A survey of adverse drug reaction reporting programs in select hospitals.

Hospitals with American Society of Hospital Pharmacists accredited residencies were surveyed to assess the state of the art for adverse drug reaction (ADR) reporting. A majority of hospitals used a concurrent ADR reporting mechanism. Only one-fourth of hospitals assessed the causal relationship between the drug and the ADR, whereas the majority assessed the severity of the ADR. Fifty-eight per cent of hospitals received fewer than seven ADR reports in a 6-month period. Antiinfective agents and central nervous system drugs were most frequently cited as causing ADRs. Various corrective action has been taken to reduce ADRs, including changing drug administration procedures, promoting awareness of ADRs, patient teaching, and drug monitoring.

Balancing workload and staffing in satellite pharmacies by using a patient acuity index.

The assignment of beds to satellite pharmacies is based primarily on proximity. Assignment will usually be by nursing unit to encourage more effective communication among the patient, doctor, nurse, and pharmacist. Usually, an equal number of beds is assigned to each satellite. Recognizing that some nursing units (e.g., Intensive Care Units) place greater demands on pharmacy resources than others makes it obvious that there is a need for a system to measure the consumption of pharmacy resources by patient acuity. This article tells how such a measure was conceived, developed, and applied.

Implementation of a unit dose distribution system for respiratory therapy medications.

The development and implementation of a comprehensive unit dose distribution system for respiratory medications is described. Initially, an evaluation of carts and unit dose packaging materials for respiratory medications was conducted. Subsequent to the selection, a unit dose processing and packaging program was developed in accordance with the Respiratory Therapy Medical Director's Standard Treatment Orders. A 24-hour exchange system, separate but paralleling the already operational unit dose system, was implemented. The primary advantages attributed to the implementation of this system were 1) a decrease in potential respiratory medication order interpretation/transcription errors; 2) a decrease in the waste of medication solutions; 3) a decrease in potential preparation errors by the respiratory therapists; 4) standardization and accuracy of respiratory medication dosages; and 5) a more equitable method of charging patients.

Estrogens + patient package insert = confused patients.

A brief review of the patient package inserts concept and estrogen pharmacology is presented. Then the need for patient education is discussed along with recommendations for a team approach to managing patient anxiety by helping patients understand the estrogen-containing products they are using.

PIP: This article takes issue with the physicians' handling of patient inserts in estrogen-containing medications when presenting such medication to a patient in need. This discussion follows a brief review of the rationale of the Food and Drug Administration of using package inserts and a review of estrogen uses, adverse reactions, cautions, and side effects. The author argues for a more cooperative approach to patient package inserts, which would require direct participation by the physician rather than simple passive reading by the patient. A questionnaire survey on patients' attitudes, knowledge, views, and sources of drug information on oral contraceptives, with particular attention to the role of the patient-oriented package insert, concluded that professional sources (physician, nurse, or pharmacist) were preferred over nonprofessional and media sources. A collaborative approach to drug education is recommended, and suggestions for implementation are set forth.