1. Pharmacy Services

2. Pharmacy
The art and science of preparing, compounding, stabilizing, preserving and dispensing medications and the provision of drug and related information.
Also a place where drugs are stored, compounded and dispensed.
A Pharmacist is a health care professional who
Compounds and dispenses medications and other pharmaceutical supplies, using standard physical and chemical procedures to fill written prescriptions issued by physicians.
Maintains records on all unit dose for each nursing unit and also IV additive program.
Maintains inventory of supplies.
A graduate from accredited school of pharmacy and licensed in the state of practice.

3. Responsibilities of Pharmacists
Compounding drugs
Dispensing drugs
Medication profile review
Patient education
Provider of drug information
Clinical pharmacy
Pharmaceutical care
Patient care provider

4. Compounding Drugs
Pharmacists compounded drugs used to treat patients in the 1940s and 50s.
Then pharmaceutical manufacturers began to take over this role.
Hospital pharmacists assumed responsibility for compounding parenteral admixtures in the 1960s and 70s.
Today more pharmacists are compounding specialty products that are not commercially available and more compounding is predicted in the future.

5. Dispensing Drugs
In the 1960s hospital pharmacists implemented unit-dose drug distribution systems to reduce medication dispensing and administration errors.
In unit dose system medication distribution, medications are contained in single unit packages; they are dispensed in as ready-to-administer form as possible; and for most medications, not more than a 24-hour supply of doses is delivered to or available at the patient-care area at any time.
Most hospitals and long term care facilities now use a unit-dose system.
In the 80s automated dispensing devices became available for use in hospital and community settings.

6. Dispensing Drugs – Automation
Webster’s Ninth New Collegiate Dictionary Automatically controlled operation of an apparatus, process, or system by mechanical or electronic devices that take the place of human organs of observation, effort, or decision.
Pharmacy Automation
a collection of apparatus, process, and systems (mechanical and/or electronic) to enhance drug distribution and clinical drug therapy management.
Robots:
Automated mechanical equipment specifically designed to fill medication vials with tablets or capsules, apply a lid to the vial, and place a prescription label on the vial.

7. Dispensing Drugs – Automation Benefits
Automation of the dispensing process offers the potential for improved service delivery in four key areas:
Efficiency.
Faster speed of operation than humans
Staff can then be utilized in more patient-centered activities
Safety
According to the US National Academy of Science, > 78% of dispensing errors could be avoided by the use of automated dispensing systems.
Stock management.
Improve stock rotation
Improve overall stock control
Environment.
Less space requirements
Less staff movements

8. Medication Profile Review
In the 1970s pharmacists began maintaining medication profiles to review patient medications for drug related problems.
Computerized systems for automatically reviewing prescriptions for allergies, drug interactions, appropriateness of the dosage, and other common drug related problems have since evolved.

9. Patient Education
In the 1980s most states required pharmacists to provide patient medication counseling to outpatients on new prescriptions.
Verbal, written and computerized printed education materials to supplement verbal patient counseling has since evolved.

10. Provider of Drug Information
In the 1960s drug information centers were created in hospitals to provide drug information to physicians and other health care providers.
The role of pharmacists as drug information providers led to decentralization of pharmacists to provide drug information.

11. Clinical Pharmacy
In the 70s and 80s most hospitals began to develop clinical pharmacy services.
Pharmacists were decentralized to patient care units to provide clinical services.
Ambulatory clinical services also began in clinics and a few community pharmacies.
Early Clinical Pharmacy
Patient focused, drug focused, interdisciplinary, and data driven
Provider of drug information to patients and health professionals
Individualizing doses: clinical pharmacokinetics
Monitoring drug therapy: Order review and feedback
Nutritional support

12. Pharmaceutical Care
A fairly new concept in providing health care; 1990s - these terms became very popular
Involves direct involvement of the pharmacist in the design, implementation, and monitoring of a therapeutic drug plan to produce a specific therapeutic outcome.
A strategy that attempts to utilize drug therapy more efficiently to achieve definite outcomes that improve a patient’s quality of life.
Requires a reorientation of physicians, pharmacists, and nurses toward effective drug therapy outcomes.
It is a set of relationships and decisions through which pharmacists, physicians, nurses, and patients work together to design, implement, and monitor a therapeutic plan that will produce specific therapeutic outcomes.

13. Community Pharmacy Practice
Community pharmacists
counsel patients,
answer questions about prescription and over-the-counter drugs, such as possible adverse reactions and interactions, and
give patients health care advice.
They also give advice about durable medical equipment, home care and preventive care.
Some community pharmacists offer disease management services for conditions such as diabetes, asthma, hypertension, etc.
Some community pharmacists offer preventive health programs: smoking cessation, immunizations, screening for lipid disorders, etc.

14. Hospital Pharmacy Practice
Unit-dose and parenteral admixture programs
Clinical services.
Computerized drug distribution systems and use some automated dispensing devices.
Some hospitals have comprehensive inpatient pharmaceutical care programs.
Few hospitals have extensive ambulatory pharmaceutical care programs.

15. Pharmacy Trends
Increased emphasis on patient care services as well as drug distribution
Increased emphasis on continuity of care (home-office practice-hospital-long term care, etc.)
Increased emphasis on preventive care (use of OTCs, alternative medicines, self-diagnostic kits, diet, screening procedures, immunizations, etc.)
Increased use of automation for pharmacy dispensing
Increased use of information technology