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Biomedical subjects

B G Kay

Publications and source records attributed to B G Kay.

13 recordsLinked to original sources
PubMed1992

Overcoming unit dose drug distribution system logistical problems on a 32-acre campus.

The literature contains numerous articles regarding the implementation of unit dose drug distribution systems, but little has been written concerning the logistical problems sometimes encountered with such systems. This article describes the implementation of a drug distribution system at a psychiatric institution at which the inpatient units are scattered throughout a 32-acre campus.

Hospital Bed Capacity, 100 to 299↗
PubMed1990

Documenting concurrent clinical pharmacy interventions.

The documentation of clinical pharmacy activities is an important issue and the authors describe a relatively simple and easily implemented method of documenting concurrent clinical pharmacy interventions. This quality assurance measure was added to the quality assurance calendar of a tertiary care medical center/teaching hospital to: (1) document to the Joint Commission on Accreditation of Healthcare Organizations that the pharmacy department is involved in direct patient care, and (2) demonstrate to hospital administrators that pharmacists are an integral and necessary component of the health care team. At least 115 of 428 (27%) documented interventions during 1988 prevented patients from suffering potentially serious side effects and adverse drug reactions. Physicians and nurses initiated consultations by contacting pharmacists, either by phone or in person, and asking them to: (1) recommend dosages for renally impaired patients; (2) monitor patients receiving medications such as aminoglycosides, digoxin, and phenytoin; (3) suggest appropriate doses for specific indications; (4) recommend a formulary drug for a specific condition; and (5) provide drug information. Pharmacists initiated consultations by contacting physicians and nurses, either by phone or in person, to clarify an order or make recommendations regarding drug therapy. Nurses, pharmacists, and physicians initiated 37%, 33%, and 30% of the clinical interventions, respectively. Most of the physician (89%) and nurse (82%) initiated interventions were requests for drug information, whereas most of the pharmacist initiated interventions were order clarifications (51%). The daily documentation of clinical pharmacy interventions demonstrated that the quality of patient care and patient outcome was improved and served as an effective method of cost-justifying pharmacist positions in this era of fiscal constraints.

Concurrent Review↗
PubMed1988

Microbiology of indwelling central intravascular catheters.

Indwelling central-line catheters (n = 502) from 362 patients in intensive care units were analyzed prospectively. The skin site, 6-cm-distal and -proximal subcutaneous segments of the catheter, exudates, and blood were cultured. Semiqualitative roll plate cultures of the catheter segments were followed by broth cultures and examined for 72 h. All isolates were identified, and susceptibilities were determined. Line infections, defined clinically, yielded 22 different microbial species; 10 different species were recovered from colonized lines. Of the Staphylococcus epidermidis isolates recovered, 39% occurred singly and 21% occurred in combination with other microorganisms; Enterococcus faecalis, S. hominis, and Pseudomonas aeruginosa were next in frequency of isolation. Line infections also yielded other staphylococci, viridans group streptococci, several members of the family Enterobacteriaceae, acinetobacters, anaerobic bacteria, Candida spp., and Aspergillus fumigatus. While S. epidermidis was also the most frequent isolate among the line colonizers, different species and different frequencies of isolation were found among this group. The study showed that the distal catheter segment broth culture was the best predictor of clinical line infections; in addition, gram-negative bacteria were isolated only from the catheters of patients with overt infections.

Bacteria↗
PubMed1987

Pharmacokinetic comparison of intranasal, oral, and intramuscular metoclopramide in healthy volunteers.

This was a randomized, crossover study of the bioavailability and pharmacokinetics of metoclopramide given by intranasal (IN), oral (PO), and intramuscular (IM) routes. The formulations tested were 5 and 10 mg of IN gel, 10 mg PO, and 5 mg IM. The findings showed that metoclopramide follows similar absorption and elimination characteristics when given via these three extravascular routes. There were no statistically significant differences in the area under the drug concentration versus time curve (AUC) or peak metoclopramide plasma concentration (Cmax) data following PO, IM, or 10-mg IN administration. However, the 5-mg IN doses achieved an AUC that was 39.5% the AUC of the 10-mg IN dose. These data show consistent and relatively predictable metoclopramide plasma concentrations following IN administration. Further, 10-mg doses of IN and PO metoclopramide appear to be bioequivalent.

Administration, Intranasal↗
PubMed1986

Designing a modern hospital pharmacy.

Cooperation between the pharmacy director and the hospital's architects in planning a modern hospital pharmacy is described. The pharmacy director at an 870-bed voluntary nonprofit institution and the hospital's architects planned the design for a new 3250-square foot pharmacy department. They developed a preliminary floor plan based on the following functions that the pharmacy would perform: centralized unit dose drug distribution; compounding; bulk and unit dose prepackaging; preparation of sterile products; controlled substance storage; outpatient and employee prescription dispensing; reserve stock storage; purchasing, receiving, and inventory control; drug information services; and administrative services. A final floor plan was designed that incorporated these functions with structural and utility requirements, such as placement of the computer system and dispensing and lighting fixtures. By integrating modern material management concepts with contemporary hospital pharmacy practice, the pharmacy director and the hospital's architects were able to plan and construct a pharmacy that receives, processes, and dispenses medication efficiently.

Computers↗
PubMed1978

Distributing estrogen patient package inserts to institutional patients.

A procedure for the distribution of patient package inserts (PPIs) for estrogens to outpatients (ambulatory and home health care) and inpatients (acute and long-term) was developed. The pharmacist dispenses the PPI to outpatients along with the prescribed drug. The name of the drug, the date, the pharmacist's initials and the fact that the PPI was issued are recorded in the patient's profile. The pharmacist then orally reinforces the information in the PPI. For inpatients, a preprinted double-tab label is adhered to the PPI which is distributed with the medication upon new estrogen orders. The portion adhered to the PPI lists instructions to the physician. The unadhered portion contains an area for recording the name of the drug product, the patient's name, the physician's signature and the date; this tab is affixed to the order sheet by the physician after he has provided and explained the PPI to the patient. Estrogens are not administered until physicians comply with the PPI procedure. While compliance with the PPI procedure has been satisfactory, this may be the result of a substantial decrease in the number of physicians ordering estrogens, along with a corresponding reduction in the number of estrogen products they now prescribe.

Ambulatory Care↗
PubMedDate not supplied

Nurses, physicians, and pharmacists: their knowledge of hazards of medications.

At a major tertiary care teaching hospital, random samples of 100 nurses, 102 physicians, and all of the hospital's 14 pharmacists were tested on their knowledge of the hazards of medications. The 25-question examination was generated by way of a rigorous validating procedure and was self-administered by the practitioners. Based on a perfect examination score of 100, the group mean scores of the nurses, physicians, and pharmacists were 72.3, 81.3 and 85.1, respectively. A one-way analysis of variance demonstrated that the difference in knowledge among the three groups of practitioners was significant (p less than .001). Pairwise (Scheffe) contrast tests revealed that the difference in knowledge between the physicians and nurses, and the pharmacists and nurses was significant; the nurses proved to be the least knowledgeable of the three practitioner groups. The nurses' scores were analyzed by years of nursing experience, type of educational preparation, hospital service affiliation, and hospital shift. A one-way analysis of variance revealed that there was a significant difference in nurses: knowledge by hospital shift (p less than .05). A posteriori contrast tests (Scheffe) indicated that the group mean score of the day shift nurses (mean = 75.6) was significantly different than the average of the evening and night shift nurses' scores (mean = 69.9).

Cognition↗