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At least 19 recordsLinked to original sources
PubMed1978

Computer system for unit dose drug distribution.

A computerized unit dose drug distribution system, part of an online hospital information system, is described. Differences between manual and computerized pharmacy distribution, and the advantages and deficiencies of the automated system are discussed. The system seems to improve pharmacy's efficiency, accuracy, control of drugs and capabilities for patient monitoring and drug use review. If mechanical failure occurs, back-up procedures keep the distribution system operational. The computer system is believed to decrease the time spent by pharmacists on routine distribution tasks, leaving time for other necessary pharmacy functions.

Computers↗
PubMed1978

Training staff pharmacists for clinical positions.

A five-phase education and training program for establishing and maintaining the clinical competency of pharmacists in a 940-bed private, nonprofit hospital is described. In Phase 1 of the program, pharmacists are given selected textbook and journal materials in 15 study sections, each requiring 20--30 hours of the pharmacist's own time to complete. Phase 2 consists of two months of instruction in the daily clinical routine with emphasis on applying knowledge by investigating clinical problems through case presentation and by answering questions of health professionals. During Phase 3, the pharmacist is assigned to a patient-care area for two months to perform the duties of a clinical pharmacist. The pharmacist is assigned to the drug information center for two months during Phase 4. Phase 5, the year-round continuing education component of the program, consists of regularly scheduled clinical rounds, meetings and conferences. Upon completion of Phases 1--4, pharmacists selected for clinical positions provide clinical services for eight to 10 months and rotate to the pharmacy distribution area during the remaining two to four months per year. The education and training program described is important to the development and expansion of clinical services in this hospital.

Curriculum↗
PubMed1975

The spatial distribution of urban pharmacies.

Pharmacists are thought to play a central role in providing information and advice on health to lower income and other socially disadvantaged groups. However, recent evidence suggests that social biases exist in the spatial distribution of urban pharmacies. Such biases would severely limit the accessibility of the poor and the nonwhite to pharmacy services. To test the general nature of this evidence, we used multiple regression techniques to assess the simultaneous influence of several ecological and socioeconomic variables on the location of pharmacies in Pittsburgh and Omaha. After controlling for the influence of physicians, hospitals, commercial activity, population, and other variables thought to affect pharmacy location, we were unable to detect any evidence of a direct association between pharmacy location and the socioeconomic or demographic (other than total population) characteristics of areas in either city.

Delivery of Health Care↗
PubMed1976

Pharmacy personnel activities and costs in decentralized and centralized unit dose drug distribution systems.

Pharmacy personnel activities and labor costs directly associated with concurrent decentralized and centralized unit dose drug distribution systems in the same institution were compared. A work-sampling observation technique was used for the activity survey. Analysis of the data showed that: (1) the activities of pharmacy personnel vary significantly between the decentralized and centralized systems, (2) pharmacists in the decentralized area spent a significantly greater portion of their productive time performing therapy-related activities than did those pharmacists in the centralized system, (3) multiple staffing patterns associated with the centralized unit dose system afforded a significantly greater participation in educational activities by all pharmacy personnel staffing that area, (4) dispensing activities accounted for most nonpharmacist personnel time in both systems, and (5) based on cost/unit dose and existing staffing patterns, there was no appreciable difference in personnel labor costs associated with the two systems. However, it was determined that a considerable cost difference could be expected if the decentralized system's hours of service were equivalent to those associated with the centralized system.

Communication↗
PubMed1991

Expanding staff pharmacists' responsibilities to maintain pharmacy services in a neonatal intensive-care unit.

The conversion of pharmacist responsibilities in a neonatal intensive-care unit (NICU) pharmacy satellite from drug distribution to both clinical services and drug distribution is described. When the pharmacy department could not recruit a specialty-trained clinical practitioner to fill an open NICU position, the position was converted to a fourth satellite pharmacist position, and each of the four NICU satellite pharmacists assumed clinical responsibilities for the NICU. Clinical and distributive functions had previously been separate. Staff development programs and a contract with the previous NICU clinical practitioner for consultative services helped to ease the transition. NICU pharmacists currently provide inservice education to medical residents and the nursing staff, provide drug information, monitor drug therapy, perform pharmacokinetic monitoring, are involved in research, and work to streamline satellite operations. For one of every four months, the NICU pharmacists primarily provide clinical services; the remainder of the time clinical activities are combined with drug distribution responsibilities. The staffing schedule has enabled the department to extend the hours that clinical services are available. The NICU pharmacists maintain secondary areas of staffing, and other pharmacists periodically staff the NICU satellite. Staff pharmacists in the NICU pharmacy satellite developed clinical skills that permitted integration of clinical and distributive pharmacy services.

Hospital Bed Capacity, 500 and over↗
PubMed1991

Drug use and the role of patients and prescribers.

In order to move towards rational drug use in any national or local setting the methods of inquiry have to be expanded. Both the public and private sector have to be addressed. In the latter the pharmacists might be studied using a tracer, fictitious client. One important factor influencing prescribing, drug information, has rarely been assessed scientifically. Experimental studies using group randomization are, however feasible even in developing countries. The individual human being must be in the focus of drug studies and health care and health in the foreground. The combination of qualitative and quantitative methods will assist us to achieve rational drug use that is culturally acceptable, economically feasible and pharmacologically sound.

Developing Countries↗
PubMed1976

National survey of selected hospital pharmacy practices.

