Ward pharmacists

The ward pharmacist is an important member of any hospital healthcare team with a number of key responsibilities. They will review each patient s drug chart on a daily basis and annotate the chart as appropriate ... 

If the drug name is unclear or written on the drug chart as a proprietary product, the ward pharmacist will annotate the entry with the correct generic name (hospital prescribing is not constrained by the same rules regarding the supply of proprietary items as those NHS prescription forms originating in the community (see Section 2.4.1, Part VIII)). If the... 

The ward pharmacist will annotate the Pharmacy box on the chart with information to help the nursing staff to locate the medication. This will include annotating whether the item is a ward stock item (see Section 4.2.1), an item that the patient has brought into the hospital (which is suitable for use during their stay) (see Section 4.2.2) or an item that has been specifically ordered by the ward pharmacist for administration to the patient during their stay (see Section 4.2.1) according to the directions of the pre-scriber. 

Patients own drugs (POD) schemes allow the use of medication brought into the hospital by patients. Medication is checked by the ward pharmacists for suitability and the patient s drug chart annotated appropriately. 

Patients operating within this scheme are first assessed for suitability (usually by the ward pharmacist). Although this scheme would not be suitable for many patients, there are a significant number of patients who are perfectly capable of self-administration of medication. This not only enables a patient to be in control of their own medication, but also helps to reduce staff workload. 

In addition to the patient s name and details of the ward they are staying on, in-patient orders will usually only contain the name and strength of the drug required. Therefore, it is the responsibility of the ward pharmacist to perform the clinical check on the medication on the ward. This will involve checking the dose and frequency of administration (as details of the dose and frequency of administration will be detailed in the in-patient drug chart). 

Alternatively, the ward pharmacist will perform the clinical check on the ward and sign off the TTO for dispensing before sending it down to the hospital pharmacy. In this case, it would be possible for the items on the TTO to be dispensed by a pharmacy technician and then the dispensing check could be performed by a (second) accredited checking technician (see Section 4.3.5). 

You are the ward pharmacist for Ward 1 8 and are asked by the nursing staff to order from the hospital pharmacy the antibiotics for June Bell that have just been written on the patient s drug chart by the doctor. 

Interactions There is no interaction between the Pregaday tablets and the trimethoprim tablets. In addition, the ward pharmacist should check the other sections of the patient s in-patient drug chart for any additional concurrent medication that could cause an interaction. In this case, the other sections of the patient s in-patient drug chart did not contain the details of any other medication. 

Once this change has been made, the ward pharmacist can order the amoxicillin sachets from the pharmacy via an in-patient order as follows ... 

Meet with Peter carers. Ask the ward pharmacist to attend - they can answer triclq questions and may have patient information leaflets or DVDs. Cover ... 

Fertleman M, Barnett N, Patel T, 2005. Improving medication management for patients The effect of a pharmacist on post-admission ward rounds. Qual Saf Health Care 14 207—11. 

You are a hospital pharmacist visiting your regular general medical ward to review patients and provide pharmaceutical advice. Mr HA is a 50-year-old... 

Mr Jones is subsequently transferred to the cardiology ward where his continuing atrial fibrillation is later confirmed as persistent atrial fibrillation. As the ward clinical pharmacist, you are responsible for daily review of drug charts and advice to medical and nursing staff on all aspects of drug treatment for patients on the ward. 

In a case like the one reported here, the only meaningful approach a pharmacist/health professional could take is to make sure that the client is appropriately referred to the GP for an immediate assessment by the Community Mental Health Team. The client may need to be compulsorily admitted to the local psychiatric ward. On specific occasions, it may be necessary to involve the police to cope with the situation. 

Mrs TY is a 77-year-old woman who has been admitted to the orthopaedic ward where you work as the clinical pharmacist. She slipped on the wet floor in a supermarket and has been diagnosed with a fractured hip. She is normally fit and well and doesn t take any regular medication or have any relevant past medical history. She is 157 cm tall and weighs 49 kg. She lives alone, has never smoked and drinks a small glass of sherry most nights. 

Hospital pharmacy is a discipline in permanent transition. In Fig. 1, activities conducted by hospital pharmacists as well as the number of hospital pharmacists in Spain from 1955 are presented. Originally, hospital pharmacists were responsible for management and delivery of stocks of drugs to the wards. Since then the role of the pharmacist has evolved to include a more rational dispensing system (unit-dose delivery) and clinical activities and pharmaceutical care. 

In the seventeenth century the German-Dutch chemist Johann Glauber prepared sulfuric acid by burning sulfur together with saltpeter (potassium nitrate, KNO3) in the presence of steam. As the saltpeter decomposes, it oxidizes the sulfur to SO3, which combines with water to produce sulfuric acid. In 1736, Joshua Ward, a London pharmacist, used this method to begin the first large-scale production of sulfuric acid. 

Limit hospitai formularies to essential drugs and doses Pharmacists on ward rounds to monitor and advise Briefing at handover and shift change on circumstances that increase risk of error, such as an unfamiliar disease, new staff or unusual drug regimens... 

Some European countries have developed national guidelines for the preparation of ready to administer products in hospital pharmacy (German Society of Hospital Pharmacists Guideline for the aseptic preparation of ready to use-/administer parenterals) or at the hospital ward (Dutch Society of Hospital Pharmacist Guideline for the preparation prior to use on the ward) [49, 50]. For further information on aseptic handling see Chap. 31. 

The pharmacist must be aware that other persons play a major role in the administration of medicines to patients. The pharmacist may be asked, or feel morally or legally, obliged to give care and training to the reconstitution of medicines (see Fig. 1.2) on a ward by nurses, at nursing homes or home for the elderly or to home care workers or family of the patient. 

If medicinal products have to be reconstimted in the setting of a nursing or LTC home or in a hospital ward doctors, nurses and other caretakers can be involved in handling of medicines. The pharmacist should take care to educate and if possible to supervise the doctors and muses. 

Swiss hospital pharmacists [16] do not consider monoclonal antibodies as hazardous for healthcare practitioners and only gloves are recommended for their manipulating at wards. 

Storage requirements and responsibility for stock on the wards may differ between countries. In general the pharmacist, if not directly responsible, is responsible for the training of ward staff on how to store and handle pharmacy supplied stock. 

Medicines, including specially prepared medicines, will often be stored under conditions which are not controllable with respect to the temperature e.g. Doctors emergency bags, cardiac arrest boxes in wards, ambulances etc. In such cases the pharmacist should advise on the adjustment of expiry dates (see Sect. 22.6.1)... 

This is the pharmacy s job. On the ward, check the pharmacy closing time and daily deadlines for discharge medications (To take out7 TTOs ). Medications may not be in stock, so ask the pharmacist before prescribing anything unusual. 

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