Hospital pharmacy
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Clinical pharmacists in a 580-bed teaching hospital reported all targeted recommendations that occurred during a 5-month evaluation period. Five types of clinical recommendations were identified: (1) to start drug therapy, (2) to stop drug therapy, (3) to increase drug dose, (4) to decrease drug dose, and (5) to suggest alternative drug therapy. Two thousand sixty-four unsolicited, accepted recommendations were submitted to the investigator by approximately eight holders of full-time equivalent positions dedicated to clinical pharmacy services during the evaluation period. ⋯ The costs of drugs, monitoring, and treatment for the drug regimens were compared before and after each recommendation. Three classes of drugs (antineoplastics, anti-infectives, and gastrointestinal agents) contributed more than 90% of the economic impact. The net economic impact of the evaluated recommendations was a cost saving of $4636.06; this extrapolated to a net cost saving of $34.10 per pharmacist-day.
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The purpose of this study is to assess the advantages and disadvantages of various annual financial clinical contract options between the Atlanta metropolitan area hospital and the Mercer University Southern School of Pharmacy (Atlanta, GA). Forty-five surveys with 17 statements in a Likert scale format were mailed to all directors, clinical staff of each hospital (adjunct faculty), and full-time clinical faculty to validate the perceived advantages and disadvantages of financial contracts between their hospital and the School of Pharmacy. The survey questionnaire was returned by 84% of the participants. Survey results indicate that the School of Pharmacy and area hospital pharmacies appear to have benefited from this marriage of common interests in clinical program development with 79% agreeing that the overall benefits of the educational affiliation and contract out-weighed the disadvantages.
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Patient controlled analgesia (PCA) is a proven method of administering analgesics via programmable infusion devices to relieve postoperative pain and pain associated with terminal illnesses. In mid-1989, a pain management service was started in the authors' hospital by the anesthesiology service. Since pharmacists had been previously involved in PCA postoperative pain management, it was decided they would continue in that capacity with the pain management service. ⋯ All subsequent programming including dose changes, rate changes, boluses, bag changes, and problem resolution are the responsibility of the staff pharmacists. Pharmacists are periodically certified in programming skills as part of the department's quality assurance program. In 1990, over 1800 patients received the benefits of this innovative service.
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Use of generic screening criteria for clinical interventions that link prescribing to credentialing.
Current JCAHO standards require hospitals to link the use of drugs to prescriber credentialling. The pharmacy service at the Veterans Affairs Medical Center, Iowa City, Iowa, has developed a prescriber-specific program that documents clinical interventions and links that information to physician credentialling through the Pharmacist Intervention Report and associated quality assurance (QA) program. A severity index level was also developed to rate the significance of the interventions. The Pharmacist Intervention Report is used by all medical departments in their respective QA programs.
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The purpose of this study was to justify the increased costs of providing decentralized pharmacy service by defining therapeutic interventions as they relate to improved patient care and by documenting cost savings generated by decentralized pharmacist interventions. Data were collected on a daily basis from information provided by the decentralized pharmacists using a daily worksheet. ⋯ The total cost-saving interventions in 1989 was $126,509 and this included the automatic drug conversions. The pharmacists also provided 2506 therapeutic interventions.