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Biomedical subjects

E G Nold

Publications and source records attributed to E G Nold.

13 recordsLinked to original sources
PubMed1992

Hospital pharmacy in 1991: the year in review.

Issues and activities that dominated hospital pharmacy in 1991 are reviewed, and their relationship to political and economic trends of national and international importance is described. While rising costs, equitable reimbursement, and access to care continued to dominate the nation's health-care agenda in 1991, the growing interest in quality assurance was also noteworthy. Health-care reform will likely be a dominant issue during the current election year, and pharmacists are urged to play an active role in this restructuring process, both within their work settings and in their communities. Among the major concerns of hospital pharmacy in 1991 were the appropriate use of the new products of biotechnology, advances in computer and communications technology, and measuring and improving the quality of pharmaceutical care. Other issues highlighted in the literature included the need to articulate a mission statement concerning pharmaceutical care, the role of specialization in pharmacy practice, and the appropriate allocation of human resources. The literature of hospital pharmacy continues to provide insight into the progress of the profession and to serve as a benchmark that will gauge its future course.

Computers↗
PubMed1991

Pharmacy-controlled documentation of drug allergies.

The implementation of a pharmacy-enforced policy for documenting drug allergies is described. After two incidents at a 600-bed teaching hospital in which patients experienced severe allergic reactions to drugs, an audit was conducted to evaluate the existing drug allergy documentation policy. Physicians documented allergies in medical charts and treatment orders for 68% and 78% of patients, respectively; no initial drug orders contained this information. Nurses documented allergies in admission assessments, medication records, and charts for 71%, 61%, and 15% of patients, respectively. Only 2% of pharmacy computerized drug profiles contained allergy information. A new policy for drug allergy documentation was instituted. Physicians provide allergy information on the first written drug order. Nurses independently solicit allergy information and check it against that provided by the physician. Pharmacists enter the information into the patient's drug profile. If the information has not been obtained, the drug is not dispensed. Repeat audits two months and one year after the policy was put in place showed significant improvements in the completeness and accuracy of drug allergy documentation by pharmacists and physicians. In general, documentation by nurses did not improve to the degree found for pharmacists and physicians. A policy that gave pharmacists the primary responsibility for ensuring that drug allergy information was obtained before drugs were dispensed was effective in improving allergy documentation by physicians and pharmacists.

Chicago↗
PubMed1991

Hospital pharmacy in 1990: the year in review.

The accomplishments of hospital pharmacy in 1990 are reviewed, and external and internal factors affecting the profession are described. Six issues were identified as having a major impact on hospital pharmacy in 1990: cost containment, productivity and leadership, patient safety, medical-legal and ethical considerations, human resource management, and computers and new technologies. Highlights of activity in each of these areas, as reported primarily in the American Journal of Hospital Pharmacy, are reviewed. Hospital pharmacy remains a vibrant and growing profession that is responding positively to external and internal challenges.

Clinical Pharmacy Information Systems↗
PubMed1985

Selecting a personal computer for the home and office.

Potential uses, reasons for purchasing, and principles in selecting a personal computer for the office or home are described. The decision to purchase a personal computer involves acquiring basic knowledge, determining generic software needs, selecting appropriate hardware, designing the system on paper, determining costs, selecting a vendor, and purchasing and implementing the system. The user should start with basic equipment and add to the system as technology and his own proficiency advance. A personal computer should be designed for growth (adaptability), because equipment can quickly become obsolete. Purchasing a personal computer requires an organized approach and a substantial time commitment both for research before selecting a computer and for becoming a proficient user.

Computers↗
PubMed1985

Bar codes and their potential applications in hospital pharmacy.

The technology and terminology of bar codes, the Health Industry Bar Code (HIBC) Standard, issues facing the pharmaceutical industry with respect to bar codes, and potential applications of bar codes in hospital pharmacy are reviewed. Bar codes consist of a series of parallel alternating dark lines and empty spaces. Commonly used bar codes include UPC (Universal Product Code), Interleaved 2 of 5, Codabar, Code 93, Code 128, and Code 39. There are several different types of scanners that may be used for scanning bar codes. Some of the variable features are portability, contact and noncontact, autodiscrimination, and the presence of numeric keypads. The HIBC Council (HIBCC) is a steering committee charged with developing bar-code standards for health care, assigning identification numbers to manufacturers, and providing information to interested individuals. The HIBCC Board includes representatives from health-care providers, equipment manufacturers, drug manufacturers, and wholesalers. Drug manufacturers are concerned about several issues with regard to bar codes; for example, who will pay for the cost of implementation, on what level of packaging will the bar codes be required, and are there legal implications if a poor scan results in patient harm? Bar codes have already been applied in some hospitals for coding blood containers, roentgenogram jackets, medical records, and capital equipment. The potential applications in hospital pharmacy include inventory control, verifying the accuracy of dispensing to both inpatients and outpatients, and record keeping for drug product expiration or disposal. Bar codes also offer pharmacists the ability to perform in-process dispensing controls that are not practical to perform manually. Bar-code technology offers health-care personnel the opportunity to improve work efficiency and increase the accuracy of data entry into automated systems.

