Hospital pharmacy

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A hospital pharmacist checking a liquid solution. Pharmacist.jpg
A hospital pharmacist checking a liquid solution.

A hospital pharmacy is a department within a hospital that prepares, compounds, stocks and dispenses inpatient medications. Hospital pharmacies usually stock a larger range of medications, including more specialized and investigational medications (medicines that are being studied, but have not yet been approved), than would be feasible in the community setting. Hospital pharmacies may also dispense over-the-counter and prescription medications to outpatients.

Electric track vehicle system for hospitals, type Telelift Telelift Station Hospital Pharmacy.jpg
Electric track vehicle system for hospitals, type Telelift

Hospital pharmacies may provide a huge quantity of medications per day which is allocated to the wards and to intensive care units according to a patient's medication schedule. Larger hospitals may use automated transport systems to aid in the efficient distribution of medications.

Hospital pharmacists and trained pharmacy technicians compound sterile products for patients such as total parenteral nutrition (TPN) and other medications given intravenously such as neonatal antibiotics and chemotherapy. Some hospital pharmacies may outsource high-risk preparations and some other compounding functions to companies that specialize in compounding.

Hospital pharmacists often report an interest in undertaking research, although identify barriers to doing so during routine practice. [1] Many hospital pharmacists actively participating in research also have university affiliations. [2]

Hospital pharmacists provide services to people admitted to hospitals as in-patients. [3] The services provided include ensuring appropriate therapies are identified [4] and in reducing medication errors. [5] These services may be pharmacist-led interventions [6] or part of interdisciplinary teams. [7] They may further organise for medication reviews post-discharge. [8] These services may be provided in person or via telehealth. [9]

In the United States, hospital pharmacy was not a significant practice until the 1920s. In the 18th and 19th centuries, the medicine and pharmacy were commonly one practice, in which a medical apprentice would be responsible for the drug preparation. [10] [ vague ].

Hospital pharmacists often require additional education support and professional development to develop advanced skills and specialisation. [11] Many health services require junior pharmacists to undertake pharmacy residencies for skill development. [12]

See also

Related Research Articles

<span class="mw-page-title-main">Pharmacist</span> Healthcare professional

A pharmacist is a healthcare professional who specializes in the preparation, dispensing, and management of medications and who provides pharmaceutical advice and guidance. Pharmacists often serve as primary care providers in the community, and may offer other services such as health screenings and immunizations.

<span class="mw-page-title-main">Pharmacy</span> Clinical health science

Pharmacy is the science and practice of discovering, producing, preparing, dispensing, reviewing and monitoring medications, aiming to ensure the safe, effective, and affordable use of medicines. It is a miscellaneous science as it links health sciences with pharmaceutical sciences and natural sciences. The professional practice is becoming more clinically oriented as most of the drugs are now manufactured by pharmaceutical industries. Based on the setting, pharmacy practice is either classified as community or institutional pharmacy. Providing direct patient care in the community of institutional pharmacies is considered clinical pharmacy.

<span class="mw-page-title-main">Polypharmacy</span> Use of five or more medications daily

Polypharmacy (polypragmasia) is an umbrella term to describe the simultaneous use of multiple medicines by a patient for their conditions. The term polypharmacy is often defined as regularly taking five or more medicines but there is no standard definition and the term has also been used in the context of when a person is prescribed 2 or more medications at the same time. Polypharmacy may be the consequence of having multiple long-term conditions, also known as multimorbidity and is more common in people who are older. In some cases, an excessive number of medications at the same time is worrisome, especially for people who are older with many chronic health conditions, because this increases the risk of an adverse event in that population. In many cases, polypharmacy cannot be avoided, but 'appropriate polypharmacy' practices are encouraged to decrease the risk of adverse effects. Appropriate polypharmacy is defined as the practice of prescribing for a person who has multiple conditions or complex health needs by ensuring that medications prescribed are optimized and follow 'best evidence' practices.

