Characteristics of hospital pharmacy practice

Hello, fellow pharmacist! It is great to meet you again on the web! The topic of this unit is Good Pharmacy Practice in hospital setting.

There are four main parts in this unit course: The first part, I will introduce the characteristic of hospital pharmacy practice include pharmacist’s role in medication use process, key component in hospital pharmacy practice , hospital practice standards and guidelines. The second part I’d like to show you the core element of GPP guidelines including origin, mission, requirements, frame works, and steps to establish the guidelines. Then I will describe more detail about 4 main role for pharmacist in the guidelines. In the final part, I will give you a real world example about the development of GPP, the lessons learned from the US.

What is institutional pharmacy practice? Hospital pharmacy practice includes the provision of distributional and clinical pharmacy services. Typically, the institution that pharmacists serve are linked together into integrated health system. The integrated model create the potential to provide enhanced level of patient-care continuity through access to medical records and patient care providers. The hospital system integrate all care under the umbrella of a central organization, and often include inpatient, acute care, primary care, outpatient care, long-term care, and home care. The mission of hospital is to positively impact health outcomes. In the modern world, there are hospitals in almost any cities, each employing pharmacists. Opportunities in institutional pharmacy practice are everywhere.

Pharmacist’s role in the medication use process. The role of pharmacists is to lead and influence the safety and quality of all aspects of the medication-use process. This means that pharmacists should be involved in controlling or influencing any step of the medication-use process that can impact patient health outcomes or costs. Therefore, pharmacists have important direct or indirect roles in prescribing, transcribing, dispensing, administration, and monitoring. Prescribing Prescribing medication is often viewed as something that only physician are authorized to do. However, the reality is that many other health-care professional are authorized to prescribe by law. For example, dentists, nurse practitioner, optometrists, and some others. Or through a formalized process in hospitals known as privileging.

Privileging is the process by which an oversight body of a health care organization or other appropriate provider body, having reviewed an individual health care provider’s credentials and performance and found them satisfactory, authorize that individual to perform a specific scope of patient care services within that setting. Pharmacists who have prescribing privileges in hospitals are typically authorized to do so through the formalized privileging process. A more common role for pharmacists beyond actually prescribing is the pharmacist’s duty to influence the prescribing of other health professionals. Pharmacists indirectly influence prescribing by acting as information resources about medications , providing feedback about the quality of prescribing , and developing prescribing protocols through the formulary system.

Transcribing is the process by which a prescriber’s written order is copied and either manually or electronically entered into pharmacy records. The transcribing process represents an opportunity for error , especially when done manually. Pharmacists understand potential breakdowns in the transcribing process and help find ways to minimize errors. In time, the problem of manual transcription will diminish because of the movement toward computerized prescribing order entry. However, that time is not here yet because manual transcribing of written orders is still the most common.

Dispensing Dispensing is the act of physically transferring the drug product following review and approval of the prescribing to the area responsible for the administering the medication to the patient. Dispensing is also an area where medication errors can occur, including but not limited to wrong drug, wrong dose, or wrong dosage form errors. Administration Medication administration to the patient in hospitals is typically managed by nurses. This phase of the medication-use process is the last step before patients are given their medications, and errors at this point cannot be corrected. Errors in the administration phase have been reported as being upward of 34%. Nurses usually serve as the final check in the medication-use process.

Pharmacists help improve the safety of medication administration by clearly labeling medications, using bar-coding system and unit dose packaging, reduce the time and effort involved in accessing drug and using technology that reduce administration errors. Monitoring the patient’s response to the medication is a critical phase here pharmacists play a vital role. Monitoring includes reviewing laboratory values that are correlated with the expected medication-therapy outcome, as well as other objectives sand subjective factors that indicate whether the therapy is effective, or may be having a toxic effect.