Upload
ammarah-taimur
View
219
Download
0
Embed Size (px)
Citation preview
8/14/2019 Application of Computers in Hospital and Clinical Pharmacy
1/13
CLINIC L PH RM CY SSIGNMENT
2013
Application Of
Computers In Hospital
And Clinical Pharmacy
Pharm D 4th Proff Evening
Group No 7
J I N N A HU N I V E R S I T Y
F O R
W O M E N
8/14/2019 Application of Computers in Hospital and Clinical Pharmacy
2/13
Application Of Computers In Hospital And Clinical
Pharmacy
2013
2
Group
Members
(No. 7)
1.Afshan
Mushtaq
10597 2.Ammarah
Shaikh
10604
3.Asra Alvi
10611
4.Erum
Akhter
10617
5.Halima
Sadia 10628
6.Hira
Akbar
10634
7.Sualeha
Batool Baig
10681
8.Syeda
Kinza
Mehmood
10682
9.Tuba
Hasaan
Qureshi
10692
8/14/2019 Application of Computers in Hospital and Clinical Pharmacy
3/13
Application Of Computers In Hospital And Clinical
Pharmacy
2013
3
Table of ContentsABSTRACT: ..................................................................................................................................................... 4
BACKGROUND: .............................................................................................................................................. 4
INTRODUCTION: ..................................................................................................................................... 5
DISCUSSION AND CONCLUSION: ................................................................................................................. 10
REFERENCES: ........................................................................................................................................ 12
8/14/2019 Application of Computers in Hospital and Clinical Pharmacy
4/13
Application Of Computers In Hospital And Clinical
Pharmacy
2013
4
APPLICATIONS OF COMPUTER IN
HOSPITAL AND CLINICAL PHARMACY
Afshan Mushtaque, Ammarah Shaikh, Asra Alvi, Erum Akhter, Halima Sadia, Hira
Akber, Sualeha Batool, Syeda Kinza, Tuba Hassan
Students of 4thProfessional Pharm-D
Jinnah University for Women
ABSTRACT:
Computers have become an important necessity for the pharmacist over the past decade who is
engaged in drug information services, patient counseling etc so as to satisfy patient queries
related to medicines including toxic effects, adverse drug reactions, and drug interactions and
also about the disease, disorder, acute syndrome or new innovative therapies. The field of
pharmacy is immensely benefited by the use of computer and it will continue to do so. The role
of computers in hospital and clinical pharmacy is diversified. They help in patient record
management, entry of medication errors, drug therapy monitoring, purchasing and inventory
control, patient medication profile etc. Further development in computer technology will enable
the pharmacist to discover new drugs for the complete care of dangerous of diseases like aids,
cancer etc. and reduce the cost of production of drugs for diseases which are easily cured.
Various hardware and softwares have been developed without which drug discovery, designing,
manufacturing and analyzing would become virtually impossible.
Computer and computerprograms are also aid in utilizing drug information. Thus, there are numerous applications of
computer in clinical and hospital pharmacy and computers have become a necessary solution for
optimizing patient care.
KEY WORDS:
Computers, drug information, softwares, hospital pharmacy, clinical pharmacy
BACKGROUND:
Utilization of computers in hospitals and clinical pharmacies started in United States in 1960s
and has shown fast growth in 1980s. Different researches and studies have been conducted over
the period of years to highlight the applications and beneficence of computers in hospital and
clinical pharmacy and have contributed in further advancement in the use of computers in
hospital and clinical pharmacy. With the passage of time the practice of using computers has
gained considerable priority and have ease the pharmacists job. In this study weve focused the
importance of computers in clinical and hospital pharmacist life.
8/14/2019 Application of Computers in Hospital and Clinical Pharmacy
5/13
Application Of Computers In Hospital And Clinical
Pharmacy
2013
5
INTRODUCTION:Pharmacy field plays a crucial role in patient healthcare. It is a huge field which is present
worldwide. To run pharmacy field professionally and efficiently, it requires huge management
and manpower. But now a days use of computers in pharmacy field reduced the manpower and
time. Computers are almost related to every corner of pharmacy field. (Shivraj Jadhav, 2012)
Initially the pharmacist was spending time dealing with customers and the business virtually took
care of itself. Now, however, the costs (time and money) of doing business are forcing the
pharmacist to spend a decreasing amount of time with the customers and more in attending
administrative aspects of the pharmacy. (Murray MD, 1998) Moreover, the independent
pharmacy owners face tough challenges in front of the growing customer demands and
increasing competitive threats. The development of information technology in the 20th century
brought with it significant impact on computerization of pharmacy. (Roberts MB, 2002)
(Murray MD, 1998) (Carmichael JM, 2004)
In Both Hospital and Community Pharmacies, Computer applications are used in conjunction
with drug administration, ambulatory care, clinical practice and drug distribution. Computers
have become the main component of pharmacy practice. It is essential for pharmacist and
pharmacy technicians to become computer literate, and comfortable using the common software
programs made for pharmacies. Computer can help in reducing error and potential patient harm
by keeping information up-to-date, accessible, accurate, standardized, concise and correct.
