American journal of hospital pharmacy
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As a part of an evaluation of the need for a satellite pharmacy to serve two pediatric critical-care units, an observational study was conducted to determine the incidence of medication errors in the units. A pharmacist observed nurses preparing and administering medications in 18 12-hour shifts. Of the nine shifts observed in each unit, five were day shifts and four were night shifts. ⋯ Of 147 errors, 124 (84.4%) occurred with medications with a high potential for serious consequences. The error rates were similar on the day and night shifts in the PICU (42.1% and 31.3%, respectively), but they were significantly higher on the day shifts than the night shifts in the ICN (24.5% and 8.4%, respectively). The number of medication errors in the two units was substantial, and steps were taken to implement a 24-hour pediatric critical-care satellite pharmacy with unit dose drug distribution to reduce the incidence of errors.
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The development of a home i.v. antimicrobial therapy program and associated procedures for patient teaching are described. The pharmacy department at a 940-bed, acute-care, general medical-surgical teaching hospital participated with four other departments in the development of standardized teaching methods for a home i.v. antimicrobial therapy program. The pharmacy and nursing departments each developed sections of a home antimicrobial therapy manual. ⋯ Most patients or their care-givers were able to prepare and administer the medications. After the patient was discharged, the pharmacy department offered services such as supplying medications, coordinating pharmacokinetic dosing, providing drug information, and acting as a patient contact. Hospitals that provide home i.v. antimicrobial therapy should coordinate the resources of the various departments involved to develop standardized patient-teaching methods.