Showing papers in "Hospital Pharmacy in 1983"

Providing drug information to health professionals and consumers: role and responsibility of the pharmaceutical manufacturer.

Abstract: There is no law requiring any pharmaceutical firm to maintain a drug information center for their products The package insert that accompanies the product is all that is legally mandated Roche and other drug manufacturers provide these services because they believe it is in their own best interest and that of the users of their products to do so Pharmacists are currently involved in providing drug information in numerous settings, particularly health sciences schools, hospitals, colleges, federal agencies and associations, as well as corporations To date, they have been frequent users of company drug information services It is hoped this discussion will stimulate anyone in need of product information to contact the manufacturer They have the most complete data available on their products and are generally willing to share their information with other drug information services, practitioners and, in a more limited way, consumers

Self-medication promotes patient independence in rehabilitative setting.

Abstract: Patients at Sheltering Arms Hospital in Richmond, Virginia, receive instruction about their medication by pharmacists and may progress through three levels of teaching, including monitored self-medication. Pre- and posttests are administered to determine the effectiveness of the program and the percentage of patient improvement in recall as a result. Patients who completed the program demonstrated a significant improvement in scores in four out of five testing categories.

Controlling moxalactam and cefotaxime use with a target drug program.

Abstract: A target drug program was utilized to prevent increasing costs associated with inappropriate use of moxalactam and cefotaxime. The cost saving abilities of pharmacists in this regard were calculated. Pharmacists consulted with physicians each time these drugs were prescribed to encourage cefazolin substitution when appropriate. Records of all cephalosporin piggyback doses dispensed were maintained along with quarterly purchase data. Excess costs of utilizing third generation cephalosporins in place of cefazolin were calculated for various usage levels. Actual third-generation usage was compared to usage predicted if no target program was in place, and cost saving was calculated. During the study period, combined moxalactam and cefotaxime use averaged 3.2% of total cephalosporin use at a cost of $4109 per month. Based on an expected predicted usage of 20% to 40%, an annualized cost savings of $91,071 to $202,815 was achieved. Clinical pharmacists were very effective in preventing inappropriate use of moxalactam and cefotaxime, preventing a rise in drug costs.

Use of the handheld programmable calculator in the preparation of TPN solutions.

Abstract: A handheld programmable calculator was used to increase speed and decrease errors when calculating and labeling total parenteral nutrition formulations for pediatric patients. A program was developed and tested and an evaluation of the calculator vs. the manual method was performed. The time required to calculate total parenteral nutrition formulations decreased 50% and errors decreased from 3% to 0. Use of a handheld programmable calculator saves time and increases the accuracy of calculations and labels when preparing total parenteral nutrition formulations. The approximate total cost of the calculator, printer, and card reader is $1000.

Preventing burnout: an alternative approach.

Abstract: Burnout is a potentially serious dilemma which any practicing pharmacist may encounter. Various suggestions have been proposed to prevent burnout. An alternative approach is presented which involves the pharmacist in a nontraditional role. Pharmacists participate in a 3-month rotation within the Idaho Drug Information Service and Regional Poison Control Center. Pharmacists involved in this rotation believe it is extremely important for expanding their professional roles and preventing burnout.

Mean transit time image - A new method of analyzing brain perfusion studies

Abstract: Point-by-point calculation of the mean transit time based on gamma fit was used to analyze brain perfusion studies in a vertex view. The algorithm and preliminary results in normal brain and in different stages of cerebral perfusion abnormality (ischemia, stroke, migraine, tumor, abscess) are demonstrated. In contrast to the traditional methods using fixed, a priori defined regions of interest this type of mapping of the relative regional cerebral perfusion shows more clearly the irregular outlines of the disturbance. Right to left activity ratios in the arterial part of the time-activity curves showed significant correlation with the mean transit time ratios (Qt = 1.185 - 0.192 Qa, n = 38, r = 0.716, P less than 0.001).

Hospital formulary system/drug product selection: similar or not?

Abstract: Following a brief review of the origin of antisubstitution and drug product selection laws, the legal basis of the hospital formulary system is compared with that of drug product selection. By understanding the differences in the two, the pharmacist can better understand application of the law in these areas to pharmacy practice.

Results of survey--unit-dose repackaging.

Abstract: A survey was conducted to determine drugs that hospitals frequently package in unit-dose. There were 116 responses, identifying 606 line items of tablets or capsules, liquids, and more or less than one dosage unit being packaged. In all three categories there were 108 drugs packaged by four or more hospitals. These results have been shared with the respective manufacturers, to use in marketing these drugs in unit-dose packages.

Psychiatric pharmacy in a partial hospital program.

Abstract: Psychiatric pharmacy practice in a partial hospital program (PHP) is described. The program's objectives are: (1) to provide a transitional setting in which to assist persons with psychiatric disorders to reenter the community after hospitalization; (2) to provide more structured and intensive therapy than is available in an outpatient setting; and (3) to diagnose and treat early psychiatric symptoms, providing an alternative to hospitalization. The pharmacist conducts medication history interviews, co-directs a weekly medication group, participates in weekly medication clinic, provides individual consultation, teaches pharmacy students, participates in health care group, and provides inservice education to the staff. Clinical pharmacy services in a psychiatric partial hospital program increase knowledge of psychotropic drug efficacy and side effects in PHP staff, increase learning about these medications in PHP clients, and can result in safer and more effective use of medication.

Space requirements for pharmaceutical functions in selected nonuniversity hospitals.