(Moini, 2010) (Shivraj Jadhav, 2012) With computers we can keep track of drug inventory,
narcotics use, changes in the drug formulary and personnel. Computers are used for patient
billing, insurance billing and verification, pricing, maintenance of patient profiles, generation ofmedication administration record and a number of computational an repetitive tasks. (M.D,
2007)
The amount of information used in pharmacy is huge. In addition to keeping up with the rapid
changes in field, with new drugs and new delivery systems added every day, computers and
computer programs are useful in utilizing new drug information. Computers can help to reduce
medication errors with programs that are designed to alert the user of possible medication
interactions or allergies, dose limitations, drug duplications, and other warnings. (Evans, 1998)
For Example: A properly programmed computer can suggest the proper diluting agent (diluent)to use in preparing an IV , as some drugs are more compatible with particular diluents ~ e.g., NS
as opposed to water or D5W as opposed to NS, etc. The computer may even also alert the
pharmacist to potential drug-drug interactions and drug physiology interactions, which help to
safeguard the patient. The pharmacists and physicians may also use computers (the portable palm
computers) to track a patients laboratory results or monitor drug levels. Information can also be
8/14/2019 Application of Computers in Hospital and Clinical Pharmacy
6/13
Application Of Computers In Hospital And Clinical
Pharmacy
2013
6
passed back and forth from physician to pharmacist via these portable computers, making for
optimal patient therapy.(Overhage JM, 1996) (Dexter, September 27, 2001) (Anthony, 2004)
Using Computers in Continuing Education makes the computer an excellent tool for the ongoing
education of pharmacy personnel. There are internet sites that present the latest drug information
and monograph. In addition, computers can provide the pharmacist and technician with
information on a particular topic, references, communication with researches and pharmaceutical
companies.(Anthony, 2004)
For Drug interaction screening, computer programs like MEDIPHOR (Monitoring and
Evaluation of Drug Interaction by Pharmacy Oriented Reporting) and PAD (Pharmacy
Automated Drug Interaction Screening) are made. Thus using computers can enhance the
standards of a pharmacists clinical services. In addition to these services, pharmacists use
computers for graphic printing, storage of multiple patient data for analyses and exact dosing of
drugs following one compartment model.
A frequently recommended method for preventing adverse drug events is computer-aided
screening of prescriptions. Pharmacists generally screen, or perform prospective review, of a
patient's medication regimen during the prescription dispensing process to prevent drug-related
problems.(Bates DW, 1998)
Computers play an important role in preventing medication errors. Several approaches have beenshown to decrease medication errors. Computerized physician order entry (CPOE) has been
shown to decrease medication errors by 5580%. Computer applications allow clinical
pharmacists to easily review orders and identify DRPs (Drug Related Problems). (Bates DW L.
L., 1998) (Bates DW T. J., 1999) (Kuperman GJ, 2001)
A complete search of drug information is necessary for the clinical pharmacist so as to satisfy the
queries about pharmacology, drug interactions, adverse drug reactions, toxicology etc. This job
of searching can be simplified by using computers. In 1964, National Library of medicinecreated a computerized medical information retrieval system MEDLARS (Medical Literature
Analysis and Retrieval System). In 1971, they developed a fast working system MEDLINE
(Medlars On-Line). (Paradkar, 2008)
8/14/2019 Application of Computers in Hospital and Clinical Pharmacy
7/13
Application Of Computers In Hospital And Clinical
Pharmacy
2013
7
A pharmacy computer system must assure that the pharmacys patient record database is
continually updated to reflect the current status of all patients. This updating is done by assessing
the database of admitting department to determine the information about recent admissions,
discharges and patient transfers. The computer system should be capable of producing the other
information such as: Present diagnosis, allergies, weight, height, name of attending physician andother special note about patient.
