Development and evaluation of a computer aided pharmacy profile review system in a community hospital Public Deposited

http://ir.library.oregonstate.edu/concern/graduate_thesis_or_dissertations/cf95jg10s

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  • A 140 bed community hospital was the setting where the development and evaluation of a computer aided patient profile review system took place. This clinically oriented system involved the review of patient's drug regimen, diet, allergies, and laboratory tests for well documented contraindications or interactions. The pharmacist was involved in monitoring the potential problems that the computer system located, and would determine their validity and act accordingly by notifying other professional staff of the problems. The goal of this study was to determine the effectiveness of the computer aided system in a community hospital. The study was designed to compare the impact the pharmacists had on changes in patient's orders before the computerized system was begun, with the changes initiated by the pharmacists afterwards. Statistical analysis of the data collected showed that there was a significant increase in the number of pharmacy initiated order and scheduling changes after the computer aided system was initiated (NC= 0.05). Part of the drug regimen review included a Schedule II drug order renewal or discontinuation alert initiated by the system. This section of the program had the largest influence on the effectiveness of the system and for this specific area, the computer system was considered effective. There were 124 order changes that occurred in 31 days in this drug regimen review section. The drug-drug, drug-laboratory test, drug-diet and drug allergy alerts totaled 70 different printouts in 31 days, an average of 2.26 per day. These potential problems had to be scrutinized by the pharmacist and proper action was taken if the problem seemed valid. Only seven of these alerts were eventually used to make order changes. Three additional alerts were drug-laboratory test interactions which were provided to the physician as points of information. These seven alerts were not a numerically large part of the total changes, however, in terms of patient monitoring each alert used was important. By using this broad view of the patient's clinical picture, a more successful monitoring system can be developed. The larger the amount of data collected for each patient being monitored, the greater the potential for locating problems in patient care. The system described in this paper was developed to monitor a patient's drug regimen, diet, laboratory tests and allergies for potential problems. It was shown that within a community hospital, (140 beds) this computer aided monitoring system did create a significant increase in the number of pharmacy initiated order changes that occurred. It is hoped that this study may be of value to other community hospitals that may be considering such a system.
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