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New Computer Tablets Allow Pharmacists to Stay on Rounds

During the course of a pharmacist’s typical work day, spar­ing a few minutes here and there can mean more time for consulting with fellow healthcare professionals on the care of patients, ensuring proper medication choices and dosages, and educating patients about their medications. It even can mean more time for medical interventions that can potentially save lives. 

At Children’s Hospital in Omaha, Neb., staff pharmacists no longer have to leave a patient’s bedside or step away from patient rounds to enter a medication order, examine laboratory results, or check a dosage reference. Large drug reference books and reams of paper detailing a patient’s medical record are now a thing of the past. 

Tablets Feature ASHP Drug Information 

The advent of new handheld computer tablets has lightened the load for pharmacists and is increasing their ability to share their medication expertise during rounds. The tablets are small but feature ASHP’s powerful drug databases, AHFS Drug Information and AHFS DI Essentials, now offered via Lexi-Comp® ONLINE™. 

In late 2006, Motion Computing approached Children’s about using its new C5 medical tablets in various departments of the hospital. In early 2007, ASHP member and Pharmacy Director Lisa Kwapniowski, Pharm.D., and other hospital officials, worked to adapt the devices for use in the hospital. 

The hospital piloted the new tablets with pharmacists in the pediatric intensive care unit first, and then rolled them out to pharmacists in neonatal intensive care. The emergency department and medical surgical units are scheduled to receive the tablets later this year. 

The pharmacy staff members welcomed the machines with enthusiasm and have come to depend on them. The mobile technology ended the use of computers on wheels and the heavy laptops pharmacists once toted around the facility—a welcome change, according to Kwapniowski. 

“My staff would probably hunt me down if I took the tablets away now,” she said, laughing. 

The three-pound devices feature 10-inch screens. The tablets are pre-loaded with ASHP’s drug information, other medical soft­ware, and patient information. Pharmacists can use the tablets to accomplish a number of critical tasks, including entering and verify­ing medication orders, reviewing medication profiles and laboratory results, and accessing electronic drug information databases. 

Children’s Hospital bills itself as the first in its region and one of the first hospitals in the U.S. to bring the devices onboard. Hospital officials point to immediate positive impacts, such as the fact that pharmacists can now stay on rounds to make medication recommendations and immediately answer any drug-related ques­tions the medical staff may have. 

Evidence Points to Importance of Pharmacists Rounding  

Kwapniowski pointed to studies that show pharmacists’ par­ticipation in hospital rounds with other healthcare team members decreases adverse events in patients. For instance, a 2002 study in ASHP’s American Journal of Health-System Pharmacy[1] showed that including a clinical pharmacist on daily patient rounds reduced medication errors by 51 percent. Another 2003 study published in the Archives of Internal Medicine[2]  revealed a 78 percent drop in preventable adverse drug events when pharmacists participated in weekday medical rounds in a hospital’s general medicine unit. 

Children’s estimates that use of bedside tablet technology has increased the time that pharmacists spend rounding in the pediat­ric intensive care unit from 82 to 98 percent. 

“Pharmacists can now be in rounds up to 99 percent of the time,” Kwapniowski said. “Before they had to break away and miss portions of the rounds, potentially missing medication interventions.” 

Robin Stec, Pharm.D., clinical coordinator at Children’s, said the new technology has improved patient care. “We have more opportunities to find adverse drug events because we can be present on rounds and have the information right there,” Stec said. “I think they are great tools for pharmacists to participate in rounds. We have all the resources we need at our fingertips.” 

Although the tablets are handy for verifying medication orders, they are more challenging to use for order entry because more data entry—and keystrokes—are involved, she said. 

The tablets meet the hospital’s strict infection-control guide­lines and feature bar-code scanners to read medication labels at patients’ bedsides, allowing nurses to verify a patient’s name, medi­cation, time, route, and dosage. 

[1] Pharmacists’ participation in medical rounds reduces medication errors. Am J Health-Syst Pharm. 2002; 59: 2089-92. 

[2] Pharmacists on rounding teams reduce preventable adverse drug events in hospital general medicine units. Arch Intern Med. 2003; 163: 2014-2018.