Computer applications in hospital pharmacy practice. I. Computer expectations/applications.

Following vendor selection of a pharmacy computer system, attention must be directed toward which computerized functions to include. Although most features are uniform among the various systems, a discussion is presented listing those applications considered the minimum acceptable for any hospital pharmacy computer system. The descriptions focus on computerization of those labor-intensive activities necessary to support drug distribution services. Computerized support of an intravenous (I.V.) admixture and unit dose program centers around label production and charging/crediting functions. Label production is used to generate a manual backup profile and unit dose cart fill list. The scope of information to include on I.V. and unit dose labels is described. Charging/crediting functions via computer are also discussed, with mention of free-form capabilities. Other computer applications mentioned include: medication profiling, drug interaction flagging, data confidentiality, census support, and hard copy reports. Feature selection depends on the aspects and unique needs that benefit most from computerization.

Computer applications in hospital pharmacy practice. II. Manual backup/support system.

The planning phase of a hospital pharmacy computer system usually does not address the issue of a suitable backup should the computer fail. This article describes a backup system centered around a hard-copy patient medication profile. This profile is built through use of computer-generated duplicate labels and exists for both the unit dose and intravenous admixture services. With this approach, the computer initiates its own support system and thereby eliminates the need for a separate, manually maintained backup system.

Development of a multihospital pharmacy quality assurance program.

Seven community hospitals have worked cooperatively for 18 months to develop an initial hospital pharmacy quality assurance program. Auditing criteria were developed for nine service areas corresponding to the model program developed by the American Society of Hospital Pharmacists. Current plans are to implement and modify this program as required at each participating hospital. Follow-up programs will also be essential to a functional, ongoing program, and these will be developed in the future.

Effect of whole blood on insulin adsorption onto intravenous infusion systems.

Insulin availability following the addition of whole blood to insulin infusions was evaluated. Solutions of 0.45% sodium chloride containing insulin (50) units/liter) and tracer amounts of 125I-labeled insulin were prepared and added to plastic or glass intravenous containers. Blood (5 ml) was added to the containers at the same time as the insulin or one hour after insulin. The cumulative amount of insulin delivered from these solutions over six hours was compared with that of insulin solutions containing no blood. When no blood was added to the insulin infusions, cumulative insulin delivery after two hours was 68% from the plastic containers and 76% from the glass bottles. The corresponding values for blood added simultaneously with insulin or one hour after insulin, ranged between 93% and 98%. The addition of whole blood to these low-dose insulin intravenous infusions was found to be effective in minimizing insulin adsorption onto the components of the infusion system. The method described does not expose the patient to the risks associated with receiving exogenous human serum albumin and also involves less expense.