ASHP national survey of pharmacy practice in acute care settings: dispensing and administration--1999

• Published in: American journal of health-system pharmacy Vol. 57; no. 19; pp. 1759 - 1775
• Main Authors: Ringold, DJ, Santell, JP, Schneider, PJ
• Format: Journal Article
• Language: English
• Published: Bethesda, MD ASHP 01-10-2000; Copyright American Society of Health-System Pharmacists, Inc. All rights reserved; American Society of Health Pharmacists
• Subjects: Ambulatory Care - organization & administration; Ambulatory Care - trends; Analysis of Variance; Biological and medical sciences; Chi-Square Distribution; Drug Compounding; Health participants; Hospital Bed Capacity; Humans; Medical sciences; Medication Errors - prevention & control; Pharmaceutical Preparations - administration & dosage; Pharmacists; Pharmacy Service, Hospital - organization & administration; Pharmacy Service, Hospital - trends; Professional Practice - organization & administration; Professional Practice - trends; Public health. Hygiene; Public health. Hygiene-occupational medicine; Quality Assurance, Health Care; Role; Surveys and Questionnaires; United States; North America; America; Drug; Health staff; Chemist; Drug dispensation; Management; Hospital pharmacy; Survey; Public health organization; Professional practice; Preparation; Quality; Distribution; Expenditure; Hospital; Cost analysis; Public health
• ISSN: 1079-2082; 1535-2900
• DOI: 10.1093/ajhp/57.19.1759

Results of the 1999 ASHP national survey of pharmacy practice in acute care settings that pertain to drug dispensing and administration practices are presented.Pharmacy directors at 1050 general and children's medical-surgical hospitals in the United States were surveyed by mail.The response rate was 51%. About three-fourths of respondents described their inpatient pharmacy's distribution system as centralized. Of those with centralized distribution, 77.4% indicated that their system was not automated. Decentralized pharmacists were used in 29.4% of the hospitals surveyed; an average of 58.9% of their time was spent on clinical, as opposed to distributive, activities. About 67% of directors reported pharmacy computer access to hospital laboratory data, 38% reported access to automated medication-dispensing-unit data, and 19% reported computer access to hospital outpatient affiliates. Only 13% of hospitals had an electronic medication order-entry system; another 27% reported they were in the process of developing such a system. Decentralized medication storage and distribution devices were used in 49.2% of hospitals, while 7.3% used bedside information systems for medication management. Machine-readable coding was used for inpatient pharmacy dispensing by 8.2% of hospitals. Ninety percent reported a formal, systemwide committee responsible for data collection, review, and evaluation of medication errors. Virtually all respondents (98.7%) reported that their staff initiated manual reports. Only two thirds tracked these reports and reported trends to the staff. Fewer than 15% reported that staff were penalized for making or contributing to an error.Pharmacists are making a significant contribution to the safety of medication distribution and administration. The increased use of technology to improve efficiency and reduce costs will require that pharmacists continue to focus on the impact of changes on the safety of the medication-use system.