharmacists adhered to the pharmacy department's monitoring and dosing guidelines. There was unanimous satisfaction among users of the drug information service with the response received from pharmacists, and 99% satisfaction with the promptness of response and accuracy of the information. Sixty-eight percent of the pharmacists reported discussing general issues with physicians, and 72% answered patient-specific questions from physicians. The physicians (96%) and nurses (97%) thought that there was an improvement in the quality of patient care as a result of pharmacist involvement. Pharmacists at MHMC are providing useful clinical services.

California↗
PubMed1994

Benefits and work-schedule options in hospital pharmacy practice.

Hospital pharmacy directors were surveyed to determine whether their departments offered specific family-related benefits and work-schedule options and how their attitudes about these options compared with those of female hospital pharmacists. Questionnaires were mailed to 300 randomly selected hospital pharmacy directors to collect the following information: vacancy rates and male:female ratios in hospital pharmacy positions, which of 13 selected benefits and work-schedule options were offered, barriers that prevented the other options from being offered, and attitudes about the listed options. The options included in the survey were selected because they represent ways of balancing home and work (e.g., maternity leave, job sharing, day care). The pharmacy directors' responses were compared with those from a similar survey of female hospital pharmacists. The usable response rate was 50.3%. Position vacancy rates ranged from 5.5% for directors to 35.8% for clinical supervisors. All full-time positions had an even distribution of men and women except for director and assistant or associate director positions. Of 13 options, only maternity leave, part-time schedules, and flexible schedules were offered by more than half of the hospitals. These three were also the only listed options that the respondents considered important in recruiting and retaining pharmacists. Barriers to offering other options included the perception that current benefits and work-schedule options were adequate, lack of staff coverage, lack of funds, and the perception that some positions are not compatible with alternative schedules. Respondents' ratings of the importance of the listed benefits and work-schedule options were significantly lower than ratings given by female hospital pharmacists in a separate survey.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMedDate not supplied

Ambulatory pharmacy services affiliated with acute care hospitals.

The extent to which hospital-based pharmacists provide ambulatory clinical pharmacy services in the United States is unknown. We evaluated pharmacists' activities in hospital-affiliated ambulatory clinics and home health services. A questionnaire was mailed to directors of pharmacy in one-half of the United States acute care general medical-surgical hospitals with 50 or more licensed beds. The survey response rate was 56% (n = 1174). In 19% of hospitals, pharmacists provided patient care (nondispensing activities) in ambulatory clinics. The most common clinics with pharmacist involvement were diabetes (10% of hospitals), oncology (9%), cardiology (6%), and geriatrics, infectious disease, and pain (4% each). Nondispensing roles varied by clinic type; prescribing by protocol was performed in 57% of anticoagulation clinics and 7% of diabetes clinics. Home health care services, with pharmacists' activity extending beyond providing drugs, were offered by 28% of the hospitals. Thirty-six percent of the hospitals operated one or more outpatient pharmacies. A statistically significant association was observed between hospitals' inpatient clinical pharmacy services (as assessed by the pharmaceutical care index) and the involvement of pharmacists in both ambulatory clinics and home health care services.

Ambulatory Care↗
PubMed1993

Justification of a pharmacy intravenous admixture service in an Australian hospital.

The time and cost of i.v. admixture preparation by hospital pharmacy staff members in an established admixture unit was compared with that by nurses working on wards. The preparation time of antimicrobial admixtures was determined by using a stopwatch. The total cost of preparing an admixture by pharmacy and nursing staff was calculated by combining the respective labor costs (preparation time x average salary rates weighted for overtime) with the cost of disposable items. The mean +/- S.D. time for admixture preparation in the pharmacy was 3.38 +/- 0.38 minutes, whereas preparation by nurses required 14.37 +/- 1.55 minutes. The mean +/- S.D. total cost (in Australian dollars) of admixture preparation was $1.42 +/- 0.34 per dose, and $4.59 +/- 0.46 per dose, respectively. Centralization of admixture preparation would reduce the time required by 18.32 hours for every 100 admixtures prepared, equivalent to an annual cost avoidance of $112,420 for every 100 admixtures prepared each day. Centralizing the preparation of i.v. admixtures in a hospital pharmacy resulted in significant time savings and cost avoidance.

Australia↗
PubMed1993

Use of vitamin and mineral supplements by pharmacy students.

