[Clinical pharmacist in a multidisciplinary team in a paediatric department]. / Klinisk farmasøyt i tverrfaglig gruppe på barneavdeling.

BACKGROUND: Clinical pharmacists have not been a part of multidisciplinary teams at Rikshospitalet, University Hospital, Norway, which is in contrast with common practice in other countries. We wanted to investigate how such specialists could contribute to quality assurance of drug treatment in a paediatric ward. MATERIAL AND METHOD: A clinical pharmacist reviewed medical charts from patients admitted to the paediatric ward at Rikshospitalet in the period 1.2.2006-31.3.2007. Drug related problems (DRP), identified by the pharmacist, were discussed with physicians and nurses before the ward round. In the period 31.7.2006-31.3.2007, DRPs were recorded on a quantitative and qualitative level. Nurses and physicians evaluated the project by responding to a questionnaire. RESULTS AND INTERPRETATION: The pharmacist identified 137 DRPs in 103 of the 384 screened charts. Immediate action was taken in 73 of the 137 cases, 39 DRP were considered relevant, but without requiring action, and 25 of the DRP recordings had no consequence for the treatment. The most commented DRPs were "dosage" (n = 48), "drug choice" (n = 35) and "need for monitoring" (n = 32). The pharmacist responded to DRPs, educated nurses, developed internal guidelines and recommended cost-saving measures. Seven of eight doctors and all the 15 nurses thought that the ward had benefited from the pharmacist's contribution. Interpretation. Clinical pharmacists may make a positive contribution to quality assurance of drug treatment in hospital wards.

[Pharmacy-managed drug supply may reduce drug expenditure in hospitals]. / Apotekstyrt legemiddellager kan redusere legemiddelutgiftene i sykehus.

BACKGROUND: In order to reduce the cost of drugs and the time nurses spend on them, a six-month collaboration project was carried out between the hospital pharmacy and a ward unit. The ward unit had a yearly drug expenditure of 5.9 million NOK. MATERIALS AND METHODS: Pharmacy technicians stocked up the unit twice a week according to an agreed standard. Hospital pharmacists checked the need of other drugs ordered. A comparison between periods before and during the project was done on the value of the drug stock, credited returned drugs, nurses' time spent on drug handling and the number of telephone orders to the pharmacy. The value of avoided deliveries was calculated. RESULTS: The value of the drug stock was halved and calculated at a value of NOK 22,000. The value of drugs credited by the pharmacy was NOK 52,000. The savings from avoided deliveries were NOK 90,000. Total savings were NOK 164,000, 5% of the value of total purchases. In addition, nurses spent 11 hours less a week on drug handling. The number of telephone orders to the pharmacy was halved. INTERPRETATION: Pharmacy-managed drug supply to hospital wards may reduce drug expenditure and the risk of medication errors.

[Pharmaceutical revision of hospital drug administration]. / Farmasøytisk revisjon av legemiddelhåndtering i sykehus.

BACKGROUND: Quality audits of the implementation of drug administration procedures are carried out in order to determine objectively to what extent implementation conforms to procedures. METHODS: Since September 1997, the pharmacy at Rikshospitalet University Hospital in Norway has performed quality audits of drug administration at the hospital, using interviews and surveys. Staff members in the audited unit and the auditing pharmacist agree on prospects for quality improvements and review possible action. A survey was carried out in the autumn of 2000 in order to determine staff opinion of the quality audits. RESULTS: On the basis of the observations made, improvements have been carried out at all levels of the organisation. INTERPRETATION: The survey indicates that hospital staff members are satisfied with the quality audits performed by the pharmacy.