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At least 127 records · Page 7Linked to original sources
PubMed1991

Creating the optimal nursing-pharmacy interface: a strategic plan for the pharmacy manager.

These strategies certainly do not represent an exhaustive list of the possibilities. They cover some of the major issues and reflect observed elements that exist in institutions that enjoy frequent positive interactions at the pharmacy-nursing interface. Anecdotal observations and comments confirm that in such institutions there exists greater efficiency in the drug-use process, greater job satisfaction, and better patient care than in those institutions where there are strained relationships at the pharmacy-nursing interface. The remaining articles in this issue provide specific examples to document these benefits. The pharmacy manager who makes a concerted, proactive effort to use some of the information in this article and the others to establish a positive, highly interactive pharmacy-nursing interface will experience these same rewards. Progress may occur more slowly in some institutions due to long-standing difficulties. Pharmacy initiatives may be viewed with skepticism. In these situations, actions speak much louder than words; demonstrate change (e.g., decentralization) on a pilot basis without additional resources to generate a groundswell of acceptance at the grassroots level. This will in turn contribute to a much more serious consideration of any proposal that does include increased resources or reallocation of resources (from nursing to pharmacy). No matter how difficult or frustrating it might be to implement these strategies, the potential results are worthy of the efforts.

Clinical Pharmacy Information Systems↗
PubMed1991

The effective pharmacy-nursing committee.

The Saint Joseph's Hospital Pharmacy-Nursing Committee sees a long list of pharmacy-nursing and drug distribution system problems still to be addressed and has no worry about running out of new business. In fact, increasing controlled substances accountability, creating a more reliable and timely process for moving intravenous fluid pumps through the inpatient system, and implementing a pharmacy-based, patient-controlled analgesia program across all of the hospitals' wards are three major issues now being addressed by the committee. At Saint Joseph's Hospital there is not a lot of unnecessary handwringing or undue stress over major pharmacy-nursing issues. Issues do exist, but there is also an experienced Pharmacy-Nursing Committee with a good track record of being able to resolve major issues. The committee takes on problems in a healthy and confident atmosphere of trust in both profession's skills and competencies. There is a respectful knowledge of each discipline's professional responsibilities and a full awareness that a quality patient drug system requires pharmacy and nursing elements working closely together. Wrestling with the heavy, modern-day, hospital pharmacy-nursing drug distribution system issues at this facility actually can be fun as a result of the confidence, camaraderie, and empathy that exists within the Pharmacy-Nursing Committee.

Clinical Pharmacy Information Systems↗
PubMed1995

Experience with an automated point-of-use unit-dose drug distribution system.

Two years' experience with an automated, point-of-use unit-dose system at the University of California, San Diego Medical Center (UCSDMC) is described. Growing concerns about the efficiency and cost-effectiveness of the traditional unit-dose drug distribution system at UCSDMC, and the corresponding diversion of professional staff time from pharmaceutical care responsibilities, led us to investigate alternative systems. Criteria for a new system were developed and used in evaluating alternatives. Consideration was given to three possibilities: 1) improving the existing system, 2) automating the unit-dose cassette fill process, or 3) automating the final step in medication delivery at the nursing station. Based on the realization that our traditional unit-dose system was largely inefficient in today's hospital environment, it was concluded that the drug distribution system needed to be re-engineered in a way that simplified delivery and reduced waiting time. The Medstation Rx system marketed by the Pyxis Corporation (San Diego, CA) seemed to meet the need. During a 2-year period a Medstation Rx system was implemented in most of the hospital (in all but three specialty units) and evaluated. This system has resulted in several benefits, including a net savings in labor costs, a significant reduction in waiting time for first doses, and a reduction in dispensing errors. In the process, it was possible to minimize the disruption of pharmacists engaged in the direct provision of pharmaceutical care, thereby increasing their efficiency.

Automation↗
PubMed1995

Effect of an automated, nursing unit-based drug-dispensing device on medication errors.

The effect of an automated drug-dispensing system on medication error rates was studied. Disguised observations were made on nursing units just before (phase 1) and two months after (phase 2) the implementation of Medstation Rx (Pyxis, San Diego, CA) at a 600-bed hospital. Information gathered included the time of drug administration, the time the medication as ordered to be given, a description of what happened during administration of the dose, and the type of medication error, if any. During phase 1 there were 873 observations and 148 medication errors, for an error rate of 16.9%. During phase 2 the error rate was 10.4% (97 errors in 929 observations). In both study phases, most of the errors were wrong-time errors. The mean +/- S.D. difference between actual and scheduled administration times was 34.5 +/- 48.9 minutes in phase 1 and 30.1 +/- 31.6 minutes in phase 2. Both the decrease in the error rate and the decrease in the departure from scheduled administration times were statistically significant. Medstation Rx was associated with a reduction in the rate of medication errors at a large hospital.

