Hospital Pharmacy - April 2020 - 116

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Hospital Pharmacy 55(2)

Table 4. Pharmacy Services Provided by Hospital Pharmacists.
Nonteaching
hospitals
(n = 85)

Variable
Procurement
Procurement, selection, and purchasing medications
Procurement, selection, and purchasing medical supplies
Procurement, selection, and purchasing diagnostic tests
Procurement, selection, and purchasing medical gases
Procurement, selection, and purchasing radiopharmaceutical products
Preparation and delivery
Medication dispensing
Compounding hazardous products
Compounding admixtures
Compounding total parenteral nutrition
Dispensing medical supplies
Administration
Pharmacists provides adequate information for safe medication use
Designated quality champion for medication safety
Strategies and policies are implemented to prevent medication errors
Consultation on medication management
Influences on prescribing
Leadership role in formulary management and update
Pharmacy monitoring formulary compliance
Pharmacist is a member of the pharmacy and therapeutics committee
Antibiotic stewardship
Pharmacokinetic consult
Pharmacotherapy consult
Monitoring of medication practice
Documentation in medical records
Patient counseling
Patient care rounds
Medication reconciliation upon admission, transfer of care, and discharge
Human resources and training
Pharmacy undergraduate training
PharmD student training

As reflected by the survey, the current scope of practice
of hospital pharmacists in Lebanon in comparison with the
elements of service suggested by ASHP12 includes drug
procurement and inventory of medication and sterile supplies, medication use policy development, optimizing medication therapy, influences on prescribing, monitoring of
medication use, and evaluating the medication use system.
Furthermore, the current scope of practice also includes
pharmaceutical waste management, which was recently
added by the FIP to the Basel Statements.4 In fact, the complexity in pharmacy practice in health care settings has
been documented in the literature since the early millennium. This complexity has been attributed to the numerous
and increasing drugs on the market, demand for pharmacy
service expansion, increased expectations for quality, technology and automation, frequent drug shortages as well as
challenges in maintaining cost-effectiveness for health care

Teaching
hospitals
(n = 22)

Total
(N = 107)

P value

68 (81%)
49 (58.3%)
14(16.7%)
9 (10.7%)
28 (33%)

20 (90.1%)
8 (36.4%)
3(13.6%)
3 (13.6%)
5 (22.7%)

88 (83%)
57 (53.8%)
17(16%)
12 (11.3%)
33 (31.3%)

.221
.055
.511
.473
.246

76 (90.5%)
51 (60.7%)
40 (47.6%)
34 (40.5%)
36 (42.9%)

21 (95.5%)
14 (63.6%)
10 (45.5%)
11 (50%)
6 (27.3%)

97 (91.5%)
65 (61.3%)
50 (47.2%)
46 (42.5%)
42 (39.6%)

.404
.503
.524
.473
.138

39 (63.9%)
51 (67.1%)
47 (61%)
77 (91.7%)

15 (93.8%)
19 (90.5%)
14 (63.6%)
21 (95.5%)

54 (70.4%)
70 (72.2%)
61 (61.6%)
98 (92.5%)

.29
.052
1
.475

66 (88%)
43 (70.5%)
42 (72.4%)
73 (86.9%)
60 (71.4%)
63 (75%)

22 (91.7%)
19 (100%)
16 (27.6%)
19 (86.4%)
17 (77.3%)
19 (86.4%)

88 (88.9%)
62 (77.5%)
58 (100%)
92 (86.8%)
77 (72.6%)
82 (77.4%)

1
.005
.144
.593
.399
.201

68 (81.9%)
40 (47.6%)
31 (36.9%)
25 (36.8%)

14 (82.4%)
16 (72.2%)
8(36.4%)
12 (52.2%)

82 (82%)
56 (52.8%)
39 (36.8%)
37 (40.7%)

.636
.030
.585
.225

30 (35.7%)
17 (20.9%)

18 (85.7%)
13 (61.9%)

48 (45.7%)
30 (28.6%)

<.001
<.001

systems.16 Furthermore, in 2008, the ASHP and ASHP
Research and Education Foundation introduced the
Pharmacy Practice Model Initiative (PPMI) as a call
toward change in the way pharmacists practice in health
systems. This call targeted pharmacy practice leaders with
the goal of developing and disseminating a futuristic practice model that supports pharmacists as direct patient care
providers in diverse health care settings.17 Given the diversity in cadres for hospital pharmacist practice, it is important for pharmacists working in health care settings to have
received adequate education and training within the scope
of the pharmacy services provided.18 In this study, more
pharmacists with advanced degrees or training were found
in teaching hospitals. Therefore, we recommend that nonteaching hospitals increase the variety of recruited pharmacists' specialties to accommodate for the pharmacist
contemporary role.
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