Abstract: The size of the average pharmacy is normally developed by gathering information from a large number of hospital pharmacies. The services provided by these pharmacies vary significantly. This tabulation is from selected hospitals that provided comprehensive pharmacy services. Fifty-four responses were tabulated. The results presented in this article indicate that these pharmacies require additional staff members and greater space allocation than the average hospital pharmacy department reported in other studies. Hospitals between 100-199 beds averaged 9.8 sq ft per bed, 200-299 bed hospitals averaged 10.1, 300-399 bed hospitals averaged 9, 400-499 bed hospitals averaged 8, and those over 500 beds averaged 9.4 sq ft per bed.

Analysis of drug information questions on a decentralized pharmacy service unit.

Abstract: The pharmaceutical services at Rhode Island Hospital integrate the decentralized distribution role of the pharmacist with the provision of patient-specific drug information. This service is backed up by a Drug Information Center (DIC). A study to analyze the inquiries addressed to pharmacists assigned to a decentralized unit (PSU) was conducted over a 30-day period. The survey tabulated what kind of requests were made, if they could be answered with the information available on the patient care unit, and what action was taken as a result of the information provided. When the requests were categorized according to the type of information, the PSUs and the DICs top three categories were the same. Only 3.8% of the requests for information on the PSU could not be answered using the references available on the unit. Fifty one per cent of the requests received by the PSU were acted upon by the inquirer exactly according to the information provided by the pharmacist.

The key role of software in implementing computer-based information systems for the hospital pharmacy.

Abstract: The technology of the information age has the potential to significantly alter the many ways pharmacists acquire, control, and use information about drugs, patients, and personnel. Computer-based information systems will become the expected standard of practice. To obtain maximum benefit from these automated systems requires an understanding of all three aspects of computer technology: hardware, "peopleware," and software. Knowledge of software is the weakest element. This report identifies problems associated with software acquisition and evaluation, then suggests guidelines to enhance successful implementation of automated systems. Until competence in software literacy is achieved, it is unrealistic to expect pharmacists to derive optimal benefit from any investment in computer-based pharmacy information systems.

A comparison of the practices used for distribution of controlled substances in Massachusetts hospitals with those reported nationally.

Abstract: A survey questionnaire concerning the procedures used to distribute controlled substances was mailed to 100 randomly selected Massachusetts hospital pharmacies. The tabulated results were compared to a similar study surveying 285 short-term medical and surgical hospitals nationwide. Of the 58 responding hospitals, 47 (81%) reported controlling either all or some Schedule III Controlled Substances in a manner similar to that used for the distribution and accountability of Schedule II drugs. A total of 42 (72%) reported maintaining the same systems for Schedule IV agents. In contrast, only 24 (42%) of those respondents reported controlling Schedule V drugs in a manner similar to Schedule II Controlled Substances. Similar to the findings of a nationwide study, many of the responding Massachusetts hospitals reported selective inclusion of those Schedule III, IV, and V drugs possessing an increased risk of illicit diversion into a more controlled distribution system. In conclusion, many Massachusetts hospitals distribute and account for controlled substances in a manner similar to that used nationwide.

Graphic analysis of pharmacy workload as a management tool.

Abstract: As pharmacy planners implement modern services and cost containment measures, a graphic analysis of pharmacy workload can assist the planner in better utilizing personnel time and assuring adequate time for the completion of additional functions by depicting the peak-trough relationship of workflow. Such analysis can be an effective tool to communicate to both peers and superiors.

Experiences in utilizing the quality circle concept.

Abstract: This article describes an experience with using the quality circle concept in a hospital pharmacy environment. The initial experience was positive in that the staff defined productivity standards for themselves. The staff used their productivity standards to evaluate the perceived problem of understaffing in the department.

A standard aminophylline intravenous solution with flow rate label adapted to a manufacturer's standard solution.

Abstract: The development of a standard aminophylline intravenous solution system utilizing a flow rate label is described. The original system was developed using 500 mg aminophylline in 250 ml of 5% dextrose injection in a polyvinyl chloride bag (PVC). An ancillary label was developed to be affixed to the bag to assist in maintaining flow rates. Later, this system was adapted to a premixed solution prepared by Travenol Laboratories. The difference, though, was the fact that a solution of 400 mg theophylline (equivalent to 500 mg of aminophylline) in 250 ml of 5% dextrose solution (PVC) was used. Hence, a new auxiliary label indicating flow rates between aminophylline and theophylline was developed. The success of both systems gave us more advantages than disadvantages. This was especially true with the premixed system. We feel that the auxiliary flow rate label helped maintain rates whether the physicians orders were written in theophylline or aminophylline. With proper nursing inservice, this standard aminophylline program could be successful using this auxiliary flow rate label.

Balancing workload and staffing in satellite pharmacies by using a patient acuity index.

Abstract: The assignment of beds to satellite pharmacies is based primarily on proximity. Assignment will usually be by nursing unit to encourage more effective communication among the patient, doctor, nurse, and pharmacist. Usually, an equal number of beds is assigned to each satellite. Recognizing that some nursing units (e.g., Intensive Care Units) place greater demands on pharmacy resources than others makes it obvious that there is a need for a system to measure the consumption of pharmacy resources by patient acuity. This article tells how such a measure was conceived, developed, and applied.

Antineoplastic drug-use process at a rural hospital.

Abstract: This article describes the antineoplastic drug-use process and monitoring activities performed by the Department of Pharmacy at a 225-bed rural hospital. Documents developed and used in the process assist the pharmacist in assessing drug-related toxicity, in making recommendations for laboratory or system studies, and for organizing a therapeutic rationale for inpatients and out-patients. Involvement of pharmacists in oncology in rural or small institutions can be essential for maximal therapeutic monitoring and quality patient care. The importance of monitoring antineoplastics on a per patient basis is highlighted.