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PubMed2006

Pharmacy student response to patient-simulation mannequins to teach performance-based pharmacotherapeutics.

OBJECTIVE: To design and implement a simulated patient-case assessment using a mannequin for critical care pharmacotherapeutic education of doctor of pharmacy students and to evaluate student satisfaction with the simulation. DESIGN: During the second year of the doctor of pharmacy program, all students were required to complete Introduction to Critical Care. This course consisted of didactic education, written patient-case sessions, and an interactive patient simulation session. Information on the patient case was distributed to students after completing the didactic portion of the course. Patient information was programmed into a simulation mannequin, which demonstrated characteristics of a critically ill human. Students were surveyed post-simulation to determine the effectiveness of the learning experience. ASSESSMENT: The majority of students (88%) were extremely satisfied with the experience. The facilitator was considered to be extremely useful in 75% of responses. CONCLUSION: By simulating a patient case, the facilitator was able to control students' learning environment, adapt the simulation to the level of the students' performance, and debrief students immediately. Ultimately, by involving students in actual patient cases early in the pharmacy curriculum, this type of education could produce pharmacists with a high level of expertise and confidence.

Critical Care↗
PubMed1990

Managing clinical pharmacy services by integrating drug information and dispensing.

Managing clinical pharmacy services in the 1990s will remain a challenge. Planning appropriate services, matching resources to workload and needs, and meeting the rapid changes in hospital diversification requires substantial pharmacy management knowledge and expertise. A key step in meeting these challenges is integrating the pharmacist's responsibilities for drug information and drug dispensing. This step ensures the provision of the highest quality clinical and distributive pharmacy services. Patient care demands it. Pharmacists will achieve their full potential if drug dispensing and information are provided as one comprehensive service.

Drug Information Services↗
PubMed1993

How to assemble a patient-centered pharmacy QI program.

The QI program is patient driven. The question "How does this monitoring affect the patient?" is central to decisions on designing indicators. Time spent on the various levels of quality assessment in the Pharmacy QI Committee is proportional to patient impact. Personnel time devoted to concurrent review of dosing and drug interaction overrides, drug information response accuracy, and therapeutic drug monitoring reflects the importance the Pharmacy Department places on maintaining a drug therapy safety net. The patient is central to the pharmacy QI program. The spirit of the Joint Commission's standards is met; acceptable documentation completes the requirements.

Adverse Drug Reaction Reporting Systems↗
PubMed1994

The pharmacy as part of an integrated hospital information system: a focus on benefits.

An integrated hospital information system benefits not only the pharmacy but also each department within a hospital, including the physician and patient. The Composite Health Care System (CHCS) is a fully integrated healthcare information system that has been developed for the Department of Defense's medical treatment facilities. CHCS provides modules for Patient Administration, Patient Appointment Scheduling, Radiology, Laboratory, Pharmacy, and Physician/Nursing Order Entry and Results Retrieval, which serve to integrate inpatient wards, clinical services, administrative departments, and remote outpatient clinics. CHCS provides an integrated patient profile to care givers throughout the medical facility, improving the quality of their clinical decisions. The integrated hospital information system also helps to coordinate the delivery of patient care and automates many interdepartmental transactions, which allows for more efficient use of resources and increases the turnaround time for delivery of services. This article focuses on the system's pharmacy component to demonstrate the benefits realized with an integrated hospital information system.

Clinical Pharmacy Information Systems↗
PubMed1995

The evolution of pharmacy residency training programs and corresponding standards of accreditation.

Practice-based pharmacy training has a long history, particularly in institutional pharmacy practice. Formal pharmacy residency training programs and accreditation standards were first developed in the early 1960s. Practitioners now practice in a much different environment. Residency programs and accreditation standards have changed dramatically to meet the needs of practitioners, patients, and employers. The authors trace the evolution of programs from general internships through clinical practice and specialty residencies and fellowships and the development of standards and competency-based training.

Accreditation↗
PubMed1984

Quality and applicability of an undergraduate psychopharmacy rotation: a survey of pharmacy students.

