Expanding staff pharmacists' responsibilities to maintain pharmacy services in a neonatal intensive-care unit.

The conversion of pharmacist responsibilities in a neonatal intensive-care unit (NICU) pharmacy satellite from drug distribution to both clinical services and drug distribution is described. When the pharmacy department could not recruit a specialty-trained clinical practitioner to fill an open NICU position, the position was converted to a fourth satellite pharmacist position, and each of the four NICU satellite pharmacists assumed clinical responsibilities for the NICU. Clinical and distributive functions had previously been separate. Staff development programs and a contract with the previous NICU clinical practitioner for consultative services helped to ease the transition. NICU pharmacists currently provide inservice education to medical residents and the nursing staff, provide drug information, monitor drug therapy, perform pharmacokinetic monitoring, are involved in research, and work to streamline satellite operations. For one of every four months, the NICU pharmacists primarily provide clinical services; the remainder of the time clinical activities are combined with drug distribution responsibilities. The staffing schedule has enabled the department to extend the hours that clinical services are available. The NICU pharmacists maintain secondary areas of staffing, and other pharmacists periodically staff the NICU satellite. Staff pharmacists in the NICU pharmacy satellite developed clinical skills that permitted integration of clinical and distributive pharmacy services.