HAZARD ARH INPATIENT PHARMACY SERVICES
The Inpatient Pharmacy Department at Hazard ARH provides many proactive and progressive services to improve patient care.
The department is comprised of an integrated model of unit- based clinical pharmacists and pharmacy-based distributive pharmacists.
The pharmacy is staffed 24 hours a day, 7 days a week. The inpatient pharmacy was completely renovated in 2020 and is compliant with all applicable regulatory requirements. Various types of technology are employed to improve the provision of pharmaceutical care, including BD Pyxis™ Automated Dispensing Machines, BD Logistics™ with carousels, BD CII Safe™, and MEDITECH™ electronic health record.
To support the ARH mission by providing quality pharmaceutical services including medication delivery, therapeutic recommendations, and provision of optimal drug therapy in collaboration with other healthcare professionals.
Pharmacokinetic Dosing Service
Highly trained clinical pharmacists are available to dose and monitor medications such as vancomycin, aminoglycosides, phenytoin and others. By following P&T committee approved protocols, the pharmacists are able to write orders and progress notes in the patient’s chart. The protocols utilized allow the pharmacists to order labs and to evaluate drug therapies based on serum drug levels and to make adjustments based on those levels.
Anticoagulation Monitoring Service
Clinical pharmacists evaluate each patient receiving anticoagulation. The pharmacists verify that dosing and monitoring are appropriate for indication, concomitant drug therapy, etc. and also provide patient education as needed or requested.
Clinical pharmacists work closely with the Infectious Disease physician to monitor each patient receiving targeted high-cost, broad-spectrum antibiotics/antifungals. The pharmacists verify that the medication is appropriate based on indication, ensure that the medication is dosed appropriately, and monitor the patient’s clinical course, intervening when necessary due to culture data or changes in patient condition.
Renal Dosing Service
Patients with a computer-estimated impaired creatinine clearance who are receiving target medications are reported to the clinical pharmacists daily. By following P&T committee approved protocols, clinical pharmacists verify the creatinine clearance calculation, review the patient profile, and make adjustments to ensure that target medications are dosed appropriately based on renal function.
Targeted Drug-Lab Value Service
A computer-generated report provides clinical pharmacists with identification of laboratory-related issues with medication therapy (i.e. a patient with an order for metformin whose serum creatinine has increased so that continued metformin therapy is contraindicated). Clinical pharmacists follow up on these issues, contacting prescribers as necessary to address them.
Clinical pharmacists evaluate patients receiving certain target therapies for potential IV-to-PO conversion. This decreases institutional costs while increasing patient satisfaction and safety. P&T Committee approved protocols allow clinical pharmacists to make these conversions automatically based on certain criteria.
Each year the clinical pharmacists participate in vaccination campaigns to maximize the number of people vaccinated for influenza. Flu shot clinics are conducted as well as the pharmacists helping to administer vaccinations to employees. During the COVID-19 pandemic, our pharmacists played an essential role in vaccinating employees, patients and people within the community.
Unit-Based Clinical Services
The clinical pharmacy services of the hospital have taken on a unit-based approach. Currently there are clinical pharmacists based throughout the hospital such as in the Emergency Department, each Intensive Care Unit, and in the Cancer Center. On these units the clinical pharmacist handles all the needs of that unit’s patients, performing chart review, dosing, etc.
A bi-monthly newsletter is published by the Pharmacy Department to provide education for hospital staff on various medication related topics. The “RxPress” newsletter is a collaborative effort between the clinical pharmacy staff members, students and residents.
Students from eight different colleges of pharmacy are assigned to different learning experiences in our hospital. Clinical pharmacists provide these with unit-based learning and with lectures. Lectures are also provided for medical residents.
Ambulatory Cancer Center
Clinical pharmacists provide care for oncology patients at our ambulatory Cancer Center. They ensure that medications are prescribed and prepared in a manner that provides optimal care. Patient counseling is also provided.