Clinical Pharmacy Information Systems↗
PubMed1988

Establishing a pharmacy and nursing committee.

The development of a pharmacy and nursing committee to improve communication and interdepartmental relations is described. Too often pharmacists and nurses avoid talking about concerns or procedures until they become problems that must be resolved quickly. The purpose of the committee is to resolve issues using a cooperative approach. 1. To discuss the problems in an objective manner, in an attempt to diffuse the emotional component of the problem. 2. To permit discussion from each department's perspective. 3. To identify methods to resolve the problems that would be mutually agreeable. Both the departments of pharmacy and nursing are usually represented on many hospital committees and thus it would be mutually beneficial for both departments to work as a team rather than as adversaries. The logistics in committee formation is discussed. It is also suggested that other departments such as education and risk management may assist the pharmacy and nursing committee in its implementation and assessment of procedures. Since its development, the pharmacy and nursing committee has identified numerous problems and proposed solutions. The establishment of the pharmacy and nursing committee at our institution has assisted in improving the relationship between the two departments. Other hospital pharmacies are encouraged to develop a committee similar to the one described in this article.

Communication↗
PubMed1994

Development of a computerized controlled substances system.

Maintaining controlled substances records are a required and tedious task. A computerized system was developed to meet both pharmacy and nursing needs. The original system consisted of several notebook binders that were tabbed to separate different controlled substances. Pharmacy was constantly dealing with transcription errors and incorrect calculations. In the computerized program, each controlled substance was assigned its own file and mnemonic. The computer allowed for entries and maintained a running inventory. The troubleshooter pharmacist's role was redefined to oversee of the entire system, to have sole access to the entire system, and to maintain a weekly inventory. Improvements also were made in the nursing procedure, which provided a sufficient stock of controlled substances. A new, consolidated nursing form also was devised. The primary reason that the computerized system is successful is that it accommodates the needs of both nursing and pharmacy.

Adult↗
PubMed1995

G-CSF (Granulocyte Colony-Stimulating Factor): follow-up and use in a French University hospital.

Granulocyte Colony-Stimulating Factor or G-CSF (NEUPOGEN) was approved for use in France in November 1991 for prevention of chemotherapy-induced neutropenia. This retrospective study was conducted at Saint-Louis Hospital, Paris, France, from November 1991 to March 1993 with a more detailed analysis of patient profiles for courses ordered between November 1991 and December 1992. Data were collected on standardized G-CSF-treatment summary forms. The purpose of the study was to define, in clinical terms, the patients treated by G-CSF to determine the average cost per course of therapy and its impact on the hospital pharmacy budget. From November 1991 to December 1992 data from 307 patient profiles were collected and analyzed. The subcutaneous route was the preferred route and only 16.6% of courses were administered intravenously. 45.6% of patients received a single course, 24.3% received two courses, and 30.1% received more than two courses. Each patient completed an average of 2.3 courses at an average cost per course of $2,000.00 (Canadian dollars). During March 1993, 50% of vials dispensed were administered to outpatients. During the 14-month period, an average of 613.8 vials were dispensed per month corresponding to an average monthly expenditure of $104,000.00 (Canadian dollars). In the first 12 months following the commercial availability of G-CSF, G-CSF expenditures accounted for 8% of the pharmacy budget.

Adolescent↗
PubMed1994

Nursing/pharmacy interface: a TQM project.

W. Edwards Deming's seven-step quality improvement process provided a sequential pathway to facilitate problem-solving allowing the pharmacy and nursing departments to formulate a systems perspective rather than an individual point of view. Both departments identified problems with the Medication Administration Record and defined three key outcomes needed to signify process improvement.

Communication↗
PubMed1991

A systems approach to the problem of missing medications.

Overall, the systems approach employed in this study has significantly decreased the frequency of missing medication requests on one pharmacy satellite by 38 percent. The most dramatic impact came from the systems-change phase of the study. While the pharmacy personnel-change phase did not contribute to the overall reduction in missing medications, there was a large decrease in missing medications due to discrepancies between the nursing MAR and the pharmacy profile. This study has prompted further investigation into the p.r.n. drug-distribution subsystem.

Evaluation Studies as Topic↗