Use of vitamin and mineral supplements by undergraduate pharmacy students and the students' perceptions and beliefs about these products were studied. Undergraduate pharmacy students from two schools in Philadelphia completed a questionnaire in which they were asked whether they had taken vitamin or mineral supplements within the preceding two weeks, the reason for taking the supplements, and the identity of the type of products taken. General demographic information and a self-assessment of health and diet were also obtained. In addition, using a five-point Likert scale, students were asked to rate the degree to which they agreed with five controversial statements regarding vitamin and mineral supplements. Of the 692 students completing the questionnaire, 47% had taken supplements in the preceding two weeks. This percentage is higher than that determined in surveys of the general population and of professionals in other health disciplines. No significant difference was noted in the percentage of men and women who took supplements, but the types of products taken by men and women differed significantly. The most common reasons for taking supplements were inadequate diet, to improve energy, for stress, and for colds. Year in school had a modest influence on the beliefs about vitamin and mineral supplement use expressed by students. The use of vitamin and mineral supplements among pharmacy students was high. Pharmacy schools should devote time in the curriculum to the sociological and clinical aspects of vitamin and mineral therapy.

Adult↗
PubMed2006

An advanced professional pharmacy experience in a community setting using an experiential manual.

OBJECTIVES: To determine the usefulness of a teaching and learning tool used to create structure for advanced pharmacy practice experiences (APPEs) in community pharmacy settings, and to identify differences between respondents' perspectives on the relevance and practicality of implementing specific community pharmacy-related topics during the experience. DESIGN: Community practice faculty members designed a manual that outlined a week-by-week schedule of student activities, consistent with the Center for the Advancement of Pharmaceutical Education (CAPE) outcome-based goals, and included associated teaching, documentation, and assessment tools. The manual was distributed to site preceptors and students. ASSESSMENT: Eighty-six PharmD students responded to a questionnaire upon completion of their community APPE. Student feedback concerning the impact of the manual relative to interactions with site preceptors and their overall learning experience was relatively positive. CONCLUSION: The manual was an effective teaching and learning tool for students completing a community APPE.

Accreditation↗
PubMed1975

Establishment of a nuclear pharmacy.

The University of Michigan Regional Nuclear Pharmacy is described. The scope of operation of the nuclear pharmacy includes radiopharmaceutical formulation and dispensing, quality control, inventory control, research and development of new radiopharmaceuticals, and consultation. Also discussed are program objectives, pharmacy location, organizational structure, budget and staff, economic considerations, facilities and equipment, and legal considerations.

Costs and Cost Analysis↗
PubMed2000

The conflict between ethics and business in community pharmacy: what about patient counseling?

Patient counseling is a cornerstone of ethical pharmacy practice and high quality pharmaceutical care. Counseling promotes patient compliance with prescription regimens and prevents dangerous drug interactions and medication errors. Counseling also promotes informed consent and protects pharmacists against legal risks. However, economic, social, and technological changes in pharmacy practice often force community pharmacists to choose between their professional obligations to counsel patients and business objectives. State and federal legislatures have enacted laws that require pharmacists to counsel patients, but these laws have had mixed results. This essay argues that community pharmacy's patient counseling conundrum can be solved through additional moral education persuasion, not through additional legal mandates.

Community Pharmacy Services↗
PubMed2004

Medical pluralism in action? A case study of community pharmacies in Johannesburg, South Africa.

OBJECTIVES: The main aim of this study was to examine whether, and to what extent, community pharmacies have become sites for the practice of complementary and alternative medicine (CAM) as an example of "medical pluralism." METHODS: Qualitative as well as quantitative methods such as a telephone survey of all pharmacies in Johannesburg, observations, and in-depth interviews with pharmacists and CAM healers were used. RESULTS: The evidence presented in this paper, although based on a study of community pharmacies in Johannesburg only, can be interpreted as an indication of a general trend in urban areas in South Africa, that of involvement with CAM in the form of dispensing and sales of CAM products, provision of advice, and, in a few cases, employment of CAM practitioners to consult on their premises. Thus the two systems of CAM and allopathic medicine are being practiced within the same premises. However, the manner in which they operate, as portrayed in this study, is that of two separate systems existing in relative harmony side-by-side. CONCLUSION: Because of the constraints of the study, it is difficult to ascertain to what extent this is a first step toward the development of a more meaningful integration between the systems. It is much easier to demonstrate that this growth is driven by the pharmacists' response to the growing demand from the public and their readiness to seize the opportunity to expand their responsibilities and increase their profits. This is supported by the willingness of CAM healers to participate in the endeavor.

Attitude of Health Personnel↗