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Ashenfelter's FVH career combines chemistry, care

Thursday, November 8, 2012

This automated dispensing cabinet to provide medication to Floyd Valley Hospital patients is one change hospital pharmacy manager Jerry Ashenfelter, of Le Mars, has seen in his 30-year career at the hospital.
Most