Case studies of pharmacy involvement in hospital-based home health care. Good Samaritan Hospital & Medical center.
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Home Care Services↗
Biomedical subjects
M L Slotfeldt
Publications and source records attributed to M L Slotfeldt.
Improving patient-oriented pharmacy services: what the director can do.
How pharmacy directors can further the development of patient-oriented services is described. A philosophy of responsibility for patient outcomes instead of for specific functions is necessary for achieving pharmacy's full potential. Overall, pharmacy practice today does not reflect this sense of responsibility for drug-use control. Management that encourages greater accountability; a mission statement and goals; specific definitions of performance criteria; evaluation of services in terms of patient-care outcomes; and increased interaction with physicians, nurses, and hospital administrators are needed. A director can guide pharmacists in a recommitment to professional services that will result in positive patient-care outcomes.
Humans↗
Improving patient-oriented pharmacy services: panel discussion.
A panel discussed ways to improve patient-oriented pharmacy services, drawing on the proceedings of a recent conference on directions for clinical practice in pharmacy. Clinical pharmacy should be defined in terms of responsibility rather than by a list of specific functions. Pharmacists are responsible for drug use, not just for dispensing; this implies responsibility for educating physicians and nurses to ensure optimal patient outcomes. Clinical practice cannot be separated from pharmacy practice; although pharmacy practice requires different kinds of tasks, all have the goal of patient care. Pharmacists can exercise their responsibility for control of drug use without prescriptive authority or mandated review of physician prescribing. Pharmacists can increase their influence on drug therapy through the formulary system and through their physical presence on patient-care units. A mission statement that recognizes responsibility for patient outcomes can serve as the basis for a management system that supports clinical practice. The panel members believed that pharmacy leaders at the conference were unified by a commitment to increase the profession's clinical orientation.
Humans↗
Reliability of theophylline clearance in determining chronic oral dosage regimens.
Predicted and approximated mean serum theophylline concentrations were compared to assess the feasibility of using theophylline clearance, calculated from the intravenous steady-state serum theophylline concentration, to determine appropriate oral dosage requirements. Ten patients with reversible airway disease (age 7 to 64 years) received theophylline (as Aminophylline USP) by constant i.v. infusion. Theophylline clearance was calculated for each patient from steady-state serum theophylline concentrations determined from blood samples obtained after a least 48 hours of constant theophylline infusion. Aminophylline USP tablets were then adminstered orally. Blood levels measured at peak and trough times following oral theophylline administration were used to calculate an approximate mean serum theophylline concentration. The relationship between predicted and approximated mean serum theophylline concentrations was calculated and analyzed by orthogonal least square regression line. Serum theophylline concentrations ranged from 5.1 microgram/ml to 20.1 microgram/ml, and clearances ranged from 0.03 liter/kg/hr to 0.09 liter/kg/hr. During oral therapy, the maximum concentration ranged from 10.4 microgram/ml to 23.8 microgram/ml, while the minimum ranged from 6.5 microgram/ml to 15.2 microgram/ml. The difference between predicted and approximated mean serum concentrations was within +/-1.6 micrograms/ml in all cases. The study indicates that the theophylline clearance calculated from i.v. infusion data can be used to determine appropriate oral dosage requirements.
Administration, Oral↗