Inpatient Pharmacy Department

Location:

Pharmacy and Pharmacy Administration: 1st floor - Suite 1-B78 and Suite 1-B70

Hours:

24 hours a day, 7 days a week

The Pharmacy Team includes the following:

• Director of Pharmacy Services
• Clinical Pharmacy Manager
• Clinical Pharmacists and Decentralized Pharmacists
• Pharmacy Technicians
• Clinical Pharmacy Specialist in Oncology
• Informatics Pharmacist
• Department Administrative Assistant
• Pharmacy Buyer
• Automation and Inventory Specialist

Contact Information:

• Central Pharmacy: 410-337-1480
• Inpatient Anticoagulation Management Service: 443-324-9195
• Anticoagulation Management Service: 410-337-4483
• Director: 410-337-1624
• Clinical Manager: 410-427-2281
• Decentralized Pharmacists are available by Vocera™ or phone extension
  • Critical Care/2 Central #1004
  • 6th and 7th Floor #1036
  • 5th Floor #2568
• Cancer Institute Oncology Satellite Pharmacy #5571
• Pharmacy Buyer: 410-337-1483
• Automation and Inventory Specialist: 410-427-2563

The St. Joseph Medical Center Department of Pharmacy provides systems-based services including drug and disease state information, drug preparation and distribution, and dosage monitoring services for adult patients, focusing on optimizing drug therapy outcomes. All physician orders for medications are reviewed by a pharmacist for appropriateness of therapy and entered into the pharmacy database. This database provides clinical screening tools, drug preparation lists, drug usage reports, and other helpful drug-related information. In addition, the Pharmacy contributes to the development of drug use policies through active participation on the Pharmacy and Therapeutics Committee (P&T Committee) and the Investigational Review Board.

Pharmacists provide direct patient care throughout the institution, including the outpatient setting. The Anticoagulation Management Service provides patient-specific treatment modifications and education to patients who are prescribed warfarin.

Clinical pharmacists are active, integral members of the multidisciplinary rounding team in the MSICU and assist the team by providing services including:

• drug selection
• pharmacokinetic assessment and drug dosing
• drug information (including drug interaction and adverse event screening)
• patient medication counseling and education
• other patient-focused services to optimize drug therapy outcomes

All pharmacists provide patient and health care provider education; participate in Adverse Drug Reaction (ADR) and Medication Error programs; and participate in investigational drug research, and other cost and quality improvement programs and projects. Pharmacists' clinical interventions are recorded and documented in the medical record, in addition to routine reporting throughout all institutions affiliated with Catholic Health Initiatives (CHI).

Clinical Programs (see below for details):

• Pharmacokinetic Dosing and Monitoring of –
  • Anticoagulation medications
  • Antimicrobial agents
  • Parenteral Nutrition
  • Renally eliminated medications in patients with impaired renal function
• Code Blue response
• Medication Reconciliation and discharge counseling (upon request)
• Daily drug level screening and evaluation
• Automatic intravenous to oral dosage form conversion
• Automatic therapeutic interchange(s) based on equivalency with formulary medications
• Referral-based outpatient Anticoagulation Management Service
• Investigational Drug Program
• Adverse drug reaction (ADR) and Medication Error reporting and monitoring
• Drug Usage Evaluations

Adverse Drug Reactions (ADR)

ADRs are collected and monitored by the Drug Information Service utilizing the IRIS reporting system. Routine review and evaluation is performed by the Medication Safety Team, a subcommittee of P&T. Suggestions for improvement are forwarded to the P&T and Medical Executive Committees for approval.

Anticoagulation Management Service

Pharmacists provide individualized care for patients, referred by their physicians, who are taking anticoagulation medications. The service includes blood test monitoring, dosage adjustments, education and communication with other health care providers.

Drug Usage Evaluation (DUE)

Evaluation of the usage patterns of selected medications is performed by the Pharmacy in conjunction with the primary prescribers and nursing staff. Criteria are developed and recommended by the P&T Committee and approved by the Medical Executive Committee. Suggestions for future DUEs may be forwarded to the Clinical Manager (410-427-2281).

Investigational Drug Program

The Pharmacy maintains and monitors investigational drug inventory for principle investigators. Orders for investigational drug products are processed and the drug product is prepared and delivered through the Pharmacy's distribution system. In addition, clinical pharmacists are involved in budget preparation, patient randomization, and record-keeping throughout the duration of the study period.

Pharmacokinetic Dosing

Pharmacists dose over 90% of patients receiving aminoglycoside antibiotics. The service also covers potentially toxic agents such as vancomycin and imipenem, as well as medications for patients who have renal or hepatic impairment. To obtain this service, the prescriber must specify "Pharmacy please dose" or a similar statement on the physician's orders sheet.