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

2. 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

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

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

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

6. Administrative Director of Pharmacy Assistant Directors
Clinical Coordinator
Medication Safety Officer

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

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

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

10. 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

11. 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.

12. 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.

13. 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.

14. 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

15. 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

16. 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

17. Automated Medication Dispensing Devices

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

19. 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

20. 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

21. 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

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

23. Questions Dr. Payam Parchamazad parchamp@gmail. com
Capital Regional Medical Center

24. THANK YOU FOR YOUR ATTENTION