- Section 4
“Hospital pharmacists should have access to the patients’ health record. Their clinical interventions should be documented in the patients’ health record and analysed to inform quality improvement interventions.”
What does it mean for patients? In the interest of patient safety the patients’ health records should be complete, exhaustive and include all contributions provided by all health care professionals involved in their care, including interventions made by hospital pharmacists.
What does it mean for healthcare professionals? Healthcare professionals can expect hospital pharmacists to contribute to patients ́ health records ensuring they are complete, exhaustive and accurate. This includes pharmaceutical advice, recommendations and all interventions conducted by the pharmacy team. The documentation is also necessary to support any therapeutic decision by doctors.
What does it mean for Hospital Pharmacists? Hospital pharmacists are accountable for their practice, including pharmaceutical advice, validation and any recommendation. All interventions should be documented in the patients’ health records for reasons of traceability, necessity, and patient safety. Hospital pharmacists should contribute in the definition of procedures and a classification system of such records.