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Medical Forum / General / Pharmacy / April 2004Hospital pharmacy staffing/hours
I am working on a project right now and I have a few questions -how many pharmacists would you need on staff at a 150 bed hospital? how many techs? If there are 2.5 pharmacists and 2 techs is that enough? -What hours of operation are needed? what about after hours? -how do you handle narcotics after hours? -in a 150 bed hospital are computerized Rx systems and Pyxis machines realistic? are they necessary? -should pharmacists be working on a code team? - can you think of any innovative ways to practice pharmacy in a 150 bed rural hospital? thanks for your help!! there are consultants who make a living answering just the questions that you posed. lol i am not going to pay a consultant to help me with a school project. but if I knew any I would definitely ask! It would take pages and pages of typing to answer these questions. Hospital pharmacy processes are often extremely complicated and are certainly a logistical nightmare to the uninitiated. Do a bit more legwork and come back with some more specific questions if you want. cjrph > I am working on a project right now and I have a few questions > [quoted text clipped - 15 lines] > > thanks for your help!! hmm ok. i don't know how specific you want me to be, though. you could just answer one or two questions if you want, not the whole thing. what is the role of the clinical pharmacist? do they reduce medication errors? how many would a 150 bed hospital need? copacetic80@hotmail.com (JoxerFan) raised a lot of vexing questions: (((-how many pharmacists would you need on staff at a 150 bed hospital? how many techs? If there are 2.5 pharmacists and 2 techs is that enough?))) Um, sounds kind of light to me. You mean that complement to cover ALL shifts? (((-What hours of operation are needed? what about after hours?))) The more the better. 150 beds seems like a lot of patients to me. Will you be doing discharge / outpatient rx too? (((-how do you handle narcotics after hours?))) Have someone on call? Use a nursing home model, with a sealed box of common narcs? Pyxis override? (((-in a 150 bed hospital are computerized Rx systems and Pyxis machines realistic? are they necessary?))) Computers? Does anyone do anything nowadays w/o a computer? Pyxis? Sounds like a complicated economic - cost - benefit issue. Try contacting the Pyxis people. "Are they necessary?" I doubt it, maybe the Joint Commission on Accreditation would address this. (((-should pharmacists be working on a code team?))) You said this was for a project? For pharmacy school? Then the answer is YES! For business school? For law school? Your audience may influence your answer. (((- can you think of any innovative ways to practice pharmacy in a 150 bed rural hospital?))) Warfarin clinic? Have rph collaborate on discharge orders to catch the mistakes when they are written? Greater patient presence? (((thanks for your help!!))) shucks, it weren't nothing. > what is the role of the clinical pharmacist? do they reduce medication > errors? how many would a 150 bed hospital need? Simple question, not very simple answer. A hospital clinical pharmacist has a very expansive role. The term "clinical" is in a sense to indicate that the pharmacist doesn't just hide in the pharmacy, dish out meds, and never meet a single patient or colleague in his/her lifetime. Do they reduce medication errors? Sure? Only thing is they're the ones keeping track of medication errors...  SignatureGregory M. K. Poon, Ph.D., R.Ph., B.Sc.Phm. Departments of Pharmaceutical Sciences and Chemical Engineering University of Toronto Toronto, Ontario > hmm ok. i don't know how specific you want me to be, though. you could > just answer one or two questions if you want, not the whole thing. here are some brief answers. > I am working on a project right now and I have a few questions > -how many pharmacists would you need on staff at a 150 bed hospital? A 150 bed hospital will have a normal census of about 90 or 100. The coverage you would need would depend on the hours you want to keep and the responsibilities of your pharmacy. An outpatient will reqire additional planning. > how many techs? If there are 2.5 pharmacists and 2 techs is that > enough? No way. Let me just say that if you go bare-bones you couldn't survive with less than 4 full time pharmacists (or equivalent) not including director (hes gonna be busy). You will need probably one tech per pharmacist. You may need extra techs for special duties like IS work or inventory. Don't forget the secretary. > -What hours of operation are needed? what about after hours? Depends what the CEO says. If you are 24 hours then the staff will be larger than as above but there will be no overnight worries. As far as after hours--that is a matter of much debate these days. JCAHO has tightened up the noose on non-pharmacist access to medicaton and forced many small hospitals like my own to reengineer the night procedure. This is my most current project as a matter of fact. We have JCAHO inspection in less than a month. If you visit the JCAHO website its pretty much spelled right out for you. how do you handle narcotics after hours? The pyxis machines have limited override capabilities and JCAHO is ok with a limited formulary on the overnight. Therefore we keep the most commonly used narcs on override. The catch is that all override transactions must be reconciled (or at least reasonably reviewed) by a pharmacist within 72 hours. > -in a 150 bed hospital are computerized Rx systems and Pyxis machines > realistic? are they necessary? They are becoming the standard, anyway. They have their pros and cons but in the end I think they are great machines, especially in a small facility. You save lots of running around and speed up turnover time. > -should pharmacists be working on a code team? Doesn't really matter. Ive been at places where pharmacists were on a code team and to be honest I've never seen one do anything. There is way too much company at a code, anyhow. > - can you think of any innovative ways to practice pharmacy in a 150 > bed rural hospital? Its hard to get too many programs going at a small hospital and remember, its not easy to get good staff at a rural hospital. At the very least you should encourage physicians to request consults for vanco and aminoglycoside dosing per pharmacy. This includes taking regular levels and adjusting the dose. You also might want to review microbiology reports to check for resistance and heparin reports for protimes vs infusion rate according to protocols. There are all sorts of little things like this you could add to your hospital. thanks for your help!! Youre welcome, I hope your project goes well and I got you this info in time (assuming its of any use to you at all). cjrph >should pharmacists be working on a code team? > >Doesn't really matter. Ive been at places where pharmacists were on a code >team and to be honest I've never seen one do anything. There is way too >much company at a code, anyhow. Don't know about your team, but on ours, the pharmacist does all charting and draws meds, help find items needed for code in cart. Many times you are busy as hell, especially on pediatric codes having to do dilutions. Try two or three of these on your shift while the work piles up!! We would like to get off the team but nursing does not want it. 370+ bed full service hospital. Just another opinion. Best, Bob Altic, PharmD St. Mary's Hospital Richmond, VA. Wow they do keep you busy, huh? If the staff wants you to provide code support then by all means, you should be a team player. This goes for any process. The pharmacy has a responsibility to maintain credibility with the rest of the hospital and do their best to give whatever services they can. cj > Don't know about your team, but on ours, the pharmacist does all > charting and draws meds, help find items needed for code in cart. [quoted text clipped - 7 lines] > St. Mary's Hospital > Richmond, VA. bobaltic@comcast.net (Robert L. Altic Jr.) >Don't know about your team, but on ours, >the pharmacist does all charting and ... >Bob A. Richmond They keep me locked in the basement, behind a keyboard where I can only do minimal damage. A few weeks ago I asked one of our "floor" pharmacists what they did on codes. I got a brief description of the duties, and then some good stories. Like the doctor who responded to the code and didn't know the drill. Those codes must be interesting, eh? Pete (who, in another time and universe, did six months at MCV. First I lived in a roach filled apt in the north suburbs and then rented a roach filled apt on Hanover in the fan.) |
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