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  • Medication Safety at Rhode Island Hospital

  • Rhode Island Hospital dispenses more than 10,000 doses of medication each day. Our pharmacists and clinical pharmacists actively participate in the care of our patients, reviewing each medication order to ensure that the medication and dose prescribed is safe and appropriate, including checking for allergies and drug interactions, reviewing lab results to identify any liver or renal disease that could interfere with the safety of the medication, and reviewing microbiology results to ensure the most appropriate antibiotic has been selected. We also continue to follow each patient's medications and lab results daily even after treatment has started to ensure medications and doses are appropriately adjusted based on any changes to a patient's condition.

    Pharmacists collaborate directly with the medical staff at the bedside and round with nine specialty medical teams each day. Pharmacists also provide management and close monitoring of patients on high-risk anticoagulation treatment. Specialized one-on-one drug therapy management is provided by certified pharmacists to patients with diabetes and cardiovascular diseases in our outpatient Medical Primary Care Unit and to inpatients with hard-to-manage pain.

    Standards of Care

    The pharmacy, in collaboration with physicians and other health professionals including nurses, clinical nutritionists, and respiratory therapists, develops medication and treatment guidelines to ensure medication use is safe, effective, and consistent with published literature and established standards of care.

    Medication Preparation

    Our highly trained and credentialed pharmacy technicians prepare sterile medications and chemotherapy utilizing aseptic technique in a state-of-the-art, USP 797 compliant clean room under the direct supervision of a pharmacist.

    Innovation

    Our pharmacy team has been an international leader in developing and implementing cutting-edge innovative services and systems. Over the last 3 years alone we have presented 10 peer-reviewed posters at national professional meetings on both clinical and information technology topics. Our early adoption as one of the first hospitals in the country with a closed medication safety loop led to one of the first publications with data-driven results, highlighting our success with this system in improving medication safety (published in the September 2007 issue of the American Journal of Health-Systems Pharmacists).

    Our comprehensive analysis of the processes and vulnerabilities involving oral chemotherapy, and subsequent development of unique systems to improve safety of these highly-toxic medications, led to a recent publication in the International Journal for Quality in Health Care (IJQHC).

    Most recently, a pharmacy-led project was awarded a Lifespan Risk Management grant to ensure patients at risk for developing blood clots receive the appropriate prevention medications, which would help hospitals across the country.

    Chemotherapy Safety

    The Oncoware Rx software, developed by the pharmacy department, ensures that all chemotherapy medications are ordered electronically. This is done by using a SmartForm, an electronic form that reports, automatically, high-risk, error-prone calculations such as body surface area, chemotherapy dosing, dosage adjustments and complex area-under-the-curve dosing. These order forms have standardized treatment plans applicable to all patients that further aid in prescribing medication in accordance with evidence-based based practices and standards of care. Learn more about chemotherapy safety and cancer care.

    Leadership

    Members of the pharmacy team are actively involved in providing pharmacy leadership throughout the state and nationally. We lead the Pharmacy Committee for a large NCI-funded national cancer research organization, Cancer and Leukemia Group B (CALGB), and participate on the advisory board for the Institute of Safe Medication Practices. Many of our pharmacists have served on the Board of Directors for the Rhode Island Society of Health-System Pharmacists (RISHP), including several who have served as president.

    Medication Safety

    Rhode Island Hospital and its Hasbro Children's hospital utilize a system of automated medication dispensing. Installed in all patient units, this "closed-loop" medication system is designed to enhance patient safety and reduce the human opportunity for error. It helps to ensure that the right patient receives the correct dosage of prescribed medication at the right time.Learn more about how our integrated clinical information system for medication safety works.

    Education

    We are affiliated with several universities and colleges of pharmacy and our pharmacists and clinical pharmacists serve as preceptors and faculty for pharmacy students, physicians and nurses. We provide CME-approved lectures for the medical staff throughout the year, including pharmacology lecture series in pediatric infectious diseases, pediatric behavioral health and pain management. Our clinical pharmacists are adjunct faculty at the University of Rhode Island College of Pharmacy and Rhode Island College School of Nursing.