<span class="mw-page-title-main">Telehealth</span> Health care by telecommunication

Telehealth is the distribution of health-related services and information via electronic information and telecommunication technologies. It allows long-distance patient and clinician contact, care, advice, reminders, education, intervention, monitoring, and remote admissions. Telemedicine is sometimes used as a synonym, or is used in a more limited sense to describe remote clinical services, such as diagnosis and monitoring. When rural settings, lack of transport, a lack of mobility, conditions due to outbreaks, epidemics or pandemics, decreased funding, or a lack of staff restrict access to care, telehealth may bridge the gap as well as provide distance-learning; meetings, supervision, and presentations between practitioners; online information and health data management and healthcare system integration. Telehealth could include two clinicians discussing a case over video conference; a robotic surgery occurring through remote access; physical therapy done via digital monitoring instruments, live feed and application combinations; tests being forwarded between facilities for interpretation by a higher specialist; home monitoring through continuous sending of patient health data; client to practitioner online conference; or even videophone interpretation during a consult.

A consultant pharmacist is a pharmacist who works as a consultant providing expert advice on clinical pharmacy, academic pharmacy or practice, public health pharmacy, industrial pharmacy, community pharmacy or practice, pharmaceutical analysis etc., regarding the safe use and production of medications or on the provision of pharmaceutical services to medical institutions, hospitals, universities, research institutions, medical practices and individual patients.

Pharmacotherapy, also known as pharmacological therapy or drug therapy, is defined as medical treatment that utilizes one or more pharmaceutical drugs to improve on-going symptoms, treat the underlying condition, or act as a prevention for other diseases (prophylaxis).

<span class="mw-page-title-main">Compounding</span> Preparation of a custom medication

In the field of pharmacy, compounding is preparation of custom medications to fit unique needs of patients that cannot be met with mass-produced products. This may be done, for example, to provide medication in a form easier for a given patient to ingest, or to avoid a non-active ingredient a patient is allergic to, or to provide an exact dose that isn't otherwise available. This kind of patient-specific compounding, according to a prescriber's specifications, is referred to as "traditional" compounding. The nature of patient need for such customization can range from absolute necessity to individual optimality to even preference.

A veterinary pharmacist is a specially trained pharmacist who dispenses veterinary drugs and supplies or products and advice to owners of companion animals and livestock. In addition, they advise the regulatory bodies and are involved in the formulation of veterinary drugs. Veterinary pharmacy is a field of pharmacy practice, in which veterinary pharmacists may compound medications, fill prescriptions, and manage drug therapies for animals. Veterinary pharmacists are licensed pharmacists who specialize in the distribution of medications for animals.

<span class="mw-page-title-main">Clinical pharmacy</span> Branch of pharmacy for direct provision

Clinical pharmacy is the branch of pharmacy in which clinical pharmacists provide direct patient care that optimizes the use of medication and promotes health, wellness, and disease prevention. Clinical pharmacists care for patients in all health care settings but the clinical pharmacy movement initially began inside hospitals and clinics. Clinical pharmacists often work in collaboration with physicians, physician assistants, nurse practitioners, and other healthcare professionals. Clinical pharmacists can enter into a formal collaborative practice agreement with another healthcare provider, generally one or more physicians, that allows pharmacists to prescribe medications and order laboratory tests.

Pharmacy residency is education a pharmacist can pursue beyond the degree required for licensing as a pharmacist. A pharmacy residency program allows for the implementation of skill set and knowledge acquired in pharmacy school through interaction with the public either in a hospital setting or community practice. The program is done over a span of about 2yrs after graduation from pharmacy school and licensure as a pharmacist. Pharmacy residency helps improve the resume of a pharmacist so as to increase chances of obtaining employment outside community practice. A 2022 review suggested that there is sufficient evidence that residency develops key competencies for junior pharmacists.