Rapid processing of drug order is the essential function of computer system. Formatted data
entry should allow easy entry and retrieval of orders. A pharmacist should be able to retrieve
orders for review prior to administration to patient. Data may be entered by use of codes for drug
name, dosing schedule.
Preparation of lists is an another important aspect of computer use in hospitals. Like Fill-Lists for
preparation of individual doses, List of medications charged, Drug Order Renewal lists for
prescriber and Medication administration record (MAR).
Computer as Data base is very beneficial as if the prescription containing many drugs is entered
in the computer for billing purpose, immediately the computer scans the drug and issues the
warning if there is possibility of drug interaction. Thus computer helps in avoiding the drugs
duplication. The computer also issues the warning, if two or more brands of same drug are
entered in it. Thus avoid the drug duplication. Whenever the pharmacist is very busy, he may
pass on his work of displaying the content and instructions of medication and label printing to
the computer after entering the prescription. This is useful in avoiding the human errors.
The computer can be effectively used for purchasing and inventory control in the hospital
pharmacy as maintenance of perpectual inventory control, Maintaining the inventory records,
calculation of inventory, automatic updating of the price, evaluation of demand.(Yadav, 2007)
(Richard, 2006) Whenever an item is added to stock or removed from stock, immediately the
position of stock can be updated by computer. This operation of computer is intimately linked to
other operations such as receipt of goods, dispensing of goods, billing of goods, returns of goods
etc. For annual auditing of pharmacy department, records of numerous items are required to be
typed laboriously. This can be overcome by use of computer through perpectual inventorycontrol and these records can be made ready for inspection at any time when needed. The
computer can be effectively use whenever there are changes in the prices of items recorded. The
patient billing is a time consuming but important activity for the hospital pharmacy and its
accounting department. The pharmacy department must assure that all drugs leaving the
pharmacy are billed to the appropriate patients account. The computer system automatically
charges the patient all medications and IV solutions ordered.
8/14/2019 Application of Computers in Hospital and Clinical Pharmacy
8/13
Application Of Computers In Hospital And Clinical
Pharmacy
2013
8
For Formulary search and update the computers is capable of maintaining and displaying all
drugs by descriptors code, therapeutic category or generic name.
Computerization of narcotics and other controlled substances may help in preventing excessive
supplies and unauthorized dispensing of such drugs. The specific identification codes are given
to authorized person. The drug control authorities are directly linked through computers to such
records. The program used for this purpose is DAWN (Drug Abuse Warning Network). (Yadav,
2007)
Therapeutic drug monitoring (TDM) aims to optimize treatments by individualizing dosage
regimens based on the measurement of blood concentrations.(Fuchs A, 2013) Clinical
pharmacist may use computers for therapeutic drug monitoring; which are very potent and
having very narrow therapeutic range like cardiac glycosides, anticonvulsants. Computer
program are designed to calculate drug dosage to suit individual patients need. (Shaha Y. I.,
2008) Computer-assisted TDM is gaining growing interest and should further improve,
especially in terms of information system interfacing, user friendliness, data storage capability
and report generation.(Fuchs A, 2013) (David W. Bates, 1998)
Computer Is also being effective for drug distribution. The computer system is believed to
decrease the time spent by pharmacists on routine distribution tasks, leaving time for other
necessary pharmacy functions. The system seems to improve pharmacy's efficiency, accuracy,
control of drugs and capabilities for patient monitoring and drug use review. If mechanical
failure occurs, back-up procedures keep the distribution system operational . (WL, 1978)Computer also implements its application in decentralized unit dose distribution system where
using mobile pharmacy carts and computer terminals for filling inpatient and discharge
medication orders are used . The system uses computer terminals mounted on mobile medication
carts. Medication orders are collected from each nursing station by the pharmacist. Using the
mobile combination decentralized medication cart/computer terminal (cart/CRT), the pharmacist
examines and updates the patient's drug profile, checking for drug allergies and interactions, and
bills the patient for drugs dispensed.Turnaround time for routine inpatient orders and discharge
orders decreased substantially using this system, and the system was perceived as beneficial by
nurses, physicians, and pharmacists. (Wareham DV, 1983)
It is generally recognized that drug discovery and development are very time and resources
consuming processes. Use of computational techniques in drug discovery and development
process is rapidly gaining in popularity, implementation and appreciation. Commonly used
computational approaches include ligand-based drug design (pharmacophore, a 3-D spatial
arrangement of chemical features essential for biological activity), structure-based drug design.
