The pharmacist’s role in a modern hospital is to advise the doctor of doses, caution against interactions and recommend their correct usage.
Dr. Roberto Frontini (EAHP President and Director of Pharmacy at Leipzig University Hospital) says that in addition to providing the medication safely it was the pharmacist’s role to advise patients about their medicines. He said that the highly complex regimens of medicines for individual patients provide challenges for him and his department.
For the medication for high risk patients such as cancer patients and babies/young children it is important to deliver medication that is prepared aseptically, or without the risk of contamination. A special area of the pharmacy is dedicated to providing the environment to prepare these medicines in such a way to prevent contamination. A series of airlocks, clothes changes, hand washing procedure all minimize the risks of contamination to the product. Technology includes automated airlocks which prevent two doors being open at once, preventing the free flow of air.
This aseptic department has a production licence, follows GMP and produces products such as eye drops, rehydration bags and also cytostatic medicines. Automated measuring and filling technology ensures accuracy, and second checks are always carried out such as a check on the actual weight of the products, compared to the theoretical weight. It is important that all the products are accurately labelled and this is check within the department and also by nurses on the wards. Technology is also implemented with the use of computer aided prescribing to minimize the errors that this could propose. Even though, it is essential that a pharmacist checks the dose, referring to guidelines when necessary.
When preparing cytostatic products there is a risk to the operator, so a special area of the aseptic department is used solely for this purpose. Each medicine is individually assembled for each patient; this includes cytostatic medicines given as infusions. Pumps can provide prolonged administration over a few days, and they protect the patient event in the event of leakages. Contaminated waste is disposed of by incineration by the hospital disposal services.
The overall quality of the product is ensured by the technology but also the knowledge and experience of the staff who are working there. There are nurse checks again regarding the name and label on the prescription, but they rely completely on the quality of the product produced by the pharmacy. The pharmacy services in this hospital makes the crucial difference to patient care.