<span class="mw-page-title-main">Pharmacy (shop)</span> Shop which provides pharmaceutical drugs

A pharmacy is a retail shop which provides pharmaceutical drugs, among other products. At the pharmacy, a pharmacist oversees the fulfillment of medical prescriptions and is available to counsel patients about prescription and over-the-counter drugs or about health problems and wellness issues. A typical pharmacy would be in the commercial area of a community.

Medication therapy management, generally called medicine use review in the United Kingdom, is a service provided typically by pharmacists, medical affairs, and RWE scientists that aims to improve outcomes by helping people to better understand their health conditions and the medications used to manage them. This includes providing education on the disease state and medications used to treat the disease state, ensuring that medicines are taken correctly, reducing waste due to unused medicines, looking for any side effects, and providing education on how to manage any side effects. The process that can be broken down into five steps: medication therapy review, personal medication record, medication-related action plan, intervention and or referral, and documentation and follow-up.

<span class="mw-page-title-main">Deprescribing</span> Process to taper or stop medications

Deprescribing is a process to taper or stop medications with the intention to achieve improved health outcomes by reducing exposure to medications that are potentially either harmful or no longer required. Deprescribing is important to consider with changing health and care goals over time, as well as polypharmacy and adverse effects. Deprescribing can improve adherence, cost, and health outcomes but may have adverse drug withdrawal effects. More specifically, deprescribing is the planned and supervised process of intentionally stopping a medication or reducing its dose to improve the person's health or reduce the risk of adverse side effects. Deprescribing is usually done because the drug may be causing harm, may no longer be helping the patient, or may be inappropriate for the individual patient's current situation. Deprescribing can help correct polypharmacy and prescription cascade.

<span class="mw-page-title-main">Telepharmacy</span> Pharmacy care by telecommunication

Telepharmacy is the delivery of pharmaceutical care via telecommunications to patients in locations where they may not have direct contact with a pharmacist. It is an instance of the wider phenomenon of telemedicine, as implemented in the field of pharmacy. Telepharmacy services include drug therapy monitoring, patient counseling, prior authorization and refill authorization for prescription drugs, and monitoring of formulary compliance with the aid of teleconferencing or videoconferencing. Remote dispensing of medications by automated packaging and labeling systems can also be thought of as an instance of telepharmacy. Telepharmacy services can be delivered at retail pharmacy sites or through hospitals, nursing homes, or other medical care facilities.

<span class="mw-page-title-main">Home medicines review (Australia)</span>

The Domiciliary Medication Management Review (DMMR), also named as a Home Medicines Review (HMR), in an Australian scheme for the patients residing in community setting. There are many steps included in a Home Medicine Review Service.

The Society of Hospital Pharmacists of Australia (SHPA) is a professional association. Membership mostly comprises hospital pharmacists, but is open to pharmacy technicians and pharmacy students. The organisation aims to support and provide professional development to its members and be an advocate for improved medicines management in policy and practice. The society also produces various publications, including the Journal of Pharmacy Practice and Research (JPPR).

<i>Journal of Pharmacy Practice and Research</i> Academic journal

The Journal of Pharmacy Practice and Research is a quarterly peer-reviewed scientific journal published by John Wiley & Sons on behalf of The Society of Hospital Pharmacists of Australia (SHPA). The journal covers the field of pharmacy and includes "focus sections" on geriatric therapeutics and primary care. As the official publication of SHPA, the journal also publishes editorial discussion relating to pharmacy practice, book reviews, and recurring review sections focusing on medication safety and recent research in clinical pharmacy from around the world. The editor-in-chief is Chris Alderman.

Separation of prescribing and dispensing, also called dispensing separation, is a practice in medicine and pharmacy in which the physician who provides a medical prescription is independent from the pharmacist who provides the prescription drug.

The Medication Appropriateness Tool for Comorbid Health conditions during Dementia (MATCH-D) criteria supports clinicians to manage medication use specifically for people with dementia without focusing only on the management of the dementia itself.

The Institute for Safe Medication Practices (ISMP) is an American 501(c)(3) organization focusing on the prevention of medication errors and promoting safe medication practices. It is affiliated with ECRI.

References

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