Hospitalwide medication policies and standards.

The development and composition of a hospitalwide medication policies and standards manual are described. Medication policies and procedures developed independently by individual hospital departments and services at a 789-bed private teaching institution created problems related to consistency, the approval process, accreditation standards, and retrievability. Therefore, a joint nursing-pharmacy task force was formed to create a master document containing medication policies and standards for the entire institution. The manual also contains departmental medication-related procedures, the formulary of approved drugs, and key drug information. Its format allows for periodic updating and ease of use by nurses, pharmacists, physicians, and other health care professionals. It meets the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) requirement of a collaborative framework to ensure optimal medication-use outcomes. All medication-related procedures in individual departments must comply with the new policies and standards. A hospitalwide medication policy manual, created through multidisciplinary collaboration, made the policies and procedures consistent and more accessible and met JCAHO and other regulatory requirements.

Pharmaceutical services in hospital-based home health-care agencies--1982.

A survey of Medicare-certified hospital-based home health-care agencies was conducted in May 1982 to determine the type and extent of pharmaceutical services provided. A 12-page questionnaire was mailed to 243 directors of U.S. agencies that were identified from a 1976 directory. The questions elicited information about the characteristics of the director and agency, personnel, reimbursement, and scope of services. The overall response rate was 73.7%. Ninety-five percent of the agency directors were nurses. The median patient census of the agencies was 110. All agencies reported offering visiting-nurse services, 92% provided home health-aide services, and 46% offered home hospice services. Ninety-nine percent and 91% reported receiving reimbursement from Medicare and Medicaid, respectively. One fourth of the agencies provided home services that traditionally involve hospital pharmacists, including intravenous therapy (29%), home chemotherapy (18%), and total parenteral nutrition (18%). Although 85% of the agency directors reported using the services of a pharmacist, only 4% actually employed a pharmacist on their staff. The directors viewed educational programs, drug regimen review, and drug information services as the most important functions of pharmacists in home health-care agencies. Although these agencies provided an array of pharmaceutical services in 1982, very few pharmacists were actually employed. Additional studies are needed to re-evaluate the current status of pharmacy involvement in home health care.