This paper details the results of a study of an undergraduate psychopharmacy rotation in an inpatient hospital setting and assesses its influence on pharmacy graduates careers in pharmacy. Significant features of the rotation include the students' participation in patient care activities and patient education about medications, as well as presentation of case histories. The students also took medication histories and revised patients' charts with the preceptor. Graduates of this program were sent questionnaires to assess their impressions of the rotation for quality of experience and for applicability to their pharmacy position. Ninety-four percent of the students responding worked as pharmacists and all reported dispensing psychoactive agents. Three-fourths of the respondents gave the program a positive rating for its influence on training in customer/patient relations and communications.

Clinical Clerkship↗
PubMed1984

Computer skills enhance a hospital pharmacy residency training program.

Hospital pharmacy residents participated in a program designed to introduce them to computer systems useful in pharmacy practice and to provide them with access to a variety of computer resources that could be helpful in completing their residency projects. Using existing computer facilities, various short courses and individual tutorials were employed to train residents in a variety of computer skills. These courses provided a useful vehicle for recent pharmacist graduates to acquire necessary computer skills not obtained during their academic training. Because the program provided residents with the tools needed for the management and analysis of large data sets, a marked increase occurred in the number of residency projects acceptable for publication in peer-reviewed pharmacy journals. Thus, residency projects improved in quality and faculty preceptors were more motivated to get involved in such projects.

Computers↗
PubMed1984

A residency program in community pharmacy practice.

As pharmacists increase their involvement in patients' drug therapy, the lack of opportunity for advanced clinical and administrative training becomes more critical, particularly for community pharmacists. To assist in the postgraduate development of community pharmacists, the faculty of pharmaceutical sciences at the University of British Columbia began a residency program in community pharmacy practice in June 1981. Modeled on the successful hospital pharmacy residencies, the program goals are to provide advanced clinical training in ambulatory patient care, and detailed and practical management training, and to develop pharmacists with skill in clinical teaching who will participate in the undergraduate programs of the faculty. The 12-month residency includes guided self-study and a series of practica in areas of therapeutics, management, drug information, clinical and teaching skill, professional service, and continuing education. These practica are served mainly in clinical practice settings such as community pharmacies, clinics, physicians' offices, and teaching hospitals. The residency has demonstrated its value and viability. Growing interest in such programs, and the success of this program in particular, should encourage the development of similar programs in Canada.

British Columbia↗
PubMed1994

[The first French guide for the use of pharmacy students].

The author analyzes the Nouveau guide de l'étudiant en médecine et en pharmacie published in 1825, in which the section on pharmacy is due to J.-B.-A. Chevallier. In particular he stresses the importance of this work in understanding the history of pharmacy instruction.

Education, Pharmacy↗
PubMed1976

Pharmacy personnel activities and costs in decentralized and centralized unit dose drug distribution systems.

Pharmacy personnel activities and labor costs directly associated with concurrent decentralized and centralized unit dose drug distribution systems in the same institution were compared. A work-sampling observation technique was used for the activity survey. Analysis of the data showed that: (1) the activities of pharmacy personnel vary significantly between the decentralized and centralized systems, (2) pharmacists in the decentralized area spent a significantly greater portion of their productive time performing therapy-related activities than did those pharmacists in the centralized system, (3) multiple staffing patterns associated with the centralized unit dose system afforded a significantly greater participation in educational activities by all pharmacy personnel staffing that area, (4) dispensing activities accounted for most nonpharmacist personnel time in both systems, and (5) based on cost/unit dose and existing staffing patterns, there was no appreciable difference in personnel labor costs associated with the two systems. However, it was determined that a considerable cost difference could be expected if the decentralized system's hours of service were equivalent to those associated with the centralized system.

Communication↗
PubMed2003

[The 90th anniversary of the founding of Vilnius City municipal pharmacy].

