THE CLINICAL PHARMACIST: IF HE'S ON THE WARD HE'S ON THE BAll

He makes a worthwhile contribution when he's in touch with patient needs In a 64-bed gynaecology unit in Los Angeles, the pharmacist is situated in the patient care area, and medication orders are checked hy him and compared with a daily review of the medical ad ministration records or each patient. Over an 8-month period, nearly 30,000 medication orders were processed by the pharmacist and orthese, 227 (0.8 %) were changed or modified by him . There were 48 inSlances of inappropriate dose, route or frequency of medication: 2 of which would probably have resulted in death if not corrected: 4 may have resulted in death; 8 would have led to serious toxicity and the remaining 34 would probably have resulted in minimal or no toxicity.

There were 47 cases in which incomplete orders required fu rther clarification. There were 27 in which patients were allergic to the medication ordered (possible result: 2 deaths; 14 serious toxicity). There were 17 cases with nursing t ranscription errors (which may have produced 4 with serious toxici ty). Because the pharmacist carried out a daily review of the patients' records, he was able to query 10 cases where medication was inadvertently discontinued following transrer from another unit (J with possibly serious consequences), the most imponant omission being heparin. The pharmacist also recommended discontinuation of unnecessary medication in 8 cases. In this setting, with the pharmacist closely involved in patient care, many potential errors were corrected, medications were given with a better understanding of the patients' needs, continuity was improved and unnecessary medications (and therefore costs to the patient) were eliminated. Marcus. R. .J. e{ a1. : American Joumal of I·It"lSpil3l Pharmacy 38: SSg Oun 1981)

0156-2103 /81 /0725-0015 $00.50/0 C ADIS Press INPHARMA25JuI1981 15