Hospitals and Other Institutional Settings
As society's health care needs have changed and expanded, there has been an increased emphasis on provision of care through organized health care settings. As a result, an increased number of pharmacists now practice in hospitals, nursing homes, extended care facilities, neighborhood health centers, and health maintenance organizations. As members of the health care team composed of physicians and nurses, among others, institutional pharmacists have an opportunity for direct involvement with patient care. The knowledge and clinical skills that the contemporary pharmacist possesses make this individual an authoritative source of drug information for physicians, nurses, and patients. In addition to direct patient care involvement, pharmacists in hospitals are responsible for systems which control drug distribution and are designed to assure that each patient receives the appropriate medication, in the correct form and dosage, at the correct time. Hospital pharmacists maintain records on each patient, using them not only to fill medication orders but also to screen for drug allergies and adverse drug effects.
Contemporary hospital pharmacy practice is composed of a number of highly specialized areas, including nuclear pharmacy, drug and poison information, and intravenous therapy. In addition, pharmacists provide clinical services in adult medicine, pediatrics, oncology, ambulatory care, and psychiatry. The nature and size of the hospital helps to determine the extent to which these specific services are needed. Because of the diversity of activities involved in pharmacy departments, there is also demand for management expertise, including finance and budgeting, personnel administration, systems development, and planning. Approximately 38,000 licensed pharmacists work on a full- or part-time basis in hospitals or nursing homes. As hospital pharmacists continue to become more involved in providing patient-oriented services, the demand for practitioners in this area of pharmacy continues to grow.