8/14/2019 Application of Computers in Hospital and Clinical Pharmacy
9/13
Application Of Computers In Hospital And Clinical
Pharmacy
2013
9
(drug-target docking), and quantitative structure-activity and quantitative structure-property
relationships. (Kapetanovic, 2008)
Computer science and technology is deeply utilized in pharmacy field everywhere like in
pharmacy colleges, pharmaceutical industries, research centers, hospital pharmacy and many
more. Computer significantly reduces the time, expenditure, and manpower required for any kind
of work. Development of various softwares makes it trouble-free to handle huge data. In short,
computers are playing critical role in pharmacy field, without computers pharmacy research will
be long-lasting and expensive.(Shivraj Popat Jadhav, 2010)
8/14/2019 Application of Computers in Hospital and Clinical Pharmacy
10/13
Application Of Computers In Hospital And Clinical
Pharmacy
2013
10
DISCUSSION AND CONCLUSION:
Computers have played an important role in the development of clinical pharmacy practice and
basic pharmacy research. The use of computer in hospital administration and medical research
has become a need of todays hospitals. The computer is a processor which processes largequantity of data which may be letters, numbers, or picture elements very fastly and quickly. The
decrease in cost of computers in recent times has allowed the pharmacists to increase the
utilization of computers in clinical pharmacy practice.
There are many uses of computers in pharmacies. They can help in
Maintenance of records
Distribution Of Drugs
Drug Discovery
Therapeutic Drug Monitoring
Drug related problems
Managing Controlled drug substances
Maintaining Formulary
Purchasing
Inventory control
Medication monitoring
Drug information retrieval
Storage and many more
Computer systems in hospital pharmacy assure that patients coming in the pharmacy, their recorddatabase are continually updated to reflect the current status of them. The computer enables the
pharmacist to gather other information such as present diagnosis, allergies, weight, height and
any other special note about the patient. Computers also are very helpful in entering medication
orders of the patient which directly ease out the pharmacists job and decrease the workload. The
computers also aid in preparing labels as required. For this purpose different softwares and
hardwares have been developed by the engineers that enable the pharmacist to find out the
desired information in less than a fraction of a minute. A complete knowledge of drug
information is necessary for the clinical pharmacist so as to satisfy the queries of the patient.
This job can be simplified by the use of computers.
Apart from information on retrieval, computers can also be utilized in other ways to obtain drug
information in hospitals. Management information systems in the hospitals can be managed by
computer. The information system has two main components:
a) Information necessary for drug distribution
b) Pharmacy management information
8/14/2019 Application of Computers in Hospital and Clinical Pharmacy
11/13
Application Of Computers In Hospital And Clinical
Pharmacy
2013
11
Another important application of computer in the relevant fields is in purchasing and inventory
control. It helps to prepare a list of items to be purchased, prepares purchase orders for vendors
and avoids duplicate orders and produce periodic summary and purchasing and inventory control
statistics.
Therapeutic drug monitoring is very important to maximize the therapeutic effect of the drug and
to avoid any toxic effects especially in case of geriatric and pediatrics patients and for drugs
having high tendency of drug interactions. The utility of computers in medication monitoring is
of 2 types:
1. Pharmacokinetic applications
2. Non pharmacokinetic applications
Pharmacokinetic applications include the estimation of pharmacokinetic parameters in
individuals. The parameters commonly determined are rate of excretion, volume of distribution,
clearance etc. whereas non pharmacokinetic application includes the drug-drug, drug allergy,drug-disease interaction detection. For interaction screening different computer programs have
been developed such as MEDIPHOR (Monitoring and evaluation of drug interaction by a
pharmacy oriented reporting) and PAD (Pharmacy automated drug interaction screening).
Thus, using computers can enhance the standard of pharmacists clinical and hospital services.
Computers gives faster, more accurate, more complete reporting with greater efficacy, their use
in pharmacy is very beneficial. They have become indispensable in the development of clinical
pharmacy, hospital pharmacy and pharmaceutical research. The use of computers has
demonstrated the potential to decrease adverse events, preserve financial and medical resources,
and improve patient management. As more hospitals move in the direction of computer accessmore clinical applications for computing programming have been identified. The computer is
becoming the mainstay of hospital pharmacy practice. Enhancement of computer technology is
essential to assist the hospital pharmacist in assimilating all relevant data in order to provide
optimal oversight of drug therapy. As more data become available on drugs, optimal use of
drugs, and factors which place the patient at risk for developing reactions to drugs, one must
have to say that computer has become a necessary solution for optimizing patient care.
