(2) DPP 1054 Hospital in General

7/30/2019 (2) DPP 1054 Hospital in General

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HOSPITAL PHARMACY

HOSPITAL IN GENERAL


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Learning Objectives Describe the various unit in hospital

Identify the process of medication

dispensing. Describe specialty services

Discuss the origins and purpose of thehospital formulary.

Discuss the role of automation andinventory control in the hospital.


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Learning Objectives

Describe the classifications andfunctions of a hospital.

Identify the roles of major hospitalcommittees.

List common universal precautions to

protect hospital employees.


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Functions of a Hospital1. Diagnosis and testing

2. Treatment and therapy

3. Public processing (includingadmissions, record keeping, billing,and planning for post-release patientcare)

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Functions of a Hospital4. Public health education andpromotion, done through a variety of

programs, including smoking cessationprograms, weight loss programs, supportgroup programs, and screening ofcommunity members (includingmammographies and testing of bloodpressure and cholesterol)


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Functions of a Hospital

5.Teaching (i.e., training healthprofessionals)

6.Research (i.e., carrying outadd to the sum of medical kno

programs thatwledge)


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Hospital Pharmacy ServicesServices Similar to Community Pharmacy Services

1.Maintaining drug treatment records

2.Ordering and stocking medicationsand medical supplies

3. Repackaging medications

4. Dispensing medications

5.Providing information about theproper use of medications


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Hospital Pharmacy Issues

Safety Note!Only unopened unit doses can be returned to stock.

Why ? Medication Error etc


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Hospital Pharmacy ServicesServices Similar to Community Pharmacy Services

6.Collecting and evaluating information aboutadverse drug reactions and interactions.

7.Preparing medications in various dose forms fordispensing

8.Educating and counseling patients about theirdrug therapies

9.Preventing, identifying, and resolvingmedication-related problems


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Hospital Pharmacy ServicesServices Provided by a Hospital Pharmacy

1.Preparing and maintaining aformulary

2. Conducting drug use evaluations3. Following universal precautions

4.Preparing products using aseptic

techniques


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5.Ensuring that hazardous agents arehandled and disposed of properly

6.Filling medication orders (as opposed toprescriptions)

7.Routinely preparing 24-hour supplies ofpatient medications in a form appropriate for

a single administration to a patient


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8.Stocking nursing stations with medicationsand supplies

9. Delivering medications to patients rooms10.Maintaining a drug information service, andproviding drug information to the otherhealthcare professionals in the institution

11.Educating and counseling inpatients &outpatients about their drug therapies


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12.Monitoring patient outcomes

13.Preventing, identifying, and resolving

medication-related problems14.Participating in clinical drug investigationsand research

15. Providing in-service drug-related education


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16.Reviewing or auditing prescriptionservices for evaluation of service accuracy

and quality17.Providing expert consultations in suchareas as pediatric pharmacology, nutritionalsupport, and pharmacokinetics


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Safety Note!As in the community pharmacy, in thehospital pharmacy the technician worksunder the direct supervision of the

pharmacist.


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HOSPITAL PHARMACY SERVICES

Inpatient Pharmacy Service: Hospitalpharmacies carry out a number of uniqueactivities such as unit dose drug distributionsystem, repackaging, floor stock, and an IVadmixture/TPN service. Also, a unit dosedrug distribution system saves money andreduces the chance of medication errors.


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HOSPITAL PHARMACY SERVICES

Outpatient Pharmacy Services: Many largehospitals operate an outpatient pharmacy to

serve the medication needs of patientsdischarged from the hospital, as well as forthose patients who are seen in theemergency room or other ambulatory clinicsadjoining the hospital.


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HOSPITAL PHARMACY SERVICESClinical Services: Many hospitals offer clinical and

consultative services such as nutrition support,pharmacokinetics, critical care, and other specialties.

Drug Information Services: Most hospitals have adrug information service that is primarily responsiblefor making recommendations on a drug formulary. Ahospital pharmacy may maintain a drug informationcenter, containing reference works, including books,

periodicals, microfilm, CDs, DVDs, and access tocomputerized or Internet databases.


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AUTOMATION IN

THE HOSPITAL PHARMACY

Technology is used in the hospital pharmacyto increase accuracy and improve efficiencyand quality of pharmacy services.

Automated pharmacy services are replacingsome of the routine, time-consuming fillingprocedures. For instance, large automatedrobots are now being used to perform some

of the filling procedures with near 100%accuracy


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VIal Delivery Windows

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Safety Note!All computer systems must protect

patient privacy.


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Safety Note!Although automation reduces errors,technical errors must still be monitored.


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Safety Note!Expiration dates must be included on all

repackaged medications.


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INVENTORY MANAGEMENT

An important part of the technicians positionis the receipt, storage, and ordering of

pharmaceuticals; discrepancies in the orderfrom the wholesaler or pharmaceuticalmanufacturer should be resolved.

Automation from the pharmacy wholesalersis making inventory management moreaccurate and less costly.


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ORGANIZATION OF THE HOSPITALPharmacy Administration: The director of

pharmacy is the pharmacist-in-charge, withoverall responsibility for the hospitals pharmacy

services. Depending on the hospital size,additional assistant or associate directors maywork under the director. In small rural hospitals,only one or two pharmacists may make up thepharmacy staff.


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ORGANIZATION OF THE HOSPITAL

Pharmacy and TherapeuticsCommittee: The P&T committee isprimarily responsible for making the final

decision on drug formulary decisions.

Infection Control Committee: Themajor role of the infection control committee(ICC) is the prevention of nosocomialinfections in the hospital. Universalprecautions are used to prevent infectionwhen a hospital worker comes into contactwith blood or other bodily fluids.


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ORGANIZATION OF THE HOSPITAL

Institutional Review Board: The IRB

is responsible for protecting the patientin investigational studies undertaken inthe hospital.


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Universal Precaution Guidelines

1. Universal precautions apply to all personswithin the hospital

. 2. Universal precautions apply to all contact orpotential contact with blood, other bodily fluids,or body substances.

3. Disposable latex gloves must be worn whencontact with blood or other bodily fluids is

anticipated or possible.


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4.Hands must be washed thoroughly afterremoving the latex gloves.

5.Blood-soaked or contaminated materials,

such as gloves, towels, or bandages, must bedisposed of in a wastebasket lined with aplastic bag

6.Properly trained custodial personnel must

be called if cleanup or removal ofcontaminated waste is necessary.


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7. Contaminated materials such as needles,syringes, swabs, and catheters must beplaced into red plastic containers labeled fordisposal of biohazardous materials. Properinstitutional procedures generally involveincineration.


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8. A first-aid kit must be kept on hand in anyarea in which contact with blood or other

bodily fluids is possible. The kit shouldcontain, at minimum, the following items:

adhesive bandages for covering small wounds


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alcohol

antiseptic/disinfectant

bottle of bleach, which will be diluted at timeof use to create a solution containing 1 partbleach to 10 parts water, for use in cleaningup blood spills

box of disposable latex gloves

disposable towels


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medical tape

plastic bag or container for

contaminated waste disposal

sterile gauze for covering largewounds


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DiscussionCommunicating in the hospital setting often means working with awide variety of other healthcare providers. Understanding what rolethey play in the patients healthcare is essential to effectivecommunication. What duties do each of the following have?

a. primary care physician

b. anesthesiologist

c. registered nurse

d. practical nurse

e. nurses aide

f. housekeeping aide

g. social services aide or

worker

h. respiratory therapist

i. paediatric

j. medical lab technician

k. pharmacist

l. pharmacy technician

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(2) DPP 1054 Hospital in General

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