Progressive pharmaceutical services in a small community hospital.

The pharmaceutical services in an 86-bed community hospital in rural Maine are described. With a staff of two full-time pharmacists, one hospital pharmacy resident, and 2.6 full-time equivalent technicians, the pharmacy department operates a 24-hour unit dose drug distribution system with complete i.v. admixture services. In addition, the department supervises nurses on medication administration and i.v. therapy teams. Clinical pharmacy services include patient-education programs, protocols giving pharmacists responsibility for initiating and monitoring specific drug therapies when authorized by a physician, and concurrent antibiotic review. The department publishes a bimonthly newsletter for physicians and nurses and a quarterly newsletter for hospital employees and patients; it also conducts continuing-education programs for nurses. By maintaining a delicate balance between creativity and practicality, pharmacists in small hospitals can develop progressive services.