Hospital Pharmacy Payam Parchamazad, PharmD Staff Pharmacist Capital Regional Medical Center Tallahassee, Fl

Ownership Government Owned Privately Owned VA Hospitals Hospital affiliated with state universities Non-Profit Privately Owned Responsible for own funding May be for profit or non-profit

Care Provided Acutely Ill Chronically Ill with acute illness Primary Basic Care Secondary Involves a specialist Tertiary Requires specialized skill, technology or support services

Teaching Affiliation Teaching Hospital Teaching affiliated Hospitals Shands Teaching affiliated Hospitals TMH Non-Teaching Hospitals CRMC

Pharmacy Organization Functional Divisions Administrative Clinical Distributive Physical Locations Centralized Decentralized Combination

Administrative Director of Pharmacy Assistant Directors Clinical Coordinator Medication Safety Officer

Director of Pharmacy Responsible for the entire pharmacy department. Policies & Procedures Ensuring compliance with Joint Commission Standards. Pharmacy Budget Serves on various committees

Assistant Directors May be over inpatient services or outpatient services. Responsible for Staff Maintaining the appropriate pharmacy license for the establishment.

Clinical Coordinator Supervises clinical pharmacists Developing and maintaining clinical programs Annual employee assessments Participates in P&T

Medication Safety Officer Oversees all aspects of medication safety. Coordinates medication safety interventions. Responsible for educating all health care professionals about medication safety. Medication Safety Issues Look-a-like Sound-a-like Illegible handwriting Unapproved abbreviations

Clinical Clinical pharmacists Generally work in decentralized units May round with physicians Work with physicians, nurses, and other health care professionals to manage patient drug therapy. May have to perform order entry.

Distributive Deliver the medications to the patient care units. Pharmacy technicians & Pharmacists Medications may be delivered through a tube system or they may be sent in bulk to the patient care units.

Classification According to Location Centralized Staff Pharmacist Pharmacy Technicians Distribute medications from a central location Decentralized Clinical Pharmacist Clinical Services Order Entry Pharmacy Technicians (sometimes) Reside on nursing units or wards, may serve more than one unit. Often times may be a combination of both.

List of medications approved by an expert panel of healthcare practitioners, predominantly physicians and pharmacists. Each medication on the formulary is kept in-stock in the pharmacy. The Formulary Book is a list of all the pharmaceuticals stocked in the pharmacy. Continuously updated and revised Physicians may order medications that are non-formulary if it is necessary. Formulary Systems

Pharmacy & Therapeutics Committee Evaluate pharmaceutical products and make the decision whether or not to include them on the formulary. Products are evaluated based on efficacy, safety, ease of use and cost. Provide educational materials and programs about drug products added to the formulary to all healthcare practitioners. Pharmacy & Therapeutics Committee

Pharmacy & Therapeutics Committee Develop and monitor quality issues in regard to correct drug use for the organization. Monitor adverse drug reactions Develop generic substitution policies and procedures. Interact with quality assurance or medical utilization committees in the development of treatment guidelines for drug therapy. Subcommittees may be formed to address specific issues. Pharmacy & Therapeutics Committee

Automated Medication Dispensing Devices

Drug storage devices or cabinets that electronically dispense medications in a controlled fashion. Can be stocked by centralized or decentralized pharmacies. What are they???

Allow for medications to be obtained for inpatients at the point of use. Free pharmacists from labor-intensive distributive functions and help pharmacists provide pharmaceutical care. Improve the accuracy and timeliness of distributive functions. Assist with inventory control. Advantages

Pyxis Medstation Units are kept on the patient care units Computer interfaces with pharmacy computers. Physician orders are entered into the pharmacy computer. This information is then sent electronically to the Medstation where it is displayed on the patient profile. Nurses are given personal passwords or Bio ID. Nurse selects a medication and the drawer containing the medication opens. Pharmacy technicians restock the units. Pyxis Medstation

Education and Training Must have procedures for ensuring that all the staff members involved receive adequate education and training. Should ensure that there are adequate resources for providing effective education and training on a continual basis are present. Must evaluate staff to ensure competency in the use of automated machines. Education and Training

Potential for Harm?? Refill errors Medication shift from one drawer to another Reduction of medication errors Potential for Harm??

Questions Dr. Payam Parchamazad parchamp@gmail. com Capital Regional Medical Center 850 325 5070

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