[Index]

8.0 PROFESSIONAL PHARMACY SERVICES
 
The Pharmacy offers the following services:
 
Clinical Pharmacy Services
1.       Provision of pharmaceutical care to inpatients at VA.  Elements of pharmaceutical care provision include:
a.       Medication history taking
b.       Allergy history clarification
c.       Assessment of appropriateness of drug therapy
d.       Responsibility for optimization of drug therapy through direct interaction with patients and
          other caregivers (e.g. Nurses, Physicians, other disciplines)
e.       Monitoring for efficacy and toxicity of drug therapy. Clinical pharmacists have been authorized to order serum concentrations of all measurable drugs including (but not limited to) aminoglycosides (with serum creatinine), carbamazepine, cyclosporine, digoxin, lithium, phenobarbital, phenytoin (with serum albumin), tacrolimus, theophylline, valproic acid, and vancomycin (with serum creatinine).
f.        Discharge medication teaching and coordination to ensure proper medication use following
          discharge.
2.          Attendance at medical and interdisciplinary rounds and participation in patient care conferences.
3.          Pharmacokinetic monitoring and consultation on all drugs where such monitoring is indicated.
4.          Provision of drug information.
5.          Inservice education to all disciplines.
6.          Teaching to undergraduate and post-graduate students from the Faculty of Pharmaceutical
             Sciences at UBC.
 
Clinical pharmacists provide comprehensive clinical services from Monday to Friday, 0800-1600 hours.
 
Drug - Distribution
The Pharmacy Department operates a computerized medication system in which pharmacists receive a faxed copy of a physician’s orders. They are interpreted and clarified for orders that are incomplete, illegible, ambiguous or inappropriate.
 
Using a computerized drug profile, the pharmacist checks the appropriateness of the dose, route, drug interactions, drug duplication, allergy contraindications, and adjustments for renal dysfunction.
 
Subsequent to these editing, interpretation and monitoring functions, orders are scheduled and entered into the computer.
 
 
Medications are supplied to the units as follows:
 
                VGH:
The Pharmacy provides traditional medication distribution whereby the majority of medications are dispensed to individual patients as a seven-day supply (referred to as personal prescriptions) and the remainder are issued as wardstock. Medications are sent to the unit via pneumatic tube or messenger service.
 
                UBCH:
The pharmacy provides a unit dose medication distribution system whereby the majority of medications are dispensed for individual patients in individual medication cassettes on a 24 or 48- hour basis and the remainder are issued as wardstock.
                        Cart exchange times:
                        Koerner and 3rd Floor Purdy: 1530 hours on Monday, Wednesday, Friday and Sunday
                        Detweiller: 1530 hours on Monday, Wednesday, Friday, Saturday
   
                GFS:
                    The pharmacy dispenses a 10 days supply of medication.
  •       All scheduled doses are dispensed in one zip-lock bag.  E.g. For nortriptyline 10mg TID, 30 caps are supplied in one bag.  For atenolol 25mg daily, 5 tabs of atenolol 50mg are supplied.
  •       If required, tablets may be split using a pill cutter; the remaining portion may be saved in the bag for future use.
  •       If the dose changes from TID to QID for example, pharmacy will not send a new supply (continue using from the old supply and request for additional supply by sending the refill label to pharmacy).
  •       If the tablet strength of a medication changes, pharmacy will send a new supply.
 
Wardstock top-up
The Pharmacy Department maintains a wardstock top-up service to all nursing units. The stock is replenished on designated days.
 
On certain units, this may be managed through Omnicell machines. Omnicell is an automated dispensing system (ADS), which automates the distribution, management, and control of medications. The medications in Omnicell are: narcotic and controlled drugs, medications that are required “stat”, night cupboard medications, and wardstock. 
 
Central intravenous admixture service (CIVA)
The pharmacy provides a total intravenous admixture service. As far as possible, IVs requiring the addition of medications in a bag are prepared with appropriate quality control checks in a laminar flow hood in the IV Compounding Area located within the Main Pharmacy. A 24 hour supply is prepared and sent to the nursing units.
 
 
Research
The pharmacy department operates a Clinical Drug Research Program and conducts independent clinical drug research & publication. For further information, visit: http://www.vhpharmsci.com/CDR.htm