ABSTRACT
This article describes the development of a computerized pharmacy order entry system using IBM's Patient Care System software at a large teaching hospital. The pharmacy component is part of a hospital-wide order entry system that includes other departments such as dietary, radiology, central supply, and laboratories. Pharmacy orders are entered into the computer system at the patient care unit by secretaries or nurses and subsequently checked and supplemented by pharmacists in satellite pharmacies. The system produces a medication administration record for use by nursing that becomes a permanent part of the patient medical record. Pharmacy cassette fill lists, i.v. labels, and charge summaries are produced. Billing is automatically accomplished upon the completion of an order. Initial hardware problems have been resolved and the system has been fully operational for 2 years. Ongoing development seeks to enhance the system's range of functions.
Subject(s)
Electronic Data Processing , Hospital Information Systems , Pharmacy Service, Hospital/organization & administration , Boston , Computers, Mainframe , Hospital Bed Capacity, 300 to 499 , SoftwareABSTRACT
An improved system for preparing total parenteral nutrient (TPN) solutions is described. The new system uses a personal computer, a three-station volumetric pump, and empty polyvinyl chloride (PVC) containers. The computer's order-entry screen facilitates data entry by displaying a format similar to the physician's order sheet. After calculating the volumes of i.v. solutions and additives and the total cost of the TPN solution, the computer prints labels containing this information. Using the volumetric pump, the required volumes of crystalline amino acids, dextrose injection, and sterile water for injection are added simultaneously to either one-liter or three-liter PVC containers. Each bag contains the patient's entire daily TPN requirements. Approximately 30 liters of TPN solution are prepared daily by specially trained technicians in a centralized i.v. room. Compared with the previous method of preparing TPN solutions using evacuated one-liter glass bottles, the average time required to prepare and determine the cost of each patient's TPN solutions has decreased from 35 to 21 minutes daily. Total savings resulting from reduced materials and labor costs is approximately $28,240 annually. The new system for preparing TPN solutions is efficient and cost effective.
Subject(s)
Parenteral Nutrition, Total , Parenteral Nutrition , Drug Compounding , Drug Packaging , Polyvinyl Chloride , SolutionsABSTRACT
The Addi-Chek Quality Control System (Millipore Corporation) and Ivex-2 Filterset (Abbott Laboratories) were evaluated to determine their effectiveness, applicability, and cost as part of a pharmacy quality-control program. Each method was tested using 50 solutions, 25 of which had been contaminated by inoculation with one of five micro-organisms; the other 25 solutions were used as controls. Aseptic technique was used, and procedures were carried out in a laminar air flow hood. Contaminated solutions were blinded from the person performing the tests. Addi-Chek detected contamination in all the inoculated solutions and in three of the uninoculated solutions. The latter may have been a result of adventitious contamination during the testing procedure. Ivex-2 detected contamination in 24 of the 25 inoculated solutions; no other contamination was found. The effectiveness of the methods in detecting low-level microbial contamination appears comparable. Both methods have been shown to be useful in the pharmacy setting, but Ivex-2 could be used to test for contamination when used as an in-line filter at the patient level. Ivex-2 is less expensive and warrants further evaluation in monitoring for microbial contamination during preparation and administration of intravenous solutions.
