Development of an operating room pharmacy substation on a restricted budget.

Pharmaceutical services implemented in an operating room (OR) pharmacy substation without addition of staff in a 764-bed teaching hospital with 22 operating rooms are described. In 1984 an interdepartmental task force recommended that pharmacy take control of responsibility for controlled drugs used in anesthesia. The anesthesia department contributed space for a pharmacy substation and some of the necessary equipment. Two technicians staff the substation (1.5 full-time equivalent positions); pharmacy contributed 0.5 FTE and the additional FTE was obtained through staffing adjustments in other departments. Anesthesiologists and nurse anesthetists obtain controlled drugs directly from the technicians, and records of drug disposition are compared with inventory twice daily. The substation also handles exchange carts for noncontrolled drugs for anesthesia and for other drugs used in the operating rooms. Total cost (additional cost to pharmacy and other departments) for operating the substation for its first year was +2161, and there were no unresolved discrepancies in controlled drug accounting. Undocumented use of noncontrolled drugs has been reduced by 67%, and cooperation and communication between the pharmacy and anesthesia departments has improved. Substation personnel do not prepare intravenous admixtures or provide clinical services. An operating room substation staffed by technicians 10.5 hours daily Monday through Friday provided cost-effective pharmacy control of drugs used in the OR.