ASHP national survey of pharmacy practice in hospital settlings: Prescribing and transcribing-2010

Purpose: Results of the 2010 ASHP national survey of pharmacy practice in hospital settings are described. Methods: A stratified random sample of pharmacy directors at 1968 general and children's medical-surgical hospitals in the United States was surveyed by Internet and mail. SDI Health LLC supplied data on hospital characteristics; the survey sample was drawn from the SDI Health hospital database. Results: In this national probability sample survey, the response rate was 28.8%. Patient-specific pharmacist activities are increasing, as shown by the substantial use of pharmacist empowered therapeutic interchange programs, extensive prevalence of pharmacist review of medication orders before doses are available for administration to patients, and the widespread use of pharmacist consultations by prescribers, with almost complete acceptance of pharmacist recommendations. Pharmacists are also leading antibiotic stewardship programs, managing anticoagulation medication therapy, addressing pharmaceutical waste management, and standardizing i.v. infusion concentrations. Electronic health information is rapidly being adopted, with the use of electronic medical records and computerized prescriber-order-entry to improve prescribing and use of medications. Metrics are commonly used to track and monitor trends in operational, clinical, and safety performance in hospital pharmacy departments. Pharmacist and pharmacy technician staffing has increased significantly, while vacancy rates have declined. Conclusion: Pharmacists contribute to improving prescribing and transcribing. Patient safety is now a priority for medication management.