Senior Pharmacist Research Articles

DO DISTRACTIONS INCREASE THE NUMBER OF PRESCRIBING ERRORS IN PAEDIATRIC INTENSIVE CARE?

BackgroundThe safe administration of medicines and the avoidance of adverse events have been at the forefront of patient safety initiatives for many years.1–3 There have been many studies looking at...

PAEDIATRIC SIMULATION—A NEW ROLE FOR PHARMACISTS IN IMPROVING PATIENT SAFETY

AimSimulation has become an important resource in patient safety and education. Senior pharmacist involvement in high fidelity simulations began through regional educational “road shows” in referring hospitals which identified areas...

GM-008 The recruitment of more experienced clinical pharmacists and new ways of working: impact on patient care

BackgroundFew elements in the literature detail the organisation and impact of pharmaceutical work in care units. Pharmacists perform pharmaceutical interventions (PIs) when they detect a possible medicines error (ME). Another...

Validity of a clinical decision rule-based alert system for drug dose adjustment in patients with renal failure intended to improve pharmacists’ analysis of medication orders in hospitals

ObjectiveThe main objective of this study was to assess the diagnostic performances of an alert system integrated into the CPOE/EMR system for renally cleared drug dosing control. The generated alerts were compared with the daily routine practice of pharmacists as part of the analysis of medication orders. Materials and methodsThe pharmacists performed their analysis of medication orders as usual and were not aware of the alert system interventions that were not displayed for the purpose of the study neither to the physician nor to the pharmacist but kept with associate recommendations in a log file. A senior pharmacist analyzed the results of medication order analysis with and without the alert system. The unit of analysis was the drug prescription line. The primary study endpoints were the detection of drug dose prescription errors and inter-rater reliability (Kappa coefficient) between the alert system and the pharmacists in the detection of drug dose error. ResultsThe alert system fired alerts in 8.41% (421/5006) of cases: 5.65% (283/5006) “exceeds max daily dose” alerts and 2.76% (138/5006) “under-dose” alerts. The alert system and the pharmacists showed a relatively poor concordance: 0.106 (CI 95% [0.068–0.144]). According to the senior pharmacist review, the alert system fired more appropriate alerts than pharmacists, and made fewer errors than pharmacists in analyzing drug dose prescriptions: 143 for the alert system and 261 for the pharmacists. Unlike the alert system, most diagnostic errors made by the pharmacists were ‘false negatives’. The pharmacists were not able to analyze a significant number (2097; 25.42%) of drug prescription lines because understaffing. ConclusionThis study strongly suggests that an alert system would be complementary to the pharmacists’ activity and contribute to drug prescription safety.

Does profession or experience affect a practitioner's perception when assigning potential harm avoided by pharmacists interventions

AimThe aims of the study were to assess the differences in rating of potential harm avoided by a pharmacist's intervention using a multidisciplinary team and whether the experience of a...

