Pharmacy-based skin-testing program in a community hospital

The establishment of a pharmacy-based skin-testing program at a community hospital is described. Problems with existing skin testing were brought to the attention of the pharmacy and therapeutics committee, which decided that one group of caregivers within the hospital should be chosen and trained to perform skin testing. A problem-solving team identified specific problems and developed solutions. The top four causes of the skin-testing problems were failure to follow procedure, inaccurate reading of tests, failure to report positive results, and failure to document results. Groups within the hospital who might perform skin testing were assessed according to several criteria; the pharmacy staff was selected because of ease of notification, availability, and ability to conduct follow-through (reading, documenting, and reporting results). Other improvements were step-by-step instructions for all phases of skin testing, a portable skin-test supply kit, and a skin-test record form to be placed in the physician progress notes. Pharmacists were trained by the employee health nurse. Pharmacist skin testing began in March 1995. Pharmacists administered tests to 93 inpatients and about 250 employees during the first 13 months of the program, and no problems were reported. Establishment of a pharmacy-based skin-testing program improved the quality of inpatient skin testing and enabled pharmacists to increase their role in patient care.