Cardinal Health's work with facilities is a great source of information, first-hand knowledge and experience for the guide, Uselton said, especially on insight with regard to the accrediting organizations. "The book is more than just the title suggests. There is information in the eighth edition on the newest accrediting organizations. The guide has information on all the different accrediting organizations."

Uselton points out that a certainty in the industry is that there is always change. That includes some reflection of the growing use of health information technology. "If there is new technology or new processes to ensure better compliance, that creates other issues. There is a never-ending battle; you always have to stay ahead of the curve." Some of the issues in health information technology that have arisen concern handling drugs that have bar coding, or computerized physician order entry. The new technologies usually lead to new elements of surveys, especially with drug safety. "There is a huge focus on medication safety. There is much that can go wrong with drugs. We have to stay one step ahead. Medication safety is probably the most important part of the surveys."


The eighth edition of the guide was put together through the ASHP. All three authors have had experience as hospital staff pharmacists and directors of pharmacies over the years. "We all have a strong operational background and have been through many surveys," Uselton said.

Other aspects of the co-authors' experience adds to the depth of the guide. Murdaugh has a Ph.D in toxicology. So, Uselton notes, "For hazardous products and high-risk drugs, she has a great background to be able to contribute to those topics." Kienle has a special interest and experience in IV preparation. She also has expertise on USP 797 (Pharmaceutical Compounding: Sterile Preparations) standards, so the guide has a chapter devoted to that topic.

Although Uselton and the co-authors built the guide to reflect the surveys, the guide also has information on hospital committees. "We get questions all the time on what makes a good agenda for a pharmacy and therapeutics committee, what should a committee be monitoring in a hospital. The chapter in the book addresses that topic." Most hospitals have a pharmacy and therapeutics committee, and the medical staff on the committee approves all of the medication business for a facility.

in drafting the guide, the chapters were divided between each co-author; all three had around eight chapters to write. Each author's chapters were then reviewed by the co-authors for grammar, content, and technical aspects. "That took place before the book even went to ASHP. Then, ASHP also reviewed it. The review process was very thorough and comprehensive." The edition took almost a year and half to complete. Uselton explained that as a guide is developed, the standards keep changing. "We wanted to make this edition as current as possible when it hit the market. It's a continuing battle to keep up and build the changes into the new edition. That was one of the biggest challenges."

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