Computers↗
PubMed1979

Cost-effectiveness of clinical pharmaceutical services: a follow-up report.

The cost-effectiveness of pharmacist-conducted training programs for patients self-administering at home antihemophilic factor, calcitonin, cytarabine, injectable analgesics and parenteral nutrients was studied. Records of 35 patients participating in the training programs from September 1976 through August 1978 were reviewed. The benefits of the patient training programs were measured by approximating the days of hospitalization or outpatient visits saved (and their related costs) per patient. For every dollar charged by the pharmacy service for the patient training programs, 1.25 days of hospitalization and $321.90 in hospital charges were saved. The cost-effectiveness ratios demonstrated the benefits of the patient training programs. Third-party reimbursement can be improved by designing comprehensive measures of cost-effectiveness.

Cost-Benefit Analysis↗
PubMed1979

Reimbursable pharmacy teaching program for adrenalectomy patients.

A three-step, pharmacist-taught education program for adrenalectomy patients is described. Twenty-three patients were trained during the two years of the project. Training included: (1) an explanation of the patient's disease state and need for supplementary medication; (2) an explanation of each medication taken; and (3) training on self-administration of an i.m. dose of dexamethasone. Blue Cross agreed to pay the hospital ø25 per patient trained. Thirteen patients were available for interviews designed to evaluate the program. All patients knew the signs and symptoms of adrenal crisis and had excellent recall of information about their medication. Eight patients had increased their oral steroid doses as instructed to avoid adrenal insufficiency during stress. Substantial cost savings resulted from the program. The costs saved by offering the program justified the cost of supplying the service.

Adrenal Cortex Hormones↗
PubMed1979

Developing reimbursable clinical pharmacy programs: pharmacokinetic dosing service.

The development, operation and evaluation of a pharmacy-conducted pharmacokinetic dosing service is described. Pharmacists recommend individualized drug dosing regimens based on pharmacokinetic models and equations clinically tested for accuracy by the pharmacy department. Pharmacokinetic values are determined with the aid of online computer programs developed by the department. Drug assays are provided by the hospital's laboratory. All of the department's pharmacists were trained to provide the 24-hour service. The pharmacy department's $20 pharmacokinetic dosing service fee is reimbursed by Blue Cross. The pharmacokinetic dosing service is the first nonteaching, nonproduct-oriented pharmaceutical service whose cost-effectiveness has been recognized by a third-party payer.

Body Surface Area↗
PubMed1979

Developing reimbursable clinical pharmacy programs: a goal-oriented approach.

Using a goal-oriented approach, a model for achieving third-party reimbursement for clinical pharmaceutical services is proposed. Within the framework of this model, the discussion includes: (1) determination of the hospital pharmacy mission, goals and objectives; (2) classification of clinical services into eight categories to establish the reimbursement potential for each service; (3) development of a clinical service protocol, techniques to establish charges and stages involved in communicating with the parties affected by the clinical services; and (4) methodologies for evaluating program outcome.

Evaluation Studies as Topic↗
PubMed1977

Third-party reimbursement for clinical pharmacy services: philosophy and practice.

A step-by-step approach is outlined for obtaining third-party reimbursement for clinical pharmacy services separate from dispensing fees. The program is based on a patient-care philosophy rather than a cost-conscious philosophy. The steps in implementation of the program were: (1) a total commitment to the patient's health, (2) identification of patient needs that require clinical pharmacy expertise, (3) development of a patient training program, (4) presentation of a written proposal to the hospital administration, (5) presentation of the proposal to third-party agencies, (6) initiation of charges for the services, and (7) preparation of reports on the progress of the program. Third-party reimbursement covers pharmacist instruction of home therapy patients receiving antihemophilic factor, cytarabine, parenteral nutrition, calcitonin-salmon and injectable analgesics. Financial data based on one year's experience with the program show that savings far outweight the charges.

Blue Cross Blue Shield Insurance Plans↗