Se
TE
SP
C OTL ct io H N IGH n be OL T O gi N ns on O G pa Y ge
The Pharmacist’s News Source
pharmacypracticenews.com Printer-friendly versions available online
in this issue UP FRONT
6
The power of observation in sterile compounding.
POLICY
8
New drugs for multiple sclerosis, cystic fibrosis, and more.
OPERATIONS & MGMT
13
ECRI study: drug administration a danger spot in acute care setting.
14
Right and wrong words in the peacemaking process: Ernie Anderson Jr.
CLINICAL
17
Making pharmacogenomics a practical reality.
TECHNOLOGY
28
Clean rooms, hoods and outsourcing: striking the right balance for safety.
EDUCATIONAL REVIEW
Compatibility Of Commonly Used IV Drugs See insert after page 16.
Volumee 39 • Number 10 • October 2012
40th ANNIVERSARY YEAR 1972–2012
Initiative Boosts Compliance With Electrolyte Therapy Baltimore—A new software-based protocol for standardizing electrolyte replacement therapy (ERT) across multiple sites and types of care has yielded major improvements in speed and accuracy, according to a task force of health professionals at Sentara Obici Hospital, in Suffolk, Va. With the new system in place, nine of every 10 patients who are candidates for ERT now get the infusions in a timely manner, with the ingredients well matched to the metabolic needs of the patients—a rarity before the system was implemented, the team reported in a poster presented at the 2012 Summer Meeting of the American Society of Health-System Pharmacists. The protocol was designed and developed in-house by a cross-disciplinary team of physicians, nurses, pharmacists and information technology professionals, according to task force member Olubukola Fakunle-Adeyemi, PharmD. Introduced a
•
see ELECTROLYTES, page 27
Shift to Electronic Tools Boosts Event Detection Baltimore—Health systems are using a variety of electronic trigger tools and other software-based solutions to boost the reporting and detection of medication events, in many cases before the mishaps reach patients. At St. Jude Children’s Research Hospital, in Memphis, the multipronged strategy has led to a 20% increase in event reporting and has had a significant impact on the
•
see TRIGGERS, page 25
Price Gouging: A Black Mark On Gray-Ma G
ray-market distributors are taaking advantage of long-term critical drug shortages to demand exorbitaant payments from hospital pharmacies that run out of options for obtainiing lifesaving treatments from regular wholesalers, according to a recent C Congressional report. Investigators who compiled the report found numerous instances in which short-supply medication ns changed hands multiple times across a chain of buyiing and selling, with each transaction adding a fat marrkup until the products reached hospital pharmacies at prices at least 30 times higher than typical contract amounts. Several pharmacy directors from m top health systems say that in the months since the rreport was issued, they have continued to feel the stiing of steep price hikes. “Just last week, I paid abou ut 10 times what it used to cost me for propofol,” said Tom Van Hassel, RPh, MPA, of Yum ma Regional Medical Center, in Yum ma, Ariz. “If I am truly out, I really havee no choice; I have to buy whatever I can. It doesn’t matter if it’s $27 a bottle o or $300 a bottle. I can’t close my hosspital surgery down because I don’t have a crucial induction agent.”
•
see GRAY MARKET, T page 10
Sticker shock: one wholesaler charged $600 for a vial of fluorou uracil—a markup of 8,471% over the original $7 price.
Layered Learning Plugs Students Into Real-World Pharmacy Svces
T
hree years ago, the Esshelman School of Pharmacy at the University of North Carolina at Chapel Hill (UNC) unfurrled its layered learning practice m model (LLPM). Since that time, the program’s focus and conten nt have been steadily refined with one primary goal in mind: to improve the learning experience of pharmacy students and residents, while simultaneously adapting patient care practices to keep pace with the rapid changes in health care.
““We wanted to turn the maany needs that faced us into posiitive outcomes,” said Rowell Dan niels, PharmD, MS, director of p pharmacy for UNC Hospitaals and Clinics and executiive associate dean for pharmacy clinical practice at the m School of Pharmacy. “At the S same time, we wanted to increase the quality of experiences in the pharmacy school, so we sought to elevate the level of pharmacy practice in the hospital while providing an
•
The Book Page Drug Discovery and Development: Technology in Transition: Second Edition
see LEARNING, page 19
New Product
Raymond G Hill
Pfizer Injectables announces availability of methotrexate injection, USP.
See page 29.
See page 18.
21