Pharmacists

Scenario I

Anita Valesquez, PharmD, enters her hospital pharmacy at 7 AM promptly, as she does every week end morning. She takes a seat at her computer station, logs on to the hospital home page on the Dynamic Monitoring™ (DPM) system as part of her normal morning routine. She rapidly clicks through her pre-programmed searches to see what has transpired through the night: heparin/PTT, coumadin/INR, renal clearance alerts and antibiotic. Within three minutes she has identified three high priority and five medium priority alerts.

Anita clicks through each event, quickly identifies the issues from the alert event pages, and reviews each patient’s pharmacy orders and lab results via the DPM lab and pharmacy links. She institutes, under her hospital protocols, changes to five of the patients’ medication orders, and speaks with the attending physicians caring for the other three patients, alerting them to impending problems. She is able to rapidly document her actions in the DPV system.

By 7:30 AM, Anita has completed her morning DPV rounds, dons her white coat and meets up with her medical team for morning rounds.

Scenario II

While in the ICU, the pager of Rick Dawson, Pharm.D. an adverse drug event coordinator, signals that he has a message. Upon examination of the pager screen, he sees that he has just received a high priority adverse drug event (ADE) notification from the Dynamic Monitoring™ System informing him that he has a high-priority warning, number 1579. Rick accesses the Dynamic Monitoring™ System log-on screen on a nearby computer. Once logged on, Rick easily and quickly queries the Dynamic PharmacoVigilance® Module (DPV) for details on the patient including her medications, lab results, and details of the warning.

In an instant, he sees that Doris Fuller, a 63 year old congestive heart failure patient in the ICU, has experienced a critical drop in her morning potassium level. The alert identified that she was on a combination of furosemide and digoxin. The lab result had arrived at the station following the physician's rounds that morning. This notification was sent to Rick after the passage of only one hour during which the DPM monitored the event, watching for a corrective action to be taken. This interval is a unique and exclusive feature of DPV known as the Good Medical Practice Interval or GMP.

Good Medical Practice Interval minimizes the noise often associated with less sophisticated warning and alerting systems and enables clinicians to practice quality patient care, undisturbed. Rick responds and arranges for Mrs. Fuller's potassium to be appropriately supplemented, and re-orders a follow-up potassium. Because of his rapid response, a potentially life-threatening ADE has been prevented.

Any Everyday Threat

In the hospital setting, situations like these happen every day. Lab results and corresponding drug dosages are often compared only after an adverse clinical event occurs. The failure to act in a timely fashion can have serious, often life threatening, consequences.