Chapter 7 Health-System Pharmacy

1. Chapter 7 Health-System Pharmacy

2. Figure 7.1 A health system pharmacy is often located within a hospital.

3. Health System Pharmacy • Provided to residents of: • Long-term care facilities (nursing homes) • Hospitals • Hospices • Other residential facilities (prisons, etc.) • Provides around-the-clock delivery service • Provides prescription drugs in individually packaged blister packs

4. Health System Pharmacy (cont.) • Often work with: • Physicians • Nurses • Therapists • Dietitians • Laboratory personnel • Other professionals

5. Figure 7.6 The unit-dose system makes it very easy to track a patient’s medications.

6. The Unit-Dose System • The most efficient distribution system • Scanners may be used to track and bill for medications when they are dispensed • Very easy to track a patient’s medications • Unit-dose systems can be centralized, decentralized, or a combination

7. sample Figure 7.7 A sample medication order. Click the image for a larger view of the worksheet.

8. Patient Information • Name • Room/bed number • Hospital ID number • Birth date/age

9. Medication Information • Name • Dose • Frequency of administration • Route • Signature of prescriber • Date and hour the order was written

10. Accepting a Medication Order • The medication order may arrive in the pharmacy in several different ways: • The order may be submitted electronically to the pharmacy, utilizing a point of entry (POS) or CPOE system • The order may be sent by way of a pneumatic tube device • The pharmacist may be handed the order directly

11. Accepting a Medication Order (cont.) • The medication order may arrive in the pharmacy in several different ways: • The order may be faxed to the pharmacy • Orders may be sent through the institutional computer system • A technician may be assigned to collect medication orders from many sources throughout the institution

12. Verification • Technicians may review the medication orders for completeness • These orders are called unverified

13. Verification (cont.) • Unverified orders cannot be processed until they have been verified by a pharmacist • Correct order entry • Potential interactions • Allergies • Drug utilization review • Formulary utilization

14. Comparing Centralized and Decentralized Unit-dose Systems • Centralized pharmacy system—all pharmacy-related activities are performed from one location and medications are delivered to various patient care units throughout the facility • Decentralized pharmacy system—consists of a central, or inpatient, pharmacy; multiple satellite pharmacies; and an outpatient pharmacy

15. Filling a Medication Order • Filling prescriptions is one of the most basic duties of a pharmacy technician

16. Filling a Medication Order (cont.) • Filling is more than counting and basic measuring • Pharmacy technicians are charged with maintaining the unit-dose system • Because many medications do not come in unit-dose form, it is the pharmacy technician’s responsibility to prepare all medications • Technicians preparing orders for IV medications or TPNs need specialized training

17. Filling a Medication Order (cont.) • The final check is the sole domain of the pharmacist • No medications may be dispensed without the pharmacist’s final approval

18. Pharmacy Technician Duties in Health-System Settings • Typically provide drug-related products and services 24 hours a day, 365 days a year • Provide medications for emergency departments • Many tasks once performed by the pharmacist are now delegated to pharmacy technicians