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Documentation and Quality Assessment more time can be devoted to analyzing, applying, and com-
municating the information.
Numerous methods of documenting pharmacist interven- The following factors should be considered when pur-
tions, including the provision of DI, have been described in chasing DI resources, including electronic subscriptions, for
the literature. Drug information centers are moving toward the pharmacy department or practice setting:
increased use of electronic documentation systems, which
have helped to increase the depth and quantity of documen- 1. Features of the resource (e.g., frequency of updates,
tation, as well as provide increased efficiency and cost sav- qualifications and affiliations of authors, year of pub-
ings.17-21 In addition, an electronic system can promote a lication, type of information, organization of material,
standardized and systematic approach and provides a readily method of delivery, cost).
retrievable archive that can be used to rapidly search previ- 2. Practice setting (e.g., type of facility and needs of health
ously answered questions.22,23 Documentation of DI services care professionals within that environment, state-
should incorporate elements identified through the sys- specific regulatory requirements).
tematic approach. The ASHP Guidelines on Documenting 3. Accessibility of the resource (e.g., location of print re-
Pharmaceutical Care in Patient Medical Records states that sources, number of users allowed by subscription).
the professional actions of pharmacists that are intended
to ensure safe and effective use of drugs and that may af- Keeping Current
fect patient outcomes should be documented in the patient
medical record.24 Therefore, if the DI request is patient- Pharmacists are challenged with keeping up to date with
specific, it is appropriate, but not always necessary, to docu- an increasing number of new drugs and literature.3 Drug
ment the request and response in the patients medical re- information and literature evaluation skills are crucial for
cord. Documentation is critical to appropriate patient care, building clinical knowledge and providing evidence-based
highlights the value of pharmacist services, demonstrates recommendations. It is the responsibility of the pharmacist
accountability, provides a basis for quality assessment and to commit to lifelong learning and make an effort to keep
performance improvement, and details an appropriate sys- abreast of advances both in the methods of delivering DI
tematic approach in case a medico-legal dispute arises from and the information itself. In addition to keeping up to date
a DI request. Consequently, even academic or population- with clinical knowledge, it is important for pharmacists to
based DI activities should be appropriately documented. keep current on changes in pharmacy practice as the health
Despite the importance of assessing the quality of drug- care system evolves. Recommendations for staying current
related information provided by pharmacists, there is cur- include the following:
rently no standardized method described in the literature.
However, some DI centers have reported use of double-check 1. Subscribe to table of contents of or full access to rel-
systems prior to providing a response, random retrospective evant journals, as appropriate.
audits by a DI specialist or another individual, obtaining 2. Subscribe to appropriate email listservers (e.g., Food
feedback from the requestor, and conducting an internal re- and Drug Administration Drug Information Updates,
view by a committee as methods of quality assessment.25 National Guideline Clearinghouse, Centers for Disease
Control and Prevention, Medline Plus).
Resources 3. Receive email alerts from relevant health-related web-
sites (e.g., MedWatch, Medline Plus).
It is important for pharmacists to use appropriate and cred- 4. Bookmark important websites and check regularly for
ible resources. The amount of medical knowledge has updates (e.g., Institute for Safe Medication Practices,
grown substantially and access to information has changed ASHP Drug Shortages Resource Center).
dramatically over the last few decades. Traditional print re- 5. Choose pertinent continuing education activities and
sources are rapidly being replaced by electronic databases methods that challenge learning.
(both online and included in health information management 6. Maintain active membership in local, state, and na-
systems), online resources, and mobile applications.26 The tional pharmacy associations/societies.
internet and mobile technology have allowed for convenient 7. Pursue board certification from the Board of Pharmacy
and quick access to medical information. However, pharma- Specialties.
cists should critically evaluate all resources prior to use to
ensure that they are accurate, current, and unbiased. Conclusion
General principles to consider when critically evaluat-
ing medical information available on the internet have been All pharmacists are involved in the provision of DI, which
published.27 Pharmacists should work closely with others includes a broad array of activities. A systematic approach
within the organization to ensure that up-to-date resources, should be considered for all DI requests, and pharmacists
including representative primary (e.g., peer-reviewed origi- should document their services to demonstrate account-
nal studies), secondary (e.g., indexing or abstracting ser- ability and justify the value of pharmacist care. Increased
vices such as MEDLINE and International Pharmaceutical availability of medical information, both due to increased
Abstracts), and tertiary resources (e.g., electronic databases, knowledge and technological advances, has not changed the
textbooks, review articles, clinical practice guidelines) are overall process of DI practice. It is important for pharma-
available to assist in answering a variety of DI requests. cists to select appropriate resources and keep current on new
Pharmacists should be familiar with the features of each re- literature and new tools to address a variety of DI requests.
source; familiarity makes searching more efficient so that
Medication Therapy and Patient Care: Specific Practice AreasGuidelines397