Department of Clinical Pharmacy

Head of Department: Milada Halačová, PharmD, PhD

 

Activities of the Department

The Department of Clinical Pharmacy was established in the Na Homolce Hospital in August 2010 to ensure the safety of pharmacotherapy which is one of the major priorities of the hospital management. In terms of its organizational structure, it falls within the competence of the Deputy Director for Therapeutic and Preventive Care. The working team of the Department consists of pharmacists specialized in clinical pharmacy or those who will be included in training for this specialization. The work of the clinical pharmacist is governed by the needs of the Na Homolce Hospital, safety standards set by JCI and by staff availability within the Department. The activities in which the clinical pharmacist takes part are divided into several areas.

The major areas include the assessment of a newly admitted patient’s medications. This is a so-called signal check, i.e. a gross assessment of the patient’s medication with respect to indications, contraindications, dosages and chosen route of administration. It reveals any duplication of medication and evaluates the clinical importance and risks of drug and food interactions. In such a way, future problematic medications for the patient or high-risk pharmacotherapeutic regimes are identified and continuously monitored.

The key activity of the clinical pharmacist is the everyday work in the assigned clinical department and close cooperation with treating physicians and nurses. The clinical pharmacist monitors patient medications in detail and assesses any causal relationships between specific patient problems and their changes during illnesses, laboratory examinations and current medications, and adjusts drug dosages, especially of antibiotics for patients with various degrees of renal or hepatic damage and dialysed patients. They work with nurses on drug incompatibilities and the crushing of drugs for nasogastric and jejunal probes.

The clinical pharmacist provides an on-demand consulting service within the hospital, takes part in the development of best practice, reports adverse events to the State Institute or Drug Controland is responsible for preparing expert reports on dealing with exceptional events in the hospital related to medications. The Department of Clinical Pharmacy is working on a list of high-risk and LASA (look alike-sound alike) drugs and is involved in preparing so-called proactive procedures and storage systems to minimize the number of errors in handling these drugs and the impact such errors might have on patients.

Since 2012 the Department of Clinical Pharmacy has been involved in the national Senior project implemented by the Institute of Drug Guide. Clinical pharmacists of the Na Homolce Hospital perform regular drug audits in social facilities throughout the Czech Republic. The project continues in activities of outpatient clinical pharmacy departments where in 2017 we managed to open a clinical pharmacists consulting service for the needs of outpatient physicians and patients with a financial support of the Ministry of Health.

Accreditation and specialist activities:

• The Department is an accredited facility of the Czech Ministry of Healt in the field of clinical pharmacy (in 2017 the Department trained 2 postgraduate fellows registered for the discipline and 2 undergraduate students)
• Membership in the Accreditation Commission of the Czech Ministry of Health in the field of clinical pharmacy
• Membership in the Section of Clinical Pharmacy of the Czech Pharmaceutical Society of J. E. Purkyně (the head of the Department is at the same time the chairperson of the Society)
• Educational activities in the field of pharmacology at schools of medicine and pharmacology in Prague and Brno
• Membership in the Scientific Council of the Institute for Medical Drug Guide
• Professional guarantor of the national pilot project “Senior” implemented by the Institute for Medical Drug Guide, registered institute.

A high standard of clinical pharmaceutical care was confirmed by the JCI international audit of the quality and safety of care which the Na Homolce Hospital repeatedly received in 2017. The clinical pharmaceutical care provided by the hospital has become a common standard ensuring a high level and safety of pharmacotherapy for all its inpatients. The global set-up of the clinical pharmacological care in the Na Homolce Hospital, guaranteed by the JCI independent international accreditation, is at present unique in our country. The project was awarded several times in the national competition “A Safe Hospital” (in 2013 it became the winner).