This publication deals with so far untreated topic in the historiography of Lithuanian medicine and pharmaceutics--the founding of Vilnius City municipal pharmacy and its activities in 1913-1915. The research is based on recently discovered archival documents and publications. In Tsarist Russia, the municipal or cities' medical organization was established in those parts of the Empire, which were not under the authority of "zemstvy". These also included the Lithuanian gubernijas. The history of municipal medicine in Vilnius dates back to 1876. This is one of the reasons why Vilnius had the most sophisticated infrastructure of municipal medicine. Since its very founding, the municipal pharmacy has become an integral part of city health care system. It sold medicines for a cheaper price; some medications were distributed as charity; the pharmacy served the local medical institutions.

History of Pharmacy↗
PubMed1991

Checking of unit dose cassettes by pharmacy technicians at three Minnesota hospitals.

A pilot project in which pharmacy technicians were trained to check unit dose cassettes filled by other technicians is described. With the approval of the state board of pharmacy, the Minnesota Society of Hospital Pharmacists (MSHP) conducted the nine-month project in three hospitals with different types of unit dose drug distribution systems. Twenty-seven technicians underwent didactic and practical training and were then validated as checkers if they scored 99.8% accuracy in checking carts into which errors had been deliberately introduced by the pharmacist auditor. The performance of validated technicians was audited monthly, and failed audits had to be repeated. Participating technicians did not check the preparation of first doses or extemporaneously prepared doses. In 100,000 doses audited, 60 errors by the validated checkers were identified. Of six technicians who failed a monthly audit, five passed a repeat audit. Pharmacists at the participating hospitals documented time they spent on clinical activities that would have been spent checking cassettes. In December 1990 a one-year extension of the project, expanded to 10 hospitals, began. With strict quality control measures, specially selected and trained pharmacy technicians performed unit dose cassette checking with an accuracy of at least 99.94%.

Humans↗
PubMed1990

[The development of pharmacy in German universities in the 19th century].

This article analyses the development of pharmacy as an academic discipline in Greifswald, Göttingen, Ingolstadt-Landshut-München, Breslau and Marburg. The research shows that the establishing of independent institutes of pharmacy under competent leadership (for instance Ernst Schmidt in Marburg) played a decisive role in developing the discipline pharmacy.

Education, Pharmacy↗
PubMed1989

Clinical career ladders: application to hospital pharmacy practice.

The reasons for job dissatisfaction among hospital pharmacists are reviewed, and an option for ameliorating the problem by offering clinical career ladders is advanced. Not enough new pharmacists are being trained to replace those leaving the profession, and hospital pharmacy managers seeking to recruit and retain quality pharmacists are facing stiff competition from retail outlets, academia, and the pharmaceutical industry. Hospital staff pharmacists report less of a sense of accomplishment than other workers and are more likely to change jobs. Although inadequate pay and benefits are frequently cited, one investigator found that the greatest source of dissatisfaction was the lack of opportunity for advancement. Other professions facing similar problems have experimented with a system of parallel career ladders in which alternatives to the traditional managerial advancement track are offered. Staff nurses on a clinical ladder remain in a direct patient-care role while ascending a hierarchy of clinical practice levels; each level brings greater responsibility and rewards. Outcomes have included improved recruitment, decreased turnover, and increased interest in educational programs. In pharmacy, each level of a clinical career ladder would be defined by explicit criteria for knowledge and skill in patient care and drug therapy. As in nursing, such a ladder would create advancement opportunities and reward the acquisition of knowledge and skills. Several hospital pharmacy departments now offer clinical career ladders. Implementation of clinical career ladders has the potential to enhance the job satisfaction of hospital pharmacists and improve their recruitment and retention.

Career Mobility↗
PubMed1989

The pharmacy technician--an occupation in search of consensus.