The incidence of 10 selected hospital pharmacy programs in short-term hospitals which contained a pharmacy was surveyed. A short questionnaire was mailed to a national sample of 738 hospitals. The 10 programs surveyed were: unit dose drug distribution; pharmacy-prepared i.v. admixtures; pharmacy-controlled drug administration; radiopharmaceutical dispensing; drug usage review; use of computers in the dispensing process; 24-hour pharmacy service; participation in group purchasing; pharmacy operation of central supply; and pharmacists' authority to select the brand or supplier of drugs. In addition, the volume of drug and supply purchases was determined. A large number of pharmacies (41%) belonged to a group purchasing plan, and a high percentage (67%) reported that pharmacists had authority to select the source of supply for all drug orders unless noted otherwise by the prescriber. Less than 10% of the hospitals had both complete unit dose drug distribution and intravenous admixture programs; an additional 10% had implemented such programs partially. Only 17% of the pharmacies in large hospitals were open 24 hours a day. Computer-assisted medication dispensing was used by 13% of the large hospitals and 5% of the small hospitals. Total pharmacy purchases for all short-term hospitals in 1974 was estimated to be 1.5 billion dollars.

Computers↗
PubMed1977

Health care and hospital pharmacy in Denmark.

Health services and community and hospital pharmacy practice in Denmark are discussed. Topics covered include the education and training of pharmacists and technicians, pharmaceutical manufacturing by community and hospital pharmacies, hospital drug distribution, and drug information services. Pharmacy is unique in Denmark inthe 40% of the drug products on the market are manufactured by pharmacies, under the auspicies of the pharmacy proprietors' association. As in other Scandinavian countries, the number and location of community pharmacies are controlled by the state. Ninety pharmacists are employed in 13 hospital pharmacies; half of the pharmacists are occupied bb drug product manufacturing.

Delivery of Health Care↗
PubMed1990

Implementing therapeutic interchange of intravenous famotidine for cimetidine and ranitidine.

The steps taken to implement a therapeutic interchange program for i.v. histamine H2-receptor antagonists and to determine the potential cost savings are described. A literature review conducted by pharmacists at a 273-bed nonteaching community hospital showed that i.v. famotidine was as safe and effective as i.v. cimetidine or ranitidine and that it was feasible to add famotidine to total parenteral nutrition (TPN) solutions. Because of famotidine's cost advantage, it was proposed that i.v. famotidine be used in place of specific dosage regimens of i.v. ranitidine or cimetidine and in TPN solutions ordered for patients receiving concurrent H2-antagonist therapy. The approval of the hospital attorney and hospital gastroenterologists was secured, and a formal proposal was submitted. The pharmacy department distributed a memorandum describing the advantages of famotidine, conducted inservice education sessions, and sought the compliance of physicians by placing reminders on order forms and patient charts and by contacting physicians directly. The program was implemented in May 1989. During the first three months, only one physician insisted that patients receive i.v. ranitidine rather than famotidine. It was projected that the interchange of i.v. famotidine for cimetidine or ranitidine would result in a total savings of $37,565 during the first year due to reductions in the cost of drugs, supplies, and nursing labor. The acceptance of a therapeutic interchange program for H2 antagonists was excellent, and the projected savings are substantial.

Cimetidine↗
PubMed1991

Pseudooutbreak of Candida guilliermondii fungemia in a neonatal intensive care unit.

During a 3-week period multiple blood cultures obtained from 14 Neonatal Intensive Care Unit infants and 3 Newborn Unit babies grew Candida guilliermondii, a yeast rarely associated with infections in humans. At the time of detection of positive cultures, most infants had been hospitalized for days or weeks for serious perinatal conditions and treated with antibiotics and intravenous hyperalimentation. Two critically ill premature infants from whom the yeast was isolated were given amphotericin B. In 7 other infants, however, yeasts were recovered on the day of birth, raising the question of pseudofungemia. Exhaustive interrogation on the blood culture practices revealed that when drawing blood for a culture from small infants, "butterfly" needles were often flushed with a diluted heparin solution to prevent blood clotting. Culture of a single lot of diluted heparin vials, prepared at the hospital pharmacy and distributed to the Neonatal Intensive Care Unit and Newborn Unit shortly before the onset of the epidemic, grew between 10,000 and 15,000 colony-forming units of Candida guilliermondii/ml. Removal of contaminated heparin vials and discontinuation of heparinization of needles used for blood cultures resulted in cessation of the epidemic. The present outbreak illustrates the difficulties in recognizing pseudoinfections in sick premature infants and the importance of intensive investigation and intervention during such an outbreak.

Blood↗
PubMed1992

Increasing pharmacy productivity by expanding the role of pharmacy technicians.

Efforts to meet growing clinical and distributive demands without increasing pharmacy staff are described. Real and expected increases in demands for services led pharmacists at a cancer center to seek ways of accommodating those demands within budgetary limits. Growth in the distributive workload was interfering with clinical consultation work. Research studies by the medical staff were resulting in complex dosage calculations and time-consuming compounding. Increasing requests for clinical services had to be met without compromising distributive services and teaching responsibilities and without raising costs. A plan of action was approved that included the use of a written test and a training manual to allow the hiring and retaining of skilled pharmacy technicians qualified to assume greater responsibilities. Technicians were assigned to enter drug orders into the computer, check other technicians, and dispense certain drugs. Greater use was made of commercially prepared i.v. solutions, and the floor stock was expanded. A comprehensive quality control program was concurrently put in place. The larger role for technicians not only enabled the pharmacy department to increase its distributive workload dramatically but reduced pharmacy medication errors and provided more time for clinical pharmacy practice. The number of pharmacist and technician full-time equivalents increased by only 1.5 in each category between 1985 and 1990. By making more use of pharmacy technicians, a pharmacy department was able to meet escalating demands for services with only a minor increase in personnel.

Allied Health Personnel↗