Clinical Pharmacist Tasks

It is composed of actively practicing physicians, other prescribers, pharmacists, nurses, administrators, quality improvement managers, and other health care professionals and staff who participate in the medication-use process. The P&T committee should be responsible for overseeing policies and procedures related to all aspects of medication use within an institution. The P&T committee is responsible to the medical staff as a whole, and its recommendations are subject to approval by the organized medical staff as well as the administrative approval process. The P&T committee’s organization and authority should be outlined in the organization’s medical staff bylaws, medical staff rules and regulations, and other organizational policies as appropriate. Other responsibilities of the P&T committee include medication-use evaluation (MUE), adverse-drug-event monitoring and reporting, medication-error prevention, and development of clinical care plans and guidelines. The hospital’s internal policies follow all national standards for how the P&T committee should

The pharmacy, nursing, and informatics department were required to be involved in implementing the bar-code-assisted medication administration (BCMA) patient safety initiative. The involvement of the informatics department was required for planning and coordination of the electronic medication administration record and the scanning devices. The nurses were administering the medications so they were required to undergo training on BCMA methods and the importance of BCMA implementation. Pharmacists were needed to assist nurses in case if a scanning error occurred. Pharmacy, nursing, and informatics staff members were responsible for evaluation of the BCMA system upon implementation.

The contribution of pharmacists in a clinical setting and community pharmacy is significant that the workforce benefit from. When the workforce understands their medications and complies with the prescribed treatment plans the work center becomes healthy and the potential of increased productivity becomes a realistic and profitable proposition for the organization. When the workforce takes advantage of the healthcare services the pharmacists provide in a community and clinical pharmacies productivity and profit are at high potential reality.

In the classroom, it is very important to have lab safety. In a hospital pharmacy, lab safety is essential to ensuring a safe dosage to each patient. Throughout my time interning as a pharmacist at the UVM Medical center, I was often observing how much pharmacists used DoseEdge software. DoseEdge automated system that assists the process of dose routing and preparation. This product of Baxter has allowed the tasks of pharmacy change. The focus of my project was “How does current and future technology affect efficiency and accuracy in pharmacy practice?”. Through my research of Baxter’s website, articles about their product, and reports of advancing technologies in pharmacy, I found that DoseEdge is very successful in productivity and safety in the workplace. Before DoseEdge, everything was required to be prepared by hand. This required a lot of responsibility for for pharmacists and technicians to make the correct dosage in the quickest manner. Medicine is very important to a hospital, so it is very important to have the most efficient way in preparing and distributing it. This allows pharmacist to have a better way of double-checking the preparation of drugs. In each IV hood, there is an overhead camera that takes pictures of what drug and how much of it the technician is using. Pharmacist can view multiple orders all by computer without the need of being physically next to the technician. There are also requirements to have two pharmacists check the same order for high risk drugs like chemotherapy. This

The SCHC addressed meaningful use by recording patient demographics, maintaining an active medication lists and incorporating clinical lab test results into the HER, as apart of their meaningful use objectives. For recording patient demographics, they maintained data for accurate billing and ensured that the practice workflow was adjusted to capture all of the necessary patient data. They addressed active medication lists by following the requirements for e-prescribing. Patients were able to review their active medication list during their visit. Changes to the medication list were reviewed with the nurse and adjusted within the EHR system by the doctor. They communicated information for the care coordination process by making test results efficient and safe to access. Physicians were able to make real time decisions when they receive the test results from LabCorp, Quest, and other health

Currently, more responsibilities are being given to the pharmacy technician that were traditionally performed by pharmacists, such as clarifying prescriptions and entering orders. With these additional responsibilities for the pharmacy technician, this will allow the pharmacist to spend additional time with patients. However, with these additional responsibilities enables more opportunities for error. In 2008, a study was performed at Wentworth-Douglass Hospital, a 178 bed acute care facility

Encourage the use of computer-generated or electronic medication administration records. Plan for the implementation of computerized prescriber order entry systems. Consider the use of machine-readable code (i.e., bar coding) in the medication administration process. Use computerized drug profiling in the pharmacy. Be a demanding customer of pharmacy system software; encourage vendors to incorporate and assist in implementing an adequate standardized set of checks into computerized hospital pharmacy systems (e.g., screening for duplicate drug therapies, patient allergies, potential drug interactions, drug/lab interactions, dose ranges, etc.)”. (Association,

The technology product will be used as onboarding training for new PAS and as refresher on competencies for experienced PAS. The the content will include lessons on all electronic health record platforms and resources that are used in researching medications and compiling the PTA medication list for use in reconciliation. Team member orientation also involves learning the process of completing the PAS standard work. This work includes monitoring patient lists, interviewing patients or other knowledgeable individuals about the medication taken by the patient, verifying the infomation with the pharmacy, primary physician, insurance company, etc., and updating the patient chart to reflect the information. Time management and documentation are also included.

