Hospital PharmacyPayam Parchamazad, PharmD

Staff PharmacistCapital Regional Medical Center

Tallahassee, Fl

OwnershipGovernment Owned

◦ VA Hospitals◦ Hospital affiliated with

state universities◦ Non-Profit

Privately Owned◦ Responsible for own

funding◦ May be for profit or

non-profit

Care ProvidedAcutely IllChronically Ill

with acute illness◦Primary

Basic Care◦Secondary

Involves a specialist◦Tertiary

Requires specialized skill, technology or support services

Teaching AffiliationTeaching Hospital

◦ShandsTeaching affiliated

Hospitals◦TMH

Non-Teaching Hospitals◦CRMC

Pharmacy OrganizationFunctional

Divisions◦Administrative◦Clinical◦Distributive

Physical Locations◦Centralized◦Decentralized◦Combination

AdministrativeDirector of Pharmacy

◦Assistant Directors◦Clinical Coordinator◦Medication Safety Officer

Director of PharmacyResponsible for the

entire pharmacy department.

Responsible for◦Policies & Procedures◦Ensuring compliance

with Joint Commission Standards.

◦Pharmacy Budget◦Serves on various

committees

Assistant DirectorsMay be over

inpatient services or outpatient services.

Responsible for◦Staff◦Maintaining the

appropriate pharmacy license for the establishment.

Clinical CoordinatorSupervises

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

ClinicalClinical 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.

DistributiveDeliver 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.

Formulary Systems

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 revisedPhysicians may order medications that

are non-formulary if it is necessary.

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

Develop and monitor quality issues in regard to correct drug use for the organization.

Monitor adverse drug reactionsDevelop 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.

Automated Medication Dispensing Devices

What are they???

Drug storage devices or cabinets that electronically dispense medications in a controlled fashion.

Can be stocked by centralized or decentralized pharmacies.

Advantages

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.

Pyxis Medstation

Units are kept on the patient care unitsComputer 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.

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.

Potential for Harm??

Refill errorsMedication shift from one drawer to

anotherReduction of medication errors

QuestionsDr. Payam

Parchamazadparchamp@gmail.

comCapital Regional

Medical Center850 325 5070

THANK YOU FOR YOUR ATTENTION