Setting up an automatic pharmacist-initiated pharmacokinetic dosing service

At Latrobe Area Hospital, a 300-bed teaching-community hospital, a unique pharmacokinetic program is in place that permits the pharmacist to initiate and adjust an aminoglycoside or vancomycin regimen and schedule serum drug concentrations and renal function lab tests without contacting a physician for verbal approval. To avoid the perception of pharmacist prescribing, a detailed policy and procedure protocol was written that defined each step conducted in the pharmacokinetic evaluation. Using this approach, the service was readily approved by the medical staff and put into practice. The program has been operational for more than 1 year and has met with high physician and nursing acceptance. Although not specifically studied, the quality of patient care was thought to be improved.