Pharmaceutical Services & Sciences

19057
(202) 25351500, Ext.4165
[email protected]

Overview

Overview

Department of Pharmaceutical Services and Sciences at CCHE 57357:

Our collaborative approach ensures that all our patients receive the best comprehensive clinical care from a team of pharmacy specialists spanning specific pharmaceutical and clinical subspecialties.
The department has been fully automated since November 2009. Our strategy is to provide the hospital with a cost-effective state of all pharmaceutical services.
We work 24 hours a day, 365 days a year, to optimize, compound, dispense, and monitor every one of the millions of medication doses prepared by the pharmacy each year.

Clinical Pharmacist Scope of Services

1. Safe and Effective Medication Use

Pharmacists will take clinical action and make evidence-based recommendations to ensure the safe and effective use of medications to meet therapeutic goals.

1. Evaluation of Patient Profile and Medication Orders
  - A pharmacist reviews the appropriateness of medication orders for dispensing medications in the hospital.
  - Each order will be evaluated for appropriateness before the first dose being dispensed (except in emergencies or in those instances where a medication is administered under the direct supervision of a physician)
  - Order verification in a timely manner: For priority medications, verification within 15 minutes of receiving the order, for non-urgent medications, verification within 60 minutes of receiving the order

Patient profile review upon order verification and continuously based upon team and patient acuity, Known drug allergies, and review of medication list for:

1. - Drug-drug interactions
  - Drug-disease interactions
  - Duplicate or missing medications
  - Appropriate lab orders
  - Cost-effective therapy
  - Assessment of therapeutic appropriateness:
    - Indication
    - Route and method of administration
    - Anticipated toxicity or adverse effects
    - Assessment of renal dosing upon order verification and profile review
    - Therapeutic drug monitoring and ordering of associated laboratory procedures as indicated
    - Daily antibiotic stewardship efforts require indication and duration of therapy for each antibiotic ordered and to enforce current antimicrobial formulary restrictions and practice guidelines.
    - Ensure appropriate compliance with risk evaluation and mitigation strategy medications.
    - Support distribution needs to patient care areas by coordinating with central pharmacy staff.
    - Direct pharmacy technicians and interns in their daily work by observing their performance, giving timely feedback, answering questions, providing guidance, and checking the accuracy of their work

1. Pharmacist Medication Dosing Services

Pharmacists are responsible for the pharmacy consultation services.

1. Medication Histories and Reconciliation

Pharmacists are accountable for the following:

1. - Obtain medication histories within 24 hours of patient admission
  - Complete admission medication reconciliation within 24 hours of patient admission
  - Complete transfer medication reconciliation with each level of service transfer and with transfer out of the operating room
  - Review and verification of medications ordered more than 27 days ago.

1. Discharge Reconciliation and Coordination
  - Pharmacists are held accountable for the following:
    - To complete discharge medication reconciliation before patient discharge
    - To Complete discharge medication counseling to the patient before discharge
    - To Facilitate access to outpatient prescriptions before discharge as appropriate
  - A primary focus for pharmacists daily includes:
    - Provision of consultations in a timely and accurate manner to support other health professionals regarding medication therapy selection and management
    - Provision of disease state and medication-specific education during hospitalization

1. Multidisciplinary Team Involvement

To better integrate into the medical team, pharmacists:

1. - Attend daily care coordination rounds to facilitate discharge medication needs
  - Support and augment patient care rounds
  - Pharmacists document notes and care plans are logged in the electronic medical record as appropriate.

1. Communication between Pharmacists

To ensure proper care of patients through shift changes and transfers, pharmacists are to:

1. - Proactively identify hand-off needs before the end of shifts and coordinate key hand-offs in the sign-out notes
  - Contact receiving pharmacy team members when appropriate regarding patient transfers from unit to unit to ensure continuity of care.

1. Precepting and Teaching

As part of an academic medical center, pharmacist duties include the following:

1. - Daily teaching and incorporation of evidence-based learning into resident and student rotations
  - Evaluation and feedback for residents and students regularly
  - Timely coordination of rotation activities
  - Effective use of residents, students, and interns as pharmacist extenders

1. Formulary Management

Pharmacists assess the following during their daily duties:

1. - Approved use and indication of formulary or restricted agents
  - Compliance and support of evidence-based guidelines and medication use policies
  - Approved therapeutic interchanges for medications at order verification o Assessment and prospective planning of switching patients from IV to PO regimens when able
  - Completion of non-formulary request process
  - Supply documentation to healthcare providers regarding medication use and patient outcomes from medication therapy
  - Participate and provide input in developing and applying policies, procedures, clinical care plans, guidelines, order sets, interdisciplinary standards of care, and protocols involving medication use.
  - Verify the validity of off-label medication use with primary, secondary, and tertiary medication references.

1. Emergency Management

Pharmacists support and participate in emergency management:

1. - ICU or Emergency Department pharmacists respond to all Code 4 emergencies
  - Pharmacists will respond to all rapid responses in their assigned area
  - Timely response to an emergency or disaster management process
  - Support rapid sequence intubation and conscious sedation

1. Quality and Process Improvement

Pharmacists are actively engaged in quality and process improvement:

- Represent the Pharmacy Department on committees, task forces, workgroups, and unit-based councils that make decisions concerning medication use or engage in improvement initiatives that support patient-focused care
- Lead and support medication use related to achieving outcomes around quality measures (national patient safety goals, core measures, value-based purchasing)
- Active and timely participation and support of multidisciplinary process improvement
- Actively participate in business process committees throughout the hospital

In Egypt, clinical pharmacy education was initiated at the Faculty of Pharmacy, Tanta University, as early as 1980 by visiting US professors.

In 1994, the Faculty of Pharmacy Ain-Shams University was established, following the foundation set by Tanta University and incorporating clinical pharmacy curricula into its courses (Anowr, 2010).

In 1997, a fundamental shift occurred in the clinical pharmacy practice when the National Cancer Institute (NCI) established the first Clinical Pharmacy Unit by Dr. Sherif Abouelnaga.

The experience was shared, and more hospitals and medical centers started setting up clinical pharmacy units.

In 2007, the Department of Pharmaceutical Services and Sciences (DPS), Children's Cancer Hospital Egypt 57357 (CCHE), started its operation, building upon NCI's experience (Anor, 2011).

The International Pharmacy Practice Residency (IPPR) Program, accredited by the American Society of Health-System Pharmacists, is considerably new in Africa.

The first IPPR program was initiated in Egypt in 2017 by Children’s Cancer Hospital Egypt 57357.

History

History of Clinical Pharmacy in Egypt:

_{Anor, W. M. E. I. (2011). History of Clinical Pharmacy Practice in Egypt ( Part 2 ) Children 's Cancer Hospital Egypt ‐ 57357. 2(2), 61–63.}

_{Anowr, M. El. (2010). Clinical Pharmacy in Egypt Part ( I ) Development of the teaching curricula of clinical Pharmacy in Universities of Egypt Pioneer. International Journal of Pharmacy Teaching & Practices, 1(2), 18–19.}