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Biomedical subjects

C M Karnack

Publications and source records attributed to C M Karnack.

8 recordsLinked to original sources
PubMed1985

Warfarin: a quality assurance model for concurrent drug monitoring.

Until recently, the mechanism to gain the attention of hospital decision makers on the potential implication of pharmacists' involvement in the drug use review process was missing. However, integrating clinical pharmacy services with quality assurance activities appears to provide a mechanism to reduce patient risk and cost while maintaining the quality of patient care services provided. The department of pharmacy at The Mercy Hospital of Pittsburgh, through the hospital-wide quality assurance committee (QAC) and pharmacy evaluation committee (PEC), has developed concurrent drug the reviews. The concurrent warfarin review conducted by the department of pharmacy is described in detail to illustrate the process that is followed in the development and implementation of a concurrent drug use review. The concurrent review of warfarin was initiated and, in general, criteria were met and few variations occurred. Interventions by staff pharmacists were effective in further improving compliance with certain criteria. Although it was not proven that the incidence of hemorrhage was actually decreased, the QAC felt that such an approach would serve to decrease the likelihood of hemorrhage as warfarin therapy is initiated in the hospital. Similar drug use reviews have been developed for aminoglycosides, third-generation cephalosporins, piperacillin, cefoxitin, cefazolin, vancomycin, phenytoin, and the digoxin-quinidine interaction. The objective of these reviews is also to reduce patient risk and costs associated with drug use. Therefore, in today's hospital environment, a mechanism to improve the visibility of the pharmacist's involvement in the health care process is to integrate clinical pharmacy services with quality assurance activities.

Concurrent Review↗
PubMed1981

Pharmacist involvement in home parenteral nutrition programs.

The results of a national survey of hospital-based home parenteral nutrition (HPN) programs are reported. Questionnaires were mailed to 70 hospitals that were though to have HPN programs. The response rate was 90%, with 51 (73%) usable questionnaires. The "typical" hospital providing HPN services was a private, nonprofit greater-than-400-bed, university-affiliated teaching hospital. HPN programs had been in operation a mean of three years; most served two patients or less. Hospital pharmacies prepared the nutrition solutions 57% of the time; in 25% of the programs, the fluids were prepared at home. Most HPN programs had patient education and training activities. Pharmacists and physicians were most commonly responsible fo monitoring patients' laboratory results. Most HPN programs (90%) were reimbursed for solutions and supplies; 20% were reimbursed for patient education.

Home Nursing↗
PubMedDate not supplied

An evaluation of a microcomputer in reducing the preparation time of parenteral nutrition solutions.

A microcomputer was evaluated in reducing the activities of pharmacists and pharmacy technicians in processing orders for parenteral nutrition (PN) solutions. A program in BASIC was developed for a Radio Shack TRS-80 microcomputer. The program maintains a patient profile, prints a label, generates a worksheet for the preparation of solutions, and provides statistical data for the Pharmacy Nutritional Support Service. A direct time study by intensive samplings was performed on 24 patients utilizing 51 units of PN solution. The computerized method was compared to the current manual method for processing PN orders. The computerized method significantly reduced the processing time (p less than 0.001), saving an average of 2.61 minutes/order. This represented 41.3% of the manual processing time. The time savings was greater when two or more units per patient were ordered (3.37 minutes/order) when compared to patients who received only one unit of PN (0.76 minutes/order). At Rhode Island Hospital, this would result in a savings in time of 300 to 400 hours annually. The authors concluded that a microcomputer is a valuable addition to a nutritional support service. In addition, it should provide the pharmacist with substantially more time to engage in activities related to the care of patients receiving PN solutions.

Computers↗