In hospitals, the role of the Pharmacist has evolved over many decades to include far more than the oversight of dispensing medications to acutely ill patients. There has been a clear shift toward higher patient acuity among hospitalized patients and an increasing complexity of medications used in the acute care setting (including but not limited to chemotherapy, biologics and antibiotics). These factors warrant the oversight of medication use by Pharmacists with postgraduate residency training or extensive experience.
The Hospital Pharmacist’s practice may involve autonomous or collaborative management of medication therapies such as: pharmacokinetic dosing of aminoglycosides or vancomycin; adjustment of drug doses based on kidney or liver function; alteration of antibiotic selection or route of administration based on clinical data; and discontinuation of overlapping or unsupported therapies. Additionally, the task of medication reconciliation at transitions of care is well-suited for involvement or management by a Pharmacist in collaboration with a prescriber, and many health systems now place a Pharmacist in the admission, discharge, and transfer process to facilitate optimal continuity of a patient’s medication list. Coincident with ever-increasing regulatory standards applied to sterile and hazardous drug handling, a Hospital Pharmacist also has the burden of assuring not only the accuracy but the sterility of compounded sterile (injectable) medications while minimizing unintended exposure of potentially hazardous drugs to patients and healthcare workers alike.