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Douglas J Scheckelhoff

Publications and source records attributed to Douglas J Scheckelhoff.

6 recordsLinked to original sources
PubMed2006

ASHP national survey of pharmacy practice in hospital settings: dispensing and administration--2005.

PURPOSE: Results of the 2005 ASHP national survey of pharmacy practice in hospital settings that pertain to dispensing and administration are presented. METHODS: A stratified random sample of pharmacy directors at 1173 general and children's medical-surgical hospitals in the United States was surveyed by mail. RESULTS: The response rate was 43.5%. Most hospitals had a centralized drug distribution system; however, there is evidence of growth in decentralized models compared with data from 2002. Automated dispensing cabinets were used by 72% of hospitals and robots by 15%. The percentage of doses dispensed in unit dose form increased, as did the use of two-pharmacist checks for high-risk drugs and high-risk patient groups. However, the percentage of medication preparation and dispensing quality-improvement programs declined over the past six years. Medication administration records (MARs) have become increasingly computerized over the past six years. Consequently, the use of handwritten MARs has declined substantially. Technology implemented at the administration step of the medication-use process is continuing to grow. Bar-code technology was implemented by 9.4% of hospitals, and 32.2% of hospitals had smart infusion pumps. Pharmacy hours of operation were stable, with 30% of hospitals providing around-the-clock services. About 12% of hospitals are using off-site medication order review and entry after hours. Pharmacy staffing has steadily increased over the past three years; however, hospital pharmacies reported a 5.6% vacancy rate. CONCLUSION: Safe systems continue to be in place in most hospitals, but the adoption of new technology is changing the philosophy of medication distribution. Pharmacists are continuing to improve medication use at the dispensing and administration steps of the medication-use process.

Drug Compounding↗
PubMed2005

ASHP national survey of pharmacy practice in hospital settings: prescribing and transcribing--2004.

PURPOSE: Results of the 2004 ASHP national survey of pharmacy practice in hospital settings that pertain to prescribing and transcribing are presented. METHODS: A stratified random sample of pharmacy directors at 1183 general and children's medical-surgical hospitals in the United States was surveyed by mail. SMG Marketing Group, Inc., supplied data on hospital characteristics; the survey sample was drawn from SMG's hospital database. RESULTS: The response rate was 41.7%. Compared with the results of the 2001 survey, the number of times pharmacy and therapeutics committees met increased, suggesting an increase in efforts to monitor and manage medication use in hospitals. There was an increase in the use of quality-of-life information to make formulary decisions, indicating a shift away from cost-based formularies. There was a decrease in the rates of formulary compliance, but an increase in the use of evidence-based clinical practice guidelines, suggesting the emergence of more comprehensive approaches to improving prescribing. The use of medication-use evaluations increased in smaller hospitals, suggesting greater use of best practices is occurring in these institutions. The use of drug information services continues to decline, as the use of more efficient and easily accessible online sources of drug information increases. Reading back oral orders to improve accuracy dramatically increased since 2001. The adoption of computerized prescriber-order-entry systems continues to be slow, with fewer than 5% of hospitals reporting their use. CONCLUSION: The 2004 ASHP survey results indicate that pharmacists are continuing to improve medication use at the prescribing and transcribing steps of the medication-use system.

Computer Systems↗
PubMed2004

ASHP national survey of pharmacy practice in hospital settings: monitoring and patient education--2003.

PURPOSE: Results of the 2003 ASHP national survey of pharmacy practice in hospital settings that pertain to monitoring and patient education are presented. METHODS: A stratified random sample of pharmacy directors at 1173 general and children's medical-surgical hospitals in the United States was surveyed by mail. SMG Marketing Group, Inc., supplied data on hospital characteristics; the survey sample was drawn from SMG's hospital database. RESULTS: The response rate was 47.1%. Virtually all hospitals (95.3%) had pharmacists regularly monitoring medication therapy in some capacity. Patient monitoring has improved since 2000; fewer respondents reported monitoring less than 25% of patients in the hospital, and most hospitals reported an increase in the amount of time pharmacists devoted to monitoring activities. Pharmacists were provided computer access to laboratory information in 78% of hospitals to facilitate this function. Detection and reporting of adverse drug events (ADEs) have substantially increased since 1999, with an increase of 42% in events reported internally. Strategies to improve ADE reporting were in place in 84% of hospitals, indicating that pharmacists are adopting the widely recommended philosophy of learning from errors. Errors were less widely reported externally, limiting the value of aggregated data for improving the medication-use process. Most hospitals (85.5%) had an interprofessional infrastructure in place to discuss and learn from voluntary reports of ADEs. Medication counseling continued to be relatively infrequent, with nearly three fourths of hospitals reporting fewer than 26% of inpatients received medication education. Pharmacist staffing in hospitals has risen significantly, from an average of 8.6 full-time equivalents (FTEs) in 2002 to 9.4 FTEs per hospital. Vacancy rates for pharmacists decreased from 7.3% in 2002 to 43%. It is now estimated that there are 1846 vacancies in hospital pharmacies. CONCLUSION: Notable improvements in hospital pharmacy practice have been made. The percentage of patients whose medication therapy is monitored by pharmacists has increased, and most hospitals reported that the amount of time pharmacists spent monitoring patients' medication therapy had increased. Internal and external reporting of ADEs has increased, and pharmacist vacancies have decreased from 2002. Staffing has also improved, suggesting an abatement of the critical shortage of pharmacists in the hospital setting.

Adverse Drug Reaction Reporting Systems↗
PubMed2003

ASHP national survey of pharmacy practice in hospital settings: dispensing and administration--2002.

Results of the 2002 ASHP national survey of pharmacy practice in hospital settings that pertain to dispensing and administration are presented. A stratified random sample of pharmacy directors at 1101 general and children's medical-surgical hospitals in the United States were surveyed by mail. SMG Marketing Group, Inc., supplied data on hospital characteristics; the survey sample was drawn from SMG's hospital database. The response rate was 46.7%. During 2002, both inpatient and outpatient hours of service increased compared with 2001. Paradoxically, there was an 8.5% decrease in pharmacy staffing and a 7% vacancy rate, suggesting that pharmacists are busier. Most hospitals (80%) had a centralized inpatient dispensing system, but 44% were planning to become more decentralized. Automated dispensing cabinets were used by 58% of hospitals with decentralized drug distribution systems. Most hospitals (81.4%) dispensed more than three quarters of oral doses as unit doses and 63.3% of injectable doses to non-critical care patients, increases from 1999. A large percentage of hospitals (89%) repackaged both oral and injectable medications. More hospitals were repackaging medications than three years ago, primarily because of lack of commercial availability. Approximately 20% of pharmacies either partially or completely outsourced drug preparation activities. Nurses administered medications in virtually all hospitals (99.7%). Despite widespread recommendations to use bar-code technology to check and document doses administered, only 1.5% of hospitals used this technology, an increase from 1.1% in 1999. Nearly two thirds of hospitals used computer-generated medication administration records. While pharmaceutical services are expanding, workforce issues continue to challenge pharmacists trying to maintain and enhance safe medication systems. Safe systems continue to be in place in most hospitals, but the adoption of new technology to improve safety is slow.

Documentation↗