8/14/2019 Application of Computers in Hospital and Clinical Pharmacy
12/13
Application Of Computers In Hospital And Clinical
Pharmacy
2013
12
REFERENCES:
1. Anthony, P. K. (2004). Delmar Learning's Pharmacy Technician Certification Exam Review.
NewYork: Delmar Learning.
2. Bates DW, L. L. (1998). Effect of computerized physician order entry and a team intervention
on prevention of serious medication errors.Journal of the American Medical Informatics
Association, 13111316.
3. Bates DW, L. L. (1998). Effect of computerized physician order entry and a team intervention
on prevention of serious medication errors.JAMA. 1998;280:1311-6., 1311-6.
4. Bates DW, T. J. (1999). The impact of computerized physician order entry on medication error
prevention.Journal of the American Medical Informatics Association,, 313321.
5. Carmichael JM, A. A. (2004). Establishment and outcomes of a model primary care pharmacy
service system.Am J Health Syst Pharm 2004;61(5):472-482, 472-482.
6. David W. Bates, S. J. (1998). Strategies for physician education in therapeutic drug monitoring.
The American Association for Clinical Chemistry.
7. Dexter, P. R. (September 27, 2001). A COMPUTERIZED REMINDER SYSTEM TO INCREASE THE
USE. N Engl J Med, No. 13 .
8. Evans, R. S. (1998). A COMPUTER-ASSISTED MANAGEMENT PROGRAM FOR ANTIBIOTICS. The
New England Journal of Medicine, 232-238.
9. Fuchs A, C. C. (2013). Benchmarking therapeutic drug monitoring software: a review of
available computer tools. Clinical Pharmacokinetics, 9-22.
10.Kapetanovic, I. (2008). COMPUTER-AIDED DRUG DISCOVERY AND DEVELOPMENT (CADDD): in
silico-chemico-biological approach. Chem Biol Interact., 165-176.
11.Kuperman GJ, T. J. (2001). Patient safety and computerized medication ordering at Brigham
and Womens Hospital. The Joint Commission Journal on Quality Improvement, 509521.
12.M.D, M. L. (2007). Applications of computers in pharmacy. A Journal for Continuing Education
Professionals in Health Sciences , 37-39.
13.Moini, J. (2010). Pharmacy Terminology.Delmar: Cengage Learning.
8/14/2019 Application of Computers in Hospital and Clinical Pharmacy
13/13
Application Of Computers In Hospital And Clinical
Pharmacy
2013
14.Murray MD, L. B. (1998). Effects of Computer-based Prescribing on Pharmacist Work Patterns.
Journal Of Medical Information Association, 546-553.
15.Overhage JM, T. W. (1996). Computer reminders to implement preventive care guidelines for
hospitalized patients.Arch Intern Med, 1551-6.
16.Paradkar, D. A. (2008). Hospital And Clinical Pharmacy.Pune: Nirali Prakashan.
17.Richard, F. (2006). Information Technology for Pharmacist. Pharmaceutical Press, 169-171.
18.Roberts MB, K. M. (2002). Implementing a performance evaluation system in a correctional
managed care pharmacy.Am J Health Syst Pharm, 1097-1104.
19.Shaha Y. I., P. A. (2008). Introduction to Biostatics and Computer Science- For Pharmacy and
Medical Student.Pune: Nirali Prakashan.
20.Shivraj Jadhav, K. N. (2012). Applications of Computer Science in Pharmacy: An Overview.National Journal of Physiology, Pharmacy & Pharmacology, 19.
21.Shivraj Popat Jadhav, K. N. (2010). Applications of computer science in Pharmacy: An
overview. National Journal of Physiology, Pharmacy and Pharmacology, 1-9.
22.Wareham DV, J. S. (1983). Combination medication cart and computer terminal in
decentralized drug distribution.Am J Hosp Pharm, 976-8.
23.WL, G. (1978). Computer system for unit dose drug distribution.Am J Hosp Pharm, 711-4.
24.Yadav, M. A. (2007). Hospital And Clinical Pharmacy.Pune: Nirali Prakashan.