Pharmacies within hospitals differ considerably
from community pharmacies. Some pharmacists in hospital pharmacies may have
more complex clinical medication management issues whereas pharmacists in
community pharmacies often have more complex business and customer relations
issues.
Because of the complexity of medications
including specific indications, effectiveness of treatment regimens, safety of
medications (i.e., drug interactions) and patient compliance issues (in the
hospital and at home) many pharmacists practicing in hospitals gain more
education and training after pharmacy school through a pharmacy practice
residency and sometimes followed by another residency in a specific area. Those
pharmacists are often referred to as clinical pharmacists and they often
specialize in various disciplines of pharmacy. For example, there are
pharmacists who specialize in hematology/oncology, HIV/AIDS, infectious
disease, critical care, emergency medicine, toxicology, nuclear pharmacy, pain
management, psychiatry, anti-coagulation clinics, herbal medicine,
neurology/epilepsy management, pediatrics, neonatal pharmacists and more.
Hospital pharmacies can often be found within the
premises of the hospital. Hospital pharmacies usually stock a larger range of
medications, including more specialized medications, than would be feasible in
the community setting. Most hospital medications are unit-dose, or a single
dose of medicine. Hospital pharmacists and trained pharmacy technicians
compound sterile products for patients including total parenteral nutrition
(TPN), and other medications given intravenously. This is a complex process
that requires adequate training of personnel, quality assurance of products,
and adequate facilities. Several hospital pharmacies have decided to outsource
high risk preparations and some other compounding functions to companies who
specialize in compounding. The high cost of medications and drug-related technology,
combined with the potential impact of medications and pharmacy services on
patient-care outcomes and patient safety, make it imperative that hospital
pharmacies perform at the highest level possible.
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