Greeley Reflections
Accreditation Connection, August 30, 2010
Medication Management and pharmacist first-dose review
Part 6 of 7
Provide 24/7 accountability
Even when a pharmacy is not open 24/7 a “qualified” individual must perform a review prior to dispensing and, even then, a pharmacist must be on-call so that expertise is available. A retrospective review of orders must then be completed as soon as a pharmacist is available. There is also the expectation that any discrepancies be resolved prior to dispensing the medications.
The practice of allowing nursing staff to review new medications and administer a drug without pharmacy review first still exists in some hospitals. However, ASHP recommends that hospitals have a policy and procedure in place which allows for after-hours emergency access to medications only post authorization from the on-call pharmacist. Your process should be routinely evaluated to determine what the accessed off hours drugs were, the amounts withdrawn and what their intended use was to determine if any changes are needed. For example, this evaluation might lead to additions to the stock medications supply for approved protocol initiation such as for DVT.
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