Research help for a senior pharmacist

Research help for a senior pharmacist

GlaxoSmithKline Medal of Merit 2012

Journal of Pharmacy Practice and ResearchVolume 42, Issue 4 p. 305-308 AwardFree Access GlaxoSmithKline Medal of Merit 2012 Rohan A Elliott BPharm, BPharmSc (Hons), MClinPharm, CGP, FSHP, Corresponding Author Rohan A Elliott BPharm, BPharmSc (Hons), MClinPharm, CGP, FSHP Senior Pharmacist, Clinical Senior Lecturer Austin Health, Centre for Medicine Use and Safety, Monash University, Parkville, VictoriaCorresponding author: Rohan Elliott, Pharmacy Department, Heidelberg Repatriation Hospital, Heidelberg Vic. 3081, Australia. E-mail: rohan.elliott@austin.org.auSearch for more papers by this author Rohan A Elliott BPharm, BPharmSc (Hons), MClinPharm, CGP, FSHP, Corresponding Author Rohan A Elliott BPharm, BPharmSc (Hons), MClinPharm, CGP, FSHP Senior Pharmacist, Clinical Senior Lecturer Austin Health, Centre for Medicine Use and Safety, Monash University, Parkville, VictoriaCorresponding author: Rohan Elliott, Pharmacy Department, Heidelberg Repatriation Hospital, Heidelberg Vic. 3081, Australia. E-mail: rohan.elliott@austin.org.auSearch for more papers by this author First published: 13 April 2015 https://doi.org/10.1002/j.2055-2335.2012.tb00194.xCitations: 1AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat References 1Morgan TK, Williamson M, Pirotta M, Stewart K, Myers SP, Barnes J. A national census of medicines use: a 24-hour snapshot of Australians aged 50 years and older. Med J Aust 2012; 196: 50– 3. 2Turner CD. Drug use in the elderly: results of a multicentre audit [abstract]. Proceedings of the Conference of the Victorian Branch of The Society of Hospital Pharmacists of Australia; 1992 Nov 13–15; Lorne, Victoria. 3Elliott RA. Reducing medication regimen complexity for older patients prior to discharge from hospital: feasibility and barriers. J Clin Pharm Ther 2012; 37: 637– 42. Doi:10.1111/j.1365-2710.2012.01356.x. 4Elliott RA, Thomson WA. Assessment of a nursing home medication review service provided by hospital-based clinical pharmacists. Aust J Hosp Pharm 1999; 29: 255– 60. 5Elliott RA, Woodward MC, Oborne CA. Quality of prescribing for elderly inpatients at nine hospitals in Victoria, Australia. J Pharm Pract Res 2003; 33: 101– 5. 6Sorensen L, Stokes JA, Purdie DM, Woodward M, Elliott R, Roberts MS. Medication reviews in the community: results of a randomized controlled effectiveness trial. Br J Clin Pharmacol 2004; 58: 648– 64. 7Tran T, Elliott RA, Taylor, SE, Garrett K. Development and evaluation of a hospital pharmacy generated interim residential care medication administration chart. J Pharm Pract Res 2012; 42: 100– 5. 8Elliott RA, Tran T, Taylor SE, Harvey PA, Belfrage MK, Jennings JJ, et al. Impact of a pharmacist-prepared interim residential care medication administration chart on gaps in continuity of medication management after discharge from hospital to residential care: a prospective pre- and postintervention study (MedGap Study). BMJ Open 2012; 2: e000918. 9Elliott R, Perera D, Garrett K, Woodward M, Szysz A, Marriott J, et al. Improving medication safety for subacute aged care patients through expanded pharmacy assistant (technician) support for clinical pharmacy services. Final report. Adelaide: Health Workforce Australia, Workforce Innovation and Reform: Caring for Older People Program; 2011. 10Elliott RA, Marriott JL. Review of instruments used in clinical practice to assess patients' ability to manage medications. J Pharm Pract Res 2010; 40: 36– 42. 11Elliott RA, Woodward MC. Medication-related problems in patients referred to aged care and memory clinics at a tertiary care hospital. Australas J Ageing 2011; 30: 124– 9. 12Elliott RA, Martinac G, Campbell S, Thorn J, Woodward MC. Pharmacistled medication review to identify medication-related problems in patients referred to an Aged Care Assessment Team: a randomised comparative study. Drugs Aging 2012; 29: 593– 605. Citing Literature Volume42, Issue4December 2012Pages 305-308 ReferencesRelatedInformation

