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Medical Forum / General / Pharmacy / October 2005Authority of R.Ph. to perform kinetics monitoring
A hospital near me was recently challenged by a JCAHO surveyor to show how kinetics monitoring was not the practice of medicine by a pharmacist. She was not satisfied by the hospital's policy. They eventually got the issue dropped, but it made us think about refining our policy at my hospital. We also are trying to make this pass the "read back & verified" test. Our pharmacists currently do not contact the physician routinely for kinetics orders & this is perfectly OK with our medical staff & within our policy. Our current thinking is to document in the order that this is "per previous order Dr. so-and-so". Would anyone care to comment or share a policy? Thanks very much I had, prior to retirement as a clinical pharmacist, worked in a large hospital and I monitored lab values of all patients receiving such drugs as gentamin, warfarin, chemotherapeutic drugs, theophylline, etc. I used the hospital's computer system to automate this process and the report was compiled in the background and was ready for me each morning. We also monitored creatinine clearance to identify drugs requiring renal dosing. This was also automated via the hospital's mainframe. Physicians were contacted on a daily basis if a problem was detected and were grateful for the information. I maintained a log of these clinical interventions which were included in our pharmacy;s Quality Assurance Program. JCAHO was quite pleased with our program. Suggest you discuss your needs with your data processing department - they may have an "ad hoc" report generating system available for your use. I wish you luck in this worthwhile endeavor. bobs@theaterorgans.com ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ > A hospital near me was recently challenged by a JCAHO surveyor to show > how kinetics monitoring was not the practice of medicine by a [quoted text clipped - 6 lines] > document in the order that this is "per previous order Dr. so-and-so". > Would anyone care to comment or share a policy? Thanks very much >I had, prior to retirement as a clinical pharmacist, worked in a large > hospital and I monitored lab values of all patients receiving such drugs [quoted text clipped - 28 lines] > >How much do you get paid extra for each patient that you monitor? >>I had, prior to retirement as a clinical pharmacist, worked in a large >> hospital and I monitored lab values of all patients receiving such [quoted text clipped - 29 lines] >> >>How much do you get paid extra for each patient that you monitor? No extra pay - we were all salaried. >>I had, prior to retirement as a clinical pharmacist, worked in a large >> hospital and I monitored lab values of all patients receiving such [quoted text clipped - 29 lines] >> >>How much do you get paid extra for each patient that you monitor? No extra pay - I was salaried, The last small hospital, 50 bed, that I worked at in rural Mississippi had the lab do the kinetic monitoring. When I worked at the former Sinai Hospital of Detroit years ago we used an Apple II computer and the pharmacy interns ran the computer. The recommended dose was printed out and a sheet was placed in the patient's chart. The doctor signed the sheet that OKed the dose or he could change it. I never heard of a problem ever resulting from this proceedure. The doctors really liked it. |
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