ABSTRACT
A computer program to facilitate medication incident analysis is described. This program was developed to provide the hospital's Medication Quality Assurance Committee with more meaningful data on medication incidents in an easily accessible database as well as enhanced data storage. The menu-driven program was developed on an Olivetti M-24 SP microcomputer using Lotus 1-2-3 and Harvard Business Graphics software. The structured format of the database contains specific information from each individual medication incident report. On a monthly basis, macro commands are used to extract criteria-based data from the database and present this information in a tabular format. In addition, annual data tables are complied to provide year-to-date data summaries. The database and tables are copied and stored on a computer diskette each month. This computer program has provided the Medication Quality Assurance Committee with an improved system for medication incident data analysis. The major benefit of this computer program over the previous manual system is the more timely identification of medication-related practices requiring closer monitoring and/or revision to improve patient care.
Subject(s)
Financial Management/methods , Medication Errors , Medication Systems, Hospital/standards , Quality Assurance, Health Care/methods , Risk Management/methods , Software , Data Interpretation, Statistical , Hospital Bed Capacity, 300 to 499 , OntarioABSTRACT
The implementation of a decentralized pharmacy service on a 59 bed acute patient care area was evaluated. Over a ten-month period four criteria were used to evaluate the decentralized service: (1) reported medication errors, (2) reported medication discrepancies, (3) drug costs per patient day and (4) availability and utilization of drug information. Data was collected over the ten month period for all criteria except for drug information interactions in which a self reporting data card was utilized over a six week period. Medication errors and medication discrepancies decreased by 12.5% and 80% respectively on the pilot floor as compared to the hospital (+14.8%, -18.0% respectively). Drug costs per patient day increased the least on the pilot floor (+9.1%) as compared to other areas in the hospital (range: 10.8% to 49.3%). Seventy-six percent of drug information interactions occurred on the pilot floor as compared to the central pharmacy accounting for 24% of interactions for all other hospital areas combined. It is concluded that a decentralized pharmacy service can make a significant impact on a unit dose drug distribution system by reducing medication errors, discrepancies, drug costs and by increasing the utilization of drug information resources.
Subject(s)
Centralized Hospital Services , Hospital Administration , Medication Systems, Hospital , Pharmacy Service, Hospital/organization & administration , Evaluation Studies as Topic , Hospital Bed Capacity, 300 to 499 , Medication Errors , OntarioABSTRACT
In planning for decentralization of Pharmacy Services a 2-month study of registered nurses was conducted using the work sampling technique. A quantitative analysis was made of the time which was spent in different medication related activities. Two floors which were thought to be representative of the hospital, a medical floor and a surgical floor, were selected. A classification of activities and a sampling form were prepared and evaluated in a 1 week pilot study. Instantaneous observations were made throughout the 24 hour day at random intervals and recorded on the sampling form. Over 9,400 observations were made. Registered nurses spent 11.39 z 0.66% (mean z SE) of their time in medication related activities.
Subject(s)
Medication Systems, Hospital , Nursing Staff, Hospital , Efficiency , Hospital Bed Capacity, 300 to 499 , Humans , Ontario , Task Performance and AnalysisABSTRACT
A pilot project for shared pharmacy service was undertaken to investigate costs and benefits under an agreement established between University Hospital, London and South Huron Hospital, Exeter, Ontario. The programme involved the use of facsimile telecopiers to transmit direct copies of the physicians' orders to the Pharmacy Department at University Hospital where they were entered into the computerized pharmacy system. At South Huron Hospital therapy was initiated from floor stock while the drug, dispensed in unit-of-use packaging, was delivered to the Exeter Hospital by courier service. The shared service pharmacist visited South Huron Hospital once weekly for nursing orientations, inservice lectures, patient consultations, medical staff meetings and direct contact with physicians. With the approval of the Bureau of Dangerous Drugs the pharmacist delivered Narcotic and Schedule G medications once weekly. After three months the patient census and average number of medication orders per patient per day had increased. The hours of pharmacy operation were extended, while the medication costs per patient day were reduced from $2.16 to $1.64. A shared pharmacy service can result in an improved element of drug use control for smaller hospitals in a cost-effective manner.