Medication reconciliation is defined as a “formal process of obtaining a complete and accurate list of each patient’s current home medications – including name, dosage, frequency, and route – comparing the physician’s admission, transfer, and discharge orders to the list.” (Meguerditchian N, Krotneva, Reidel, Huang, & Tamblyn, 2013). There have been several studies performed across the world to try to comprise a system that will successfully accomplish medication reconciliation. Some of these studies have been successful and others have failed to find a solution. There have been studies that have utilized a pharmacy technician in the emergency department to facilitate the input of patient’s medication reconciliation prior to admission. Other studies have relied on the pharmacist to obtain the information. Most studies involved the primary nurse providing care to the patient to obtain the medication reconciliation information. There have been several forms of documentation tried on trial bases. These forms of documentation range from a paper medication administration record (MAR) to an electronic medication administration record (EMAR) that utilizes today’s technology.

What does it take to be a pharmacist? Pharmacy involves more than just handing out drugs, otherwise anyone could do it. “A pharmacist is a health professional who follows instruction from physicians regarding the amount of education to distribute” (“Pharmacy requirements”). The pharmacy profession requires a lot of education, demands patience and attentive work, provides good pay, and offers a satisfying job.

In the process of investigating the research topic, many relevant and current research articles were discovered. Cumulative Index to Nursing and Allied Health Literature (CINAHL) was the database in which 4 out of the 5 articles were discovered. The keywords used were medication administration and electronic medication administration record entered in separate searches. Limitations applied to each search were the publication dates between 2010 and 2014 and full text. Both searches combined yielded a total of 42 articles and relevance was determined by reading first the title and then the abstract. For 1 out of 5 articles the database OvidSP was used. The key words electronic medication administration was used and applied limitations were a publication date between 2010 and 2014 and original articles. The search yielded 134 results and relevance was determined by reading the title and then the abstract. All of the discussed articles are current and published between the years 2010 and 2014 and

Biron, Lavoie-Tremblay, and Loiselle studied the number of work interruptions that occurred during medication preparation and administration. The observational study followed 18 nurses during 102 medication rounds. The study found that the main source of interruption were nurse colleagues. Other sources of interruptions during preparation were missing meds, MARs, keys for the narcotic cabinet. Sources of interruptions during administration were unplanned tasks, secondary, and unscheduled tasks. The authors state that limiting sources of frequent interruptions should be targeted. The authors hold PHD’s and have a reference listing of 27 articles.

When deciding on which area to focus on for this task it was important for me that medication administration is done with no room for error to occur. When administering any type of medication to a patient it must be clear as well as concise as to what you are doing. One thing that has to be correct at all times is the five rights’ to medication administration are followed and done correctly. The five rights’ are: Right patient, Right route, right time, right medication, Right dose. If you miss even one of these important rights you can cause severe harm to your patient.

These two days, I am spending time shadowing clinical pharmacists in different inpatient units, which turns out to be an eye-opening experience to me. For the first two days, I shadowed a clinical pharmacist in the trauma unit. It is really cool to see how different healthcare professions work as a healthcare team in a level 1 trauma hospital, with daily rounds and close cooperation between the pharmacist and other care providers. Today, my pharmacist and I discuss an ethical case which I think it is worthy to share. The case is a 92-year-old Hmong man who admitted to the hospital in early April and stays in the inpatient unit ever since. His main concern is multiple drug resistant tuberculosis, however, he refuses to take his medications including

Set-up and workflow of my pharmacy is pretty good for patient centered care. Patient does not have to wait too long for their prescriptions to be filled. Patients can call for their refills via telephone or online, which makes their life easy as they don’t have bother coming in-person for refills. Patient profile shows all medication history as well as number of refills remaining. This makes it easy for pharmacist to know whether to refill a prescription or call doctor for refill request. After confirming to fill a prescription pharmacist runs claim through insurance and print label after claim is successful. All medication is arranged alphabetically on shelves, thus it is easy and quick to retrieve. Then after technician fills medication and then pharmacist checks it. This workflow is quite smooth and quick to process. Final check is done by pharmacist, who confirms right medication for right patient as well as the NDC dispensed, amount dispensed, direction for use, and day supply. All these steps of process take place on working table in sequential order, which helps to reduce errors in filling and have effective prescription filling. Once the prescription is filled pharmacist do all paper