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–Diagnosis and testing–Treatment and therapy–Patient processing–Public health and wellness–Preventive health initiatives–Training healthcare professionals-Conducting research
Functions of a hospital
–List of drugs approved for use in the hospital
•Drug formulary
Reviews, approves, and revises the hospital’s drug formulary
Pharmacy and Therapeutics (P&T) Committee
allows for easier communication about a patient within a hospital/health system.
Electronic health records (EHRs)
The roll of the pharmacy technician on the P&T Committee
•Collects data and performs audits for the drug-information pharmacist
Up to 70% of a hospital pharmacy budget is spent on pharmaceuticals
pharmaceuticals
In certain cases, the same set of medications and treatments applies for each patient receiving the same surgery or procedure.
Standing Order
–Dose of a drug repackaged for a single administration to a particular patient at a particular time
•Unit dose
–Safe and accurate preparation of parenteral medications
Intravenous admixture
document written in understandable language about the study for patient participants
Informed consent
All information collected using automation must be used in a way that protects patient privacy according to
HIPAA
–Movable cart with removable cassette drawers for medications for all patients on a nursing unit
•Unit dose cart
This is used to –Identify and correct the system’s problem to prevent recurrence
•Medication error reports
The roll of the DOP on the P&T Committee
•Records and disseminates meeting minutes
Orders written upon admission. Includes suspected diagnoses, orders for lab tests, diet, nursing, medications (includes those taken at home and those started upon admission), and notation of drug allergies.
Admitting Order
An emergency order that is typically called in or sent electronically. It must receive priority attention.
Stat Order
–Provides nutritional needs intravenously for patients who cannot or will not eat
•Total parenteral nutrition (TPN)
•Responsibilities
–Preparing, packaging, delivering drugs to units in the hospital
–Stocking various dispensing units including emergency crash cart
–Monitoring inventory
Hospital Pharmacy Technician
Repackaged medications must be labeled carefully and documented in a
repackaging control log
•Picks, counts, packages, labels, stores, and dispenses medication using barcode technology
–Selected by robotic arm
Robotic Filling
The roll of the Drug information pharmacist on the P&T Committee
•Researches and makes objective drug formulary recommendations
•Ordered by the prescriber for a patient
•Received electronically, by fax, pneumatic tube, phone, or hand delivery
•Written in the medical chart
•Entered (most often) by the hospital pharmacist
Medication Orders
collects information on adverse reactions to investigational medications, evaluates whether studies with severe adverse reactions should continue
Institutional Review Board (IRB)
Reviews the use of investigational drugs or procedures in the hospital
Institutional Review Board (IRB)
–Bed capacity
–Targeted patient population (e.g., children, veterans)
–Type of service
–Affiliation
–Ownership
–Urban versus rural
–Financial status
Hospitals classified according to certain characteristics
orders are written when patients transfer from one unit to another or when a physician reviews and rewrites all orders periodically.
Continuation Order
An order that provides take-home instructions for a patient who is being discharged from the hospital.
Discharge Order
mobile cart that holds necessary drugs for an emergency code, such as a Code Blue
Crash cart
A new medication order written daily by a physician after every patient examination.
Daily Order
•An electronic record of the administration time of each drug
•Uses barcode technology known as barcode point-of-care (BPOC) scanning
•Reduces medication errors
•Increases nurse productivity
Electronic Medication Administration Record (eMAR)
–Director of pharmacy
–Drug-information pharmacist
–Pharmacy technician
Pharmacy members of the P&T Committe
•oversees the day-to-day operations
•Determines the level and scope of pharmacy services
•Plans and monitors the budget
•Makes staffing decisions
•Develops the Policy & Procedure Manual
Director of Pharmacy responsibilities
•Secure, locked cabinet of designated drugs on a nursing unit
Automated Dispensing Cabinets (ADC)
–Prescriber directly enters order into the electronic health record (EHR) using a mobile device or laptop computer
•Computerized prescriber order entry (CPOE)
•Confidential process by which the pharmacy “locks in” medication costs from a prime wholesale vendor for one year
Bidding Pharmaceuticals and Purchasing Contracts