Pharmacy - Healthcare Setting

Ruth Perez

Individual Project 3

American Intercontinental University

AIU Online

Abstract

     In any healthcare setting, that being oncology, pediatrics, mental health, research of investigational products etc… it is important to apply and have the best practices under the standard operating procedures policy. The value of laboratory and pharmacy efficiency is beyond important and highly significant, I won’t say “there is no room for mistake” but the pharmacist must ensure that his/her staff will do everything in their power to prevent any mistakes, as well as the Laboratory Director or on-site superior.

BEST PRACTICES

      From and oncology research perspective, all or most chemotherapy medications are to be considered poisonous to the DNA, and everyone must follow the proper procedure to prevent exposure at all costs. In research, the medications are known as investigational products which will be dispensed and prepared by a licensed pharmacist and pharmacy technician when applicable. The dispensing process should be integrated with the rest of the medication use system, including but not limited to order review, profile maintenance, packaging, labeling, delivery, and quality assurance procedures. To properly dispense the medication, there are several ways to the pharmacist may practice, one being bar-coding and scanning to verify accuracy of drug and to revise multiple times that the patient demographics are correct.

         Beforehand, all pharmacy personnel dispensing and preparing drugs will be trained on protocol-specific guidelines for preparation. A valid order or prescription and a signed informed consent must have been obtained; the drug name and dosage must be verified by both the pharmacist and the pharmacy technician. All medication orders will be inspected and initialed by the licensed pharmacist and an additional pharmacy staff member prior to dispensing to ensure correct preparation and labeling. It is crucial to take extra measures in these matters, chemotherapy agents are high risk and the smallest mistake will cause chaos and tragedy. Overall, the major solution is coaching the staff and changing their attitudes within the pharmacy, it helped to break long-term tasks into smaller, more feasible tasks, instead of simply ordering staff to accomplish something. For example; on a busy day, have a early staff meeting, or have the meeting the day before, prepare a plan, it is fine to have daily huddles for ten to fifteen minutes, creating strategic planning to prepare for a busy day, can decrease room for error, additionally, it is important to have a back up plan for short staff, emergencies can occur at any given point whether it is an employee that did not show up to work, or an employee that must leave early. Perhaps in other departments it is great to multitask and perform ones’ duties with no pressure. In pharmacy one must perform duties with full concentration provide all attention to what is being done. For example; when administering a chemotherapy agent, at least two patient identifiers must be verified by the infusion nurse prior to administration as well as a double check must be performed by two nurses, both parties will verify that the medication order is correct and the actual medication to be administered is correct, the second nurse involved in the independent double check will cosign the medication administration record.

      Laboratory safety is an integral part of the efficacy and safety of an investigational product for laboratory analysis of both blood and tissue collected during a clinical trial. At the beginning of each clinical trial the laboratory personnel or study coordinator must review the protocol and laboratory manual as well as the supplies provided by the sponsor and what will be needed to provide locally by the site. Each category of laboratory should be evaluated to ensure that the organization’s laboratory  plan  accounts for; Safety labs, Local labs, Central labs, Biomarker and outcome labs, Pharmokinetic, Tissue and anatomical specimens, Genetic Specimen is in place so that all specimen’s are collected, processed, stored, and shipped as indicated in protocol or laboratory manual. For safety laboratory tests, that usually involves chemistry and hematology, but could include other tests as indicated in protocol, the coordinator or laboratory supervisor must ensure that tests that are done locally and have an account with local laboratory with requisition slips, ensure that laboratory results would be available for the investigator as required to care for the patient medically. There are general safety procedures that must be enforced and should be followed by all laboratory personnel, that being, they must complete Initial Chemical and Biological Safety Training and Board of Regents Blood borne Pathogens Right-to-Know Training before working with potentially infectious materials, including fresh, unfixed human specimens. It is also imperative that everything is properly labeled, locations where specimens are stored would be marked with biohazard stickers, and that the staff is aware that any blood specimens go in a red hazard bag, and glass or needles in the biohazard box. Refrigerators and freezers where specimens are stored would only be accessible to authorized personnel. Regardless of the fact that we are all humans and can make mistakes at any given point, those in pharmacy and laboratory must consider and keep in mind their roles are highly important and a risk every single day they perform their duties, not only theirs, but if any incident occurs, the patient will suffer consequences and this could be a chaos for everyone involved. Besides all that has been mentioned, the easiest yet most important solution other than training is to be extremely careful and to prevent by all means any incidents of any type.