These are some of the issues that warrant consideration as we examine the development of a more efficient manpower model for pharmacy. We all realize that we have reached a point in the delivery of health services where inefficiency will have a very direct impact on economic viability. It is imperative that we develop a more rational manpower model that takes advantage of appropriately trained supportive personnel who will be functioning in an environment greatly influenced by advancing technology. As we develop our manpower model, we should also understand that pharmacy is still evolving as a profession. It, too, has problems in identifying uniform standards of practice. We in academia have not yet reached agreement on the appropriate degree required to prepare individuals for the present and future practice of pharmacy. In spite of our inability to reach consensus on a number of important issues, we continue to realize an expansion of our professional roles. As these gains in professionalization continue, we will most likely see a concomitant need for growth in the support base required by pharmacists. This need will be met by either technicians or technology. One of my favorite quotes is taken from a book title by humorist and author Lewis Grizzard: Shoot Low Boys--They're Riding Shetland Ponies. Just as the imaginary speaker above was telling his companions to change their frame of reference, I believe we, too, must change our frame of reference.

Pharmacy Service, Hospital↗
PubMed1988

[The university pharmacy and the university pharmacist in history].

The major purpose of the research is to show the influence of university pharmacy and university pharmacist on the development of pharmaceutical science. The lectures in materia medica were frequent realized in university pharmacy since middle age. In the 18th century the university pharmacy was in some cases the precursor to the institute of pharmaceutical chemistry. In the paper also a summary is given of the importance of extensive activity of the university pharmacists J.D. Leers, G.L.C. Rousseau, J.R. Spielmann, F.C. Lieblein, A.F. Duflos, E.F. Jahns, W. Mettenheimer, C. Brunnengräber, C.A. Laubinger, J. Stamm, O.H. Gerke and E. Weber.

Germany↗
PubMed1988

Survey of pharmacy directors' experience with staff vacancies and recruitment.

Hospital pharmacy directors were surveyed in September 1987 about staff pharmacist turnover, recruitment, and retention. Questionnaires were mailed to pharmacy directors at 541 hospitals in the United States. Three hundred thirty-nine questionnaires were returned (62.7% usable response rate); more than 50% of the questionnaires sent to each geographic region were completed. Only 129 respondents reported difficulty filling vacant staff pharmacist positions within the past 12 months, although 320 believed there is a pharmacist shortage. Seventy-eight reported having positions that remained unfilled for three to six months. For more than 90% of the vacant positions, two-thirds of the duties were in drug distribution. Five hundred thirty-three pharmacists were reported to have left their positions in the past 12 months; the directors said salary and working hours were the reasons most often given, and that 47.5% left to work at other hospitals and 13.1% at chain community pharmacies. National advertisements and the use of professional recruitment agencies were the recruitment methods most frequently mentioned, and salary increases, recognition through feedback from management, and participation in management decisions were the methods most commonly mentioned for retaining pharmacists. Salary was the most frequently reported reason for hospital pharmacist turnover, and nearly half of the pharmacists leaving their positions went to other hospitals.

Attitude of Health Personnel↗
PubMed1987

Functional and structural prerequisites for clinical pharmacy services.

Pharmacy directors and pharmacists in charge of clinical services at 46 medium-sized hospitals were surveyed to identify possible explanations for previously documented inconsistency in the implementation of clinical pharmaceutical services. There were three study objectives: to determine the extent to which basic structural and functional management prerequisites have been implemented at these institutions; to determine whether a relationship exists between the kind and number of clinical services offered and implementation of these prerequisites; and to identify discrepancies between responses of the pharmacy director and the pharmacist in charge of clinical services at the same hospital to the same questions. One hundred hospitals providing clinical pharmaceutical services were randomly selected from a master list of 190 hospitals that had been grouped into nine geographic areas. Of 17 functional and structural prerequisites studied, 4 to 13 of them had been implemented at the hospitals surveyed. Only 24% of the hospitals had implemented the basic functional prerequisites of unit dose drug distribution and decentralized pharmaceutical services. Of nine clinical pharmaceutical services, one to eight were being delivered. A weak correlation between the number of prerequisites implemented and the number of clinical services provided was found. Significant disagreement was found between the directors and their pharmacists about which prerequisites and clinical services were being implemented. This pilot study suggests that pharmacy directors and clinical pharmacists need to assess how effectively basic management prerequisites are being put into practice in the delivery of clinical pharmaceutical services.

Medication Systems, Hospital↗