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Biomedical subjects

W H Puckett

Publications and source records attributed to W H Puckett.

15 recordsLinked to original sources

Hospitalwide medication policies and standards.

The development and composition of a hospitalwide medication policies and standards manual are described. Medication policies and procedures developed independently by individual hospital departments and services at a 789-bed private teaching institution created problems related to consistency, the approval process, accreditation standards, and retrievability. Therefore, a joint nursing-pharmacy task force was formed to create a master document containing medication policies and standards for the entire institution. The manual also contains departmental medication-related procedures, the formulary of approved drugs, and key drug information. Its format allows for periodic updating and ease of use by nurses, pharmacists, physicians, and other health care professionals. It meets the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) requirement of a collaborative framework to ensure optimal medication-use outcomes. All medication-related procedures in individual departments must comply with the new policies and standards. A hospitalwide medication policy manual, created through multidisciplinary collaboration, made the policies and procedures consistent and more accessible and met JCAHO and other regulatory requirements.

Hospital Bed Capacity, 500 and over↗

Biological safety cabinetry.

The biological safety cabinet is the one piece of laboratory and pharmacy equipment that provides protection for personnel, the product, and the environment. Through the history of laboratory-acquired infections from the earliest published case to the emergence of hepatitis B and AIDS, the need for health care worker protection is described. A brief description with design, construction, function, and production capabilities is provided for class I and class III safety cabinets. The development of the high-efficiency particulate air filter provided the impetus for clean room technology, from which evolved the class II laminar flow biological safety cabinet. The clean room concept was advanced when the horizontal airflow clean bench was manufactured; it became popular in pharmacies for preparing intravenous solutions because the product was protected. However, as with infectious microorganisms and laboratory workers, individual sensitization to antibiotics and the advent of hazardous antineoplastic agents changed the thinking of pharmacists and nurses, and they began to use the class II safety cabinet to prevent adverse personnel reactions to the drugs. How the class II safety cabinet became the mainstay in laboratories and pharmacies is described, and insight is provided into the formulation of National Sanitation Foundation standard number 49 and its revisions. The working operations of a class II cabinet are described, as are the variations of the four types with regard to design, function, air velocity profiles, and the use of toxins. The main certification procedures are explained, with examples of improper or incorrect certifications. The required levels of containment for microorganisms are given. Instructions for decontaminating the class II biological safety cabinet of infectious agents are provided; unfortunately, there is no method for decontaminating the cabinet of antineoplastic agents.

Acquired Immunodeficiency Syndrome↗

Ideas for action.

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Competitive Bidding↗

Risk of handling injectable antineoplastic agents.

Uptake of mutagenic substances by persons handling injectable antineoplastic agents was studied, and various methods of preventing such exposure were evaluated. Six persons who prepared i.v. admixtures individually collected their urine in 24-hour batches during several eight-day study periods; each prepared from 12 to 90 admixtures per working day during each period. I.V. personnel prepared admixtures in both horizontal laminar-flow hoods and vertical-flow biological-safety cabinets, and using gloves and masks. Three pharmacy personnel who did not handle any drugs served as controls. Urine was concentrated (each 24-hour sample was concentrated to about 1 ml), and the Salmonella/mammalian microsome mutagenicity test (Ames test) was used to detect mutagenic activity in the urine concentrates. Mutagenicity was observed in the urine of all personnel during periods when they prepared antineoplastic admixtures in horizontal laminar-flow hoods, both when using no protection and while wearing gloves or masks. When admixtures were prepared in the vertical-flow biological safety cabinet by personnel wearing gloves, no urine mutagenicity was detected. The control group showed no urine mutagenicity. Protective intervention methods should be used by all persons handling antineoplastic agents. Guidelines for handling these drugs are presented.

Animals↗

ABC analysis helps to determine which drugs to bid purchase.

The advantages of bid purchasing to both buyer and supplier are described and an explanation of how an ABC classification of inventory helps to determine which items should be bid upon is provided. The cost savings that resulted from bid purchasing of drugs by one hospital using an ABC analysis is also described.

Hospital Bed Capacity, 500 and over↗