We are committed to providing the highest levels of patient safety. This is accomplished through a combination of automation, technology, computerization, redundancy, patient involvement and clinical pharmacist expertise.
When a medication is given in the hospital, it is first carefully checked to make sure the right medication is being given to the correct patient. This begins when the pharmacist reviews the medication order written by the patient’s physician. After checking the patient’s computerized profile for allergies, drug interactions, potential adverse drug reactions, etc., the pharmacist enters the order into the hospital computer system. This allows the nurse to retrieve the correct medication for the patient from the computerized medication storage device (Pyxis MedStation®). A final check is made before the nurse administers the medication to the patient when the nurse scans the bar code on the patient’s wristband and the bar code on the medication dose. An immediate alert is generated if the medication is not approved for administration to the patient. This patient safety system is part of an HCA-wide commitment to optimizing the outcomes of patients treated in our hospitals (See HCAPatientSafety.com).
Another key method used by the pharmacy at Wesley for enhancing patient safety is computerization. We have developed highly advanced computer systems to help detect potential patient safety issues. For instance, doses ordered are checked specifically for each patient based on their age, weight, allergy history, other drugs they are receiving, organ function (e.g. kidney function), etc. Alerts are generated in real time for review by the pharmacist if any potential problems are detected.
An important method for protecting patient safety is standardization and redundancy. We employ these concepts in many areas of the pharmacy and the hospital. For instance, we utilize over 1,000 pre-printed physician order sets. Such order sets standardize care, avoid handwriting recognition problems, and are based on the best evidence-based standards. Similarly, the pharmacy and medical staff continually collaborate to maintain a formulary of medications available for treating hospitalized patients. This medication formulary allows all health care team members to be familiar with the uses, dosing, potential side effects, and appropriate monitoring of the medications on the formulary. Medications admitted to the formulary undergo evidence-based review to make sure they are the safest and most effective options available.
The pharmacy also contributes to safety by standardizing the concentrations and administration rates of intravenous medications. Through standardization, nurses know exactly how to set infusion pumps to deliver the correct medication dose for the patient. In addition, the pharmacy prepares all intravenous medication doses, except those used in emergency situations. Pharmacy preparation makes sure that extremely clean and safe conditions are utilized. Limiting preparation to a few highly trained and skilled individuals also increases safety through familiarity and a double-check system. All oral and parenteral medication doses are prepared by the pharmacy for pediatric patients, in ready-to-administer form for the nurse, to further minimize opportunities for error.
Clinical pharmacy services have been shown to produce significant reductions in medication errors and to improve patient outcomes. Pharmacists at Wesley provide a broad array of clinical pharmacy services. All medication orders are carefully reviewed by a pharmacist and screened for problems related to allergies, drug interactions, dosing, etc.; the prescriber is contacted when a change to the order is indicated. Pharmacists also review each patient’s medication regimen on a daily basis to detect medication-related problems and to make sure the desired outcomes are being achieved. Pharmacists participate as an integral member of the health care team, providing drug information and therapeutic recommendations to physicians, nurses and others to improve the care of patients.
Pharmacists are available to teach patients about their medication therapy, particularly in complicated areas such as asthma, anticoagulation, chemotherapy, etc. We also encourage patients to be actively involved in their care. Patient safety is our priority, and we want patients to feel comfortable asking questions about medications and treatment options. We encourage patients to let their physician, nurse and/or pharmacist know about all of the medications they have been taking prior to hospitalization, including prescription, over-the-counter, and natural remedies or alternative medications. For more information about medication safety, visit http://www.ismp.org.