Prospective audit of drug prescribing errors in a tertiary nephrology centre

Aims To identify the nature of prescribing errors on the renal unit, determining type of error, timing, medication involved, prescriber and repeat offenders and risks for prescribing errors. Methods Prospective audit of drug errors made on our electronic prescribing system (EPR) reported by pharmacists and nurses. Data collected on a data record sheet over a 2 week period on 4 occasions between August 2011 and February 2011. This period encompassed 1 time point for previous trainees (end of post) and 3 time points for subsequent trainees (start, mid-point and end of post). Results 102 errors were identified over the 4 audit blocks (21 in August 2010, 13 in September 2011, 48 in November 2011 and 20 in February 2011).The overall approximate calculated error rate was 3.0%. 44% of errors were made during the weekday daytime shifts, 31% at night time, 11% over the weekend and 14% at evening shifts. 58% of errors were made by the SpR, 47% of which were made at night. 19% of SpR errors were related to paracetamol prescribing. 38% of all errors were due to ‘incorrect frequency’ followed by ‘unadministrable dosage’ (17.6%) and ‘incorrect dosage’ (14%). Paracetamol, Prednisolone, Methylprednisolone, Ranitidine Morphine, Nystatin and Alfa-Calcidol were the 7 most incorrectly prescribed drugs. There was no significant difference between the performance of the previous and subsequent trainees (p=NS). Conclusions The majority of errors were made by the SpRs during the weekday daytime however the error rate at night was disproportionately high. The most common error encountered was ‘incorrect frequency’ followed by ‘unadministerable dosage’. Recommendations Reinforcement of safe prescribing at junior doctors9 induction. Structured training of EPR for all junior doctors (renal and non-renal), highlighting common mistakes/prescribing errors. Senior pharmacist briefing on common errors at the end of the grand round. Modification of EPR program to facilitate correct and complete prescribing. Planned re-audit following implementation of these actions.

Prescribing errors in paediatrics

ObjectiveIn 2007 the General Medical Council commissioned a research programme to explore the causes of prescribing errors made by Foundation trainee (FY1) doctors in relation to their medical education, the...

Audit and re-audit of documentation of changes to medicines on discharge in paediatrics at St Mary's Hospital, Imperial College Healthcare NHS Trust

ObjectivesTo measure the communication of changes to medicines on the paediatric discharge summary in relation to the Commissioning for Quality and Innovation (CQUIN)1 target for discharge communication. The target relating...

Medication management—the missing link in dementia interventions

Ian D Maidment (corresponding author), Senior Pharmacist, Kent and Medway NHS and Social Care Partnership Trust, Honorary Research Fellow, Centre for Health Services Studies, University of Kent. Corresponding address – Pharmacy Department, Eastern and Area Coastal Office, St Martin’s Hospital, Littlebourne Rd., Canterbury, Kent, CT1 1AZ, UK Telephone / fax – 01227 812203. Email – ian.maidment@nhs.net

Pharmacistsʼ Interventions in Prescribing Errors at Hospital Discharge

Pharmacists have an essential role in improving drug usage and preventing prescribing errors (PEs). PEs at the interface of care are common, sometimes leading to adverse drug events (ADEs). This was the first study to investigate, using a computerized search method, the number, types, severity, pharmacists' impact on PEs and predictors of PEs in the context of electronic prescribing (e-prescribing) at hospital discharge. This was a retrospective, observational, 4-week study, carried out in 2008 in the Medical and Elderly Care wards of a 904-bed teaching hospital in the northwest of England, operating an e-prescribing system at discharge. Details were obtained, using a systematic computerized search of the system, of medication orders either entered by doctors and discontinued by pharmacists or entered by pharmacists. Meetings were conducted within 5 days of data extraction with pharmacists doing their routine clinical work, who categorized the occurrence, type and severity of their interventions using a scale. An independent senior pharmacist retrospectively rated the severity and potential impact, and subjectively judged, based on experience, whether any error was a computer-related error (CRE). Discrepancies were resolved by multidisciplinary discussion. The Statistical Package for Social Sciences was used for descriptive data analysis. For the PE predictors, a multivariate logistic regression was performed using STATA 7. Nine predictors were selected a priori from available prescribers', patients' and drug data. There were 7920 medication orders entered for 1038 patients (doctors entered 7712 orders; pharmacists entered 208 omitted orders). There were 675 (8.5% of 7920) interventions by pharmacists; 11 were not associated with PEs. Incidences of erroneous orders and patients with error were 8.0% (95% CI 7.4, 8.5 [n = 630/7920]) and 20.4% (95% CI 18.1, 22.9 [n = 212/1038]), respectively. The PE incidence was 8.4% (95% CI 7.8, 9.0 [n = 664/7920]). The top three medications associated with PEs were paracetamol (acetaminophen; 30 [4.8%]), salbutamol (albuterol; 28 [4.4%]) and omeprazole (25 [4.0%]). Pharmacists intercepted 524 (83.2%) erroneous orders without referring to doctors, and 70% of erroneous orders within 24 hours. Omission (31.0%), drug selection (29.4%) and dosage regimen (18.1%) error types accounted for >75% of PEs. There were 18 (2.9%) serious, 481 (76.3%) significant and 131 (20.8%) minor erroneous orders. Most erroneous orders (469 [74.4%]) were rated as of significant severity and significant impact of pharmacists on PEs. CREs (n = 279) accounted for 44.3% of erroneous orders. There was a significant difference in severity between CREs and non-CREs (χ2 = 38.88; df = 4; p < 0.001), with CREs being less severe than non-CREs. Drugs with multiple oral formulations (odds ratio [OR] 2.1; 95% CI 1.25, 3.37; p = 0.004) and prescribing by junior doctors (OR 2.54; 95% CI 1.08, 5.99; p = 0.03) were significant predictors of PEs. PEs commonly occur at hospital discharge, even with the use of an e-prescribing system. User and computer factors both appeared to contribute to the high error rate. The e-prescribing system facilitated the systematic extraction of data to investigate PEs in hospital practice. Pharmacists play an important role in rapidly documenting and preventing PEs before they reach and possibly harm patients. Pharmacists should understand CREs, so they complement, rather than duplicate, the e-prescribing system's strengths.

Australian Clinical Pharmacy Award 2009

Journal of Pharmacy Practice and ResearchVolume 39, Issue 4 p. 313-315 AwardFree Access Australian Clinical Pharmacy Award 2009 Susie Welch BPharm, CertPharmPract (Lond), Corresponding Author Susie Welch BPharm, CertPharmPract (Lond) Senior Pharmacist for Research St Vincent's Hospital, and Honorary Clinical Associate Lecturer, Faculty of Pharmacy, University of Sydney, Sydney, New South Wales Address for correspondence: Susie Welch, Pharmacy Department, St Vincent's Hospital, Darlinghurst NSW 2010, Australia. E-mail: [email protected]Search for more papers by this author Susie Welch BPharm, CertPharmPract (Lond), Corresponding Author Susie Welch BPharm, CertPharmPract (Lond) Senior Pharmacist for Research St Vincent's Hospital, and Honorary Clinical Associate Lecturer, Faculty of Pharmacy, University of Sydney, Sydney, New South Wales Address for correspondence: Susie Welch, Pharmacy Department, St Vincent's Hospital, Darlinghurst NSW 2010, Australia. E-mail: [email protected]Search for more papers by this author First published: 13 April 2015 https://doi.org/10.1002/j.2055-2335.2009.tb00483.xAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL No abstract is available for this article. Volume39, Issue4December 2009Pages 313-315 RelatedInformation

Assessment of Risk Associated with Medication‐Related Problems in Elderly Outpatients

ABSTRACTBackgroundThe Society of Hospital Pharmacists of Australia's (SHPA) Standards of Practice for Clinical Pharmacy provide a risk‐classification system for interventions made by pharmacists in hospital inpatients. These standards are based on Australian standards for risk management, where risk is based on an estimate of the likelihood and consequences of an adverse outcome from a medication‐related problem, if no intervention was made.AimTo adapt and validate the SHPA risk‐classification system for use in geriatric ambulatory care and to explore differences in classifications of risk made by pharmacists and geriatricians.MethodThe SHPA risk‐classification system was modified, piloted and reviewed by experts to assess face validity. 113 medication‐related problems identified by an outpatient clinical pharmacist in aged care were independently classified by a senior clinical pharmacist, a geriatrician and the outpatient clinical pharmacist. When there was disagreement, the case was discussed and consensus reached. A random sample of 30 medication‐related problems, stratified by consensus risk classification was classified by a second geriatrician.ResultsFace validity of the adapted risk‐classification system was established. Agreement between pharmacists on medication‐related problem risk was moderate and agreement between pharmacists and geriatricians was fair. Risk of adverse outcomes was rated lower by geriatricians than pharmacists. Consensus was easily reached through case discussion.ConclusionA system for classifying risk associated with pharmacist‐identified medication‐related problems in geriatric ambulatory care was developed. Differences were identified between pharmacists and geriatricians in the way medication‐related risks are perceived. Classification of pharmacist‐identified medication‐related problems/interventions may need to be based on consensus between at least one doctor and pharmacist.

PENGEMBANGAN PENDIDIKAN PROFESI APOTEKER UNTUK MENDUKUNG EKSISTENSI APOTEKER DI APOTEK

Aphothec is a place for pharmacy services especially for pharmacist who dedicates his competency in the community.n The policyn no pharmacist no service is a strategicpolicy that has to be supported by all members of Indonesian Pharmacist Association.This policy can only be accomplished if pharmacists produced are equipped with com-petencies that are needed to run an apothec and also supported with adequate motiva-tion. Transformation of senior pharmacist that has been socially established will not give significant impact. To produce competent pharmacist, transformation in educa-tion process especially for pharmacist in the apothec is needed. Transformation must be based on the need of competency and supporting resources. Only with adequate supporting resources, the education process will yield output that match with thedemand of formulated competency. As professional practician, new pharmacist has to be able to demonstrate his competency in the apothec. This competency can only be gained through experiences in handling similar activities in the job field. In thisscheme, professional pharmacy student has to work in the relevant job field for certain period followed by certification test conducted by certified professional pharmacy edu-cation provider. Only participants that pass the certification test are eligible to hold apothecary (pharmacist) degree and to run an apothec. The education provider can be university by involving certified pharmacist as examiner. This scheme is developedbased on the study on the professional pharmacy education scheme implemented in various countries.

Side-effects of antibiotics can vary from mild to life threatening

In his overview of antibiotic therapy, Kevin Frost, the senior clinical pharmacist for antibiotics at Airedale NHS Trust, West Yorkshire, describes the factors that should be taken into account when choosing an antibiotic. These include.

Impact of an Emergency Department Pharmacist on Prescribing Errors in an Australian Hospital

ABSTRACTAimTo evaluate the impact of an emergency department (ED) pharmacist on prescribing errors 24 hours post‐admission.MethodA prospective controlled sequential study was conducted in the ED of a metropolitan teaching hospital. In the control period, ED patients admitted were followed‐up by ward pharmacists (standard practice). In the active period, they were seen first by the ED pharmacist. Targets of 50 patients were recruited into each study period. All medication charts were reviewed by a senior clinical pharmacist (reviewing pharmacist) at 24 hours post‐admission. Errors were risk‐assessed by a blinded independent physician. The number and type of errors were compared.ResultsThe profile, type and complexity of patients and number of medications ordered per patient were similar in both periods. There was a 71% relative reduction in errors per patient (p &lt; 0.0001) and a 76% relative reduction in errors per drug order (p &lt; 0.0001) between the control and active periods. The number of errors rated as high‐extreme, moderate or minor, decreased by 64%, 71% and 90% respectively. Overall, the most common types of error were drug omissions (63%); and the most common drugs involved were cardiovascular (31.5%), central nervous system (18%), respiratory (12.6%) and endocrine (10.8%).ConclusionAn ED pharmacist providing timely medication histories resulted in admitted patients significantly more likely to receive an accurate medication chart early in their hospital stay.

Awareness and perceptions of emergency contraception among retail pharmacists in Kuwait

To describe the awareness and perceptions of hormonal emergency contraception (EC) among retail pharmacists. Private retail pharmacies in Kuwait City. A self-administered questionnaire was developed to elicit pertinent demographic information as well as awareness of and concerns about EC and administered to the senior pharmacist in 51 randomly selected private retail pharmacies. Proportion of pharmacists aware of EC and who had recommended EC. The respondents had a mean (SD) age of 34.2 (7.7) years; 58.8% were male, and all but one were non-Kuwaiti. The median practice experience of the pharmacists was 6 years. Oral contraceptives and male condoms were universally available in the pharmacies, but none stocked emergency contraceptives, female condoms, or diaphragms. Twenty respondents (39.2%; 95% confidence intervals 25.5-53.9%) said they were aware of EC, and 4 (7.8%) that they had ever offered EC. Nine (17.6%) respondents saw EC as offering no advantages over other contraceptive measures and effectiveness was perceived to be low. Most cited concerns were of encouraging irresponsible behaviour and women relying on EC in place of regular contraceptive measures. Religious opposition (41.2%), lack of awareness by clients (51.0%) and lack of awareness by health providers (35.3%) were seen as the most significant obstacles to provision of EC. Knowledge of EC is poor among community pharmacists in Kuwait. Action is needed to address this deficit and to make EC more accessible to women who wish to use it.

Medication errors in hospitals: computerized unit dose drug dispensing system versus ward stock distribution system.

The aim of this study was to evaluate the rates and types of drug prescription and administration errors in one pediatric nephrology ward, comparing two dispensing schemes: the first one defined as handwritten prescription plus ward stock distribution system (WSDS), and the second one as computerized prescription plus unit dose drug dispensing system (UDDDS). Data were collected over an 8-week period, from 1 February to 31 March 1999. Two fifth-year pharmacy students photocopied prescription and administration documents on the ward each day, under the supervision of a senior pharmacist. The medical record analysis was used to compare the prescription with the administration report. Prescribing and administration medication errors were classified according to the American Society of Health-System Pharmacists. Prescribing errors: overall, for both dispensing schemes, a total of 511 prescriptions, resulting in 4532 prescribed drugs (an average of 9 drugs per prescription) were prescribed. The total prescription error rate was 20.7% (937 of 4532), resulting in 1.9 errors per patient per day. The computerized prescription error rate was 10.6% (419 of 3943), the handwritten prescription error rate was 87.9% (518 of 589). This difference was very significant (P < 0.0001). ADMINISTRATION ERRORS: The total opportunity of administration errors was 4589 (sum of administered and omitted drugs). The total administration error rate was 23.5% (1077 of 4589) including wrong administration time, and 11.7% (538 of 4589) excluding administration time. The administration error rate, including administration associated with time errors, was only 22.5% (888 of 3943) for computerized prescription + UDDDS, compared with 29.3% (189 of 646) for handwritten prescriptions plus WSDS (P < 0.001). Excluding administration associated with time errors, the administration error rates were 9.7% and 24.3%, respectively (P < 0.0001). The drug prescription and administration error rates were significantly decreased using computerized prescription plus UDDDS as compared with handwritten prescription plus WSDS in a pediatric unit (even with potential biases taken into account).

Receiving Cytotoxic Drugs—Standard Practice or Russian Roulette?

Journal of Pharmacy Practice and ResearchVolume 32, Issue 3 p. 178-178 Letter to the EditorFree Access Receiving Cytotoxic Drugs—Standard Practice or Russian Roulette? Jim Siderov BPharm, Grad Dip Hosp Pharm, BCOP, CHP, Jim Siderov BPharm, Grad Dip Hosp Pharm, BCOP, CHP Senior Pharmacist jim.siderov@armc.org.au Cancer Services Austin & Repatriation Medical Centre Heidelberg Vic. 3084Search for more papers by this authorMaryann Bayles, Maryann Bayles Senior Pharmacy Technician Cancer Services Austin & Repatriation Medical Centre Heidelberg Vic. 3084Search for more papers by this author Jim Siderov BPharm, Grad Dip Hosp Pharm, BCOP, CHP, Jim Siderov BPharm, Grad Dip Hosp Pharm, BCOP, CHP Senior Pharmacist jim.siderov@armc.org.au Cancer Services Austin & Repatriation Medical Centre Heidelberg Vic. 3084Search for more papers by this authorMaryann Bayles, Maryann Bayles Senior Pharmacy Technician Cancer Services Austin & Repatriation Medical Centre Heidelberg Vic. 3084Search for more papers by this author First published: 01 September 2002 https://doi.org/10.1002/jppr2002323178AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article. Reference 1Davis J, Kirsa S, McLauchlan R, Ng L, Ooi S, Siderov J. Committee of Specialty Practice in Oncology. SHPA standards of practice for the transportation of cytotoxic drugs from pharmacy departments. Aust J Hasp Pharm 2000; 30: 116– 17 Volume32, Issue3September 2002Pages 178-178 ReferencesRelatedInformation