The Canadian Journal of Hospital Pharmacy (CJHP) / Le Journal canadien de la pharmacie hospitalière (JCPH)
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The Impact of Pharmacy Discharge Planning on Continuity of Care
Get PDFABSTRACTMaintaining high quality patient care following hospital discharge is essential for complete recovery and continued well-being. Historically, pharmacist participation in discharge planning has been minimal and has been frequently limited to last minute patient counselling. Hospital pharmacists can contribute to the continuity of patient care by summarizing changes made to a patient's therapy, their rationale, and future considerations in a discharge report to the family physician and/or community pharmacist.In this study, pharmacy discharge summaries were prepared for inclusion in the discharge report to the family physician. Summaries were also forwarded to the community pharmacist, where appropriate. Two types of pharmacy summaries completed were "Rationale for Inpatient Changes" (RIC) and "Recommendations for Future Changes" (RFC) summaries. Evaluation forms accompanying the summaries elicited very favourable responses. An independent review group of two physicians and two pharmacists rated the potential for reduction of patient mortality/morbidity as either marked, modest, minor or negligible; most of the summaries were evaluated as having a "modest" impact. Workload associated with preparation of pharmacy summaries would require additional pharmacy staff. Direct and indirect cost savings, including decreased drug costs and avoidance of drug complications and hospital readmissions, are associated with this service.RÉSUMÉDes soins de première qualité après le, congé de l'hôpital sont essentiels à un rétablissement complet et au bien-être du patient. Le pharmacien n'a jamais beaucoup participé à la planification du congé. Sa participation se limitait fréquemment à des conseils de dernière minute au patient. Les pharmaciens d'hôpitaux peuvent concourir à la continuité des soins en résumant les changements apportés à la thérapie du malade, en expliquant la raison des changements et en signalant les aspects à surveiller subséquemment dans un rapport qui sera communique au médecin de famille et(ou) au pharmacien communautaire.Dans la présenté étude, des résumés de ce genre ont été rédigés en vue d'être annexés au rapport final destiné à l'omnipraticien. On a préparé deux sortes de sommaire pharmaceutique: le premier expliquant les modifications apportées au traitement et le second formulant des recommandations pour les changements subséquents. Le formulaire d'évaluation accompagnant ces documents à donné lieu à des réactions très enthousiastes. Un comité indépendant composé de deux médecins et de deux pharmaciens à évalué les possibilités de réduction du taux de mortalité ou de morbidité du patient (importantes, modestes, mineures ou négligeables). Dans la plupart des cas, on a attribué la cote «modeste» au résumé. La charge de travail associée à la rédaction des résumés exigerait une augmentation du personnel de la pharmacie. Ce service entraînerait des économies directes et indirectes, notamment une réduction du coût des médicaments et l’élimination de certaines complications pharmaceutiques et, réadmissions à l'hôpital
Cephalothin Stability in Normal Saline, Five Percent Dextrose in Water, and Dianeal® Solutions
Get PDFABSTRACT The stability of cephalothin sodium (1 g) in polyvinyl chloride minibags containing 50 mL of 0.9% normal saline, 5% dextrose in water (D5W) or 500 mg in 2L of Dianeal® (containing 1.5% or 4.5% dextrose) was evaluated using a validated, stability-indicating, liquid chromatographic method during 30 days storage at 4° C and room temperature (23°C). Physical inspections and pH determinations also completed on each of the 11 study days during the 30 day storage period.During the 30-day study period all solutions lost more than 10% of the initial cephalothin concentration. In D5W and saline solutions stored at 4°C, 10% of the initial concentration was lost within 17 days, and at room temperature 10% was lost within one day. In Dianeal®, regardless of the dextrose concentration, solutions stored at 4°C, lost 10% of the initial concentration within eight days, and at room temperature 10% was lost within one day. During the 30-day study period the pH decreased in every solution. However, the decrease was less than 1.0 of a pH unit. The colour of solutions stored at room temperature gradually changed during the study period, becoming a deeper yellow. Solutions stored at °C remained clear and colourless throughout the study period.We conclude that cephalothin solutions (1 g/50 mL of D5W or normal saline) stored at 4°C for seven days followed by 12 hours storage at room temperature will retain 90% of the initial cephalothin concentration, whereas, cephalothin concentrations stored in Dianeal® (500 mg/2L) at 4°C will lose approximately 8% of the initial concentration after only three days storage at 4°C followed by an additional 12 hours storage at room temperature
