March 26, 2015
Dear Friends and Colleagues,
There are many unsung heroes operating in less visible stations that make a hospital great. One such station of NCH heroes is the NCH pharmacy, so essential for the functioning of our hospital.
Almost no one comes to the hospital without getting some form of medication, which originates in the pharmacy. Our 35 Pharmacy Technicians play a key role in the safe dispensing and delivery of 6,000+ doses of medications delivered on both campuses daily, under direct pharmacist supervision.
NCH Pharmacy Technicians have been registered under the Department of Health Board of Pharmacy for the past four years. Pharmacy Techs must undergo six months of training and keep up with continuing education. Everyone handling medication must be a licensed professional.
At NCH, Pharmacy Techs support the compounding of sterile products such as intravenous antibiotics, chemotherapy drugs, special drugs for cardiac patients to control heart rate and blood pressure, insulin drips, neonatal doses, pediatric formulations, and many other specialty drugs based on a patient’s body mass index, kidney or liver function or weight.
Recently I visited with Pharmacy Techs Jessica Bonilla and Daniel Banning as they performed sterile compounding duties under specially-controlled hoods, located in a clean room with positive pressure designed to preserve cleanliness, surrounded by an equally climate-controlled and air pressure-controlled anteroom. The air pressure, air filtering and number of air exchange requirements exceed that of an operating room.
The goal of such precautions is to make the compounded medication safe to use in patients. To consistently achieve this goal, these dedicated experts wear gowns, gloves, face masks, hair nets, and shoe covers. This is similar to an operating team in a sterile environment. They also wipe down their hoods and immediate environment regularly with two different antimicrobial solutions which kill spores, bacteria, and any other potential contaminants. Additionally, periodic competencies are tested by attempting to grow bacteria from test agar plates.
On the downtown campus, we also have a special room for mixing oncology medications. When Pharmacy Director Kim Thorp and I visited, Pharmacy Tech Nancy Sherlock, with 29 years of experience at NCH, was working with Pharmacist Chris DiNunzio preparing medications for the Out-Patient Infusion Service (OPIS) and the in-patient 4S Oncology Unit. Medications prepared in this area are set out the night before and then mixed the next morning using a special chemo hood with double gloves after patient labs are verified. This area is vented directly to the outside and the pressure differences make opening the door to the room a bit of a struggle. Mixing oncology drugs takes time so treatments are spaced through the day. All chemotherapy orders are triple checked by clinical pharmacists, then double checked before leaving the compounding area, with a final check completed by the nurse prior to administration. And each medication has a linage with date, time, person compounding, lot number and expiration date clearly displayed.
Delivering the right medication to the right person at the right time is serious business, and it happens thousands of times a day at NCH. Getting the initial compounding or selection of the medication correct from the start is mission critical, demanding the kind of heroic performance our NCH Pharmacy Techs deliver daily.
Allen S. Weiss, M.D., President and CEO
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