Pediatric Informatics: Computer Applications in Child Health (Health ...

346 S.H. Mitchell et al.
27.2.1 Medication Management
Medication management (specified by the Joint Commission 1 ), consisting of medication
selection and procurement (formulary processes) and storage, is primarily
the responsibility of the pharmacist and pharmacy staff.
27.2.1.1 Medication Selection and Procurement
The Joint Commission states that medications available for dispensing or administration
are selected, listed, and procured based on criteria, which at minimum, must
include: indications for use, effectiveness, risks, and costs. The role of pharmacists
is to establish criteria and to design, direct, and implement institutional medication
selection processes as part of an interdisciplinary team and to manage medication
procurement. The institutional list of available medications that results from the
selection process is the basis of the clinical formulary and the core of pharmacy
IT support.
27.2.1.2 Medication Storage
Medication storage involves comprehensive management of formulary and nonformulary
items, patient medications, refrigerated items, controlled substances and
expired/damaged/contaminated medications. Medication storage includes controlling
the availability of standardized and limited concentrations of drugs (such as
intravenous admixtures).
27.2.2 Medication Delivery
Medication delivery, a set of sequential and interrelated steps, is a shared responsibility
among providers (clinician, pharmacist, nurse) (see Chapter 25). Pharmacists
are responsible for interpreting and translating instructions from a prescriber
( prescription) into specific doses of medications, which are subsequently dispensed
for administration to a specific patient.
27.2.2.1 Ordering and Prescribing
(Including Transcription/Communication)
In the ordering/prescribing step, a clinician specifies, on the basis of clinical information,
a regimen of drugs to be given to a patient. The prescriber transcribes/
communicates this regimen to the pharmacist as a formal, standardized message,
a prescription, for preparation/dispensing.