Consultant approach to improving drug-related services to chronic hemodialysis patients

A consultant role for the pharmacist in solving a drug-related problem of another hospital department is described. The head of a 16-patient-per-day hemodialysis unit requested assistance from the pharmacy to improve the medication records for hemodialysis patients. Investigation uncovered several additional problems such as contradictory medication orders, poor patient compliance and evidence of drug abuse. The pharmacy devised and assisted in the implementation of new mechanisms for initiating, recording and charting medications. A patient education program and a system for assuring availability of medications for self-administration were also instituted. After nursing personnel were trained by the pharmacy, responsibility for maintaining the revised services was transferred to the hemodialysis staff. Documentation of medication orders, drug knowledge of the hemodialysis staff and patient compliance improved as a result of the revisions instituted by the pharmacy.