Assessing the Need for a Pharmacist in the Emergency Department of an IHS Hospital

Tuba City Regional Health Care Corporation (TCRHCC) is a tribally operated, 73-bed, regional hospital with adjacent outpatient clinics providing service to 75,000 Hopi, Navajo, and Paiute tribal members located on more than 7,000 square miles of the western Navajo Nation. Each year, the TCRHCC’s pharmacy department dispenses approximately 300,000 medication doses to all areas of the hospital, including the emergency department (ED). The ED is one unit of the hospital in which the pharmacy department does not review medication orders prior to their administration by nursing staff. The orders are retrospectively reviewed and entered into the computer system after the medications have been administered and the patients have left the facility. This process bypasses various clinical interventions that a pharmacist would perform when entering a medication order for a patient. The only situation when pharmacists are directly involved in the ED is during a code blue. This model of pharmacy practice is similar for most hospitals within the IHS.