Hospital pharmacy-based service for patient-controlled analgesia.

Area of Science:

• Pharmacy Practice
• Pain Management
• Hospital Administration

Background:

• Community hospitals can establish comprehensive patient-controlled analgesia (PCA) services.
• Pharmacists require training in pain management and PCA device operation.
• Physicians can delegate PCA management decisions to clinical pharmacists.

Purpose of the Study:

• To describe the implementation and outcomes of a hospital pharmacy-based PCA service.
• To evaluate the impact of PCA services on patient care, pharmacy workload, and revenue.
• To assess the acceptance of PCA services by healthcare professionals and patients.

Main Methods:

• A 255-bed community hospital pharmacy instituted a PCA service in 1985.
• Pharmacists and nurses received specialized training in PCA.
• Physicians initiated PCA orders, with pharmacists managing medication, device settings, and patient monitoring.
• Data on service utilization, workload, and revenue were collected and analyzed.

Main Results:

• PCA service utilization increased significantly from 56 patient days/month in 1985 to 919 in 1989.
• Pharmacy department revenue saw a corresponding increase.
• A moderate increase in workload was managed without additional staffing.
• Surveys indicated broad acceptance of the PCA service by physicians, nurses, and patients.

Conclusions:

• A hospital pharmacy-based PCA service effectively improves patient pain control.
• The service allows pharmacists to expand clinical roles and enhances pharmacy department visibility.
• Implementing a PCA service can be a viable source of revenue for hospital pharmacies.
• PCA services are well-accepted by patients and healthcare providers, demonstrating a successful integration into hospital care.