Nutritional support: pharmacists' influence on the prescribing process.

A commitment was made at a 1,025-bed county teaching facility to increase staff pharmacists' involvement in nutritional support and physician prescribing. The plan was to utilize the Nutritional Support Clinical Pharmacy Specialist (NSCPS) to train the staff pharmacists to provide direct patient care for patients receiving parenteral nutrition. The implementation included specialized training for staff pharmacists, staff pharmacists monitoring all parenteral nutrition patients, pharmacists' attendance at nutritional support rounds, documentation of all pharmacist interventions, and pharmacists' involvement in the drug-usage evaluation (DUE) process. The results of the increased influence of pharmacists on the prescribing process included more appropriate parenteral nutrition therapy, earlier transitioning from parenteral to enteral nutrition, recognition of staff pharmacists as resources by the physicians, and increased job satisfaction for pharmacists.