In the hospital pharmacy, is it better to process or to validate?
The validation of the prescription goes beyond a verification and identification of medications. Joint Commission International establishes that the hospital pharmacist must review some points that guarantee the safety of the use of medicines.
Let us agree that most organizations, not only health organizations, look for decision-making mechanisms that maximize the safety of their operations. Security for your customers, your workers, the environment in which they are located or even your shareholders.
An example outside our sector. Banks establish different decision levels when approving loans to their customers. The objective is simple, to reduce the risk of these credit operations, making that once the requests are processed (purely administrative activity), someone qualified makes a decision, to approve or reject the operation, based on the content of the documentation processed and in the knowledge available, in addition to the regulations of the banking institution itself.
Now let us transfer this example to a field linked to our organizations, hospitals in this case. Are there any parallels? We believe so: The validation, by the pharmacy services, of the prescriptions made by doctors for their hospitalized patients.
To validate, according to the Royal Academy of Language (RAE), is to give strength to something done. And validating prescriptions is probably the most important function performed in the Hospital Pharmacy, as it is the task that provides greater safety to the patient in terms of the medications they are going to receive. An example. According to an article published in June 2017, 15.2% of the prescriptions from an emergency department required the intervention of the pharmacist when errors were observed regarding the contraindications of the drug, overdosage or an incorrect description of the route of administration. . In light of these data (which do not contradict those observed in other studies), it seems reasonable to establish a validation mechanism for prescriptions by pharmacy services.
The prescription validation function goes beyond an automated check, followed by the corresponding processing for its dispensing and administration, which can be done by well-developed software that helps us identify incompatible medications or inadequate doses for the prescribed treatments.
In this going further, it is where the full potential of the hospital pharmacist is valued in his role of providing safety to the use of medicines in the hospital.
The Joint Commission International establishes that the hospital pharmacist must proceed to validate a patient’s medication prescription, reviewing some points that guarantee the safety of medication use.
For an adequate validation of the pharmacological prescription, it is necessary for the hospital pharmacist to consider the following points:
- Suitability of the drug, dose, frequency, duration of treatment and route of administration.
- Duplication or therapeutic incompatibility.
Actual or potential allergies or sensitivities. - Actual or potential interactions between the drug and other drugs or foods.
- Specificities established by the hospital for the use of the drug.
- Physiological characteristics of the patient.
- Other contraindications to take into account the patient’s condition.
- Cost-effective alternatives.
It may seem that validation generates a large amount of work, but in reality it is a task that practice and experience allow to do very quickly and effectively, also taking into account that the medication of hospitalized patients is very repetitive throughout its life. hospital stay and, above all, that its ability to generate safety in the use of medications is worth it.
The care process of a hospitalized patient is, necessarily, a multidisciplinary work in which the hospital pharmacist plays a leading role that has its maximum value expression in the validation of the prescription.