CLINICAL PHARMACY ASSIGNMENT Application Of Computers In Hospital And Clinical Pharmacy

Pharm D 4th Proff Evening

Group No 7

2013

JINNAH UNIVERSITY FOR WOMEN

Application Of Computers In Hospital And Clinical 2013 Pharmacy

9.Tuba Hasaan Qureshi 10692 8.Syeda Kinza Mehmood 10682

1.Afshan Mushtaq 10597

2.Ammarah Shaikh 10604

7.Sualeha Batool Baig 10681

Group Members (No. 7)

6.Hira Akbar 10634 5.Halima Sadia 10628

3.Asra Alvi 10611

4.Erum Akhter 10617

Application Of Computers In Hospital And Clinical 2013 Pharmacy

Table of Contents
ABSTRACT:..................................................................................................................................................... 4 BACKGROUND: .............................................................................................................................................. 4 INTRODUCTION: ..................................................................................................................................... 5 DISCUSSION AND CONCLUSION:................................................................................................................. 10 REFERENCES: ........................................................................................................................................ 12

Application Of Computers In Hospital And Clinical 2013 Pharmacy

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 4th Professional 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 computer programs 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.

Application Of Computers In Hospital And Clinical 2013 Pharmacy

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 of medication 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

Application Of Computers In Hospital And Clinical 2013 Pharmacy

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 been shown 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 medicine created 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)

Application Of Computers In Hospital And Clinical 2013 Pharmacy

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 and other 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 inventory control 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.

Application Of Computers In Hospital And Clinical 2013 Pharmacy

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.

Application Of Computers In Hospital And Clinical 2013 Pharmacy

(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)

Application Of Computers In Hospital And Clinical 2013 Pharmacy

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 large quantity 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 record database 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

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Application Of Computers In Hospital And Clinical 2013 Pharmacy

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 access more 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.

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Application Of Computers In Hospital And Clinical 2013 Pharmacy

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.

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Application Of Computers In Hospital And Clinical 2013 Pharmacy

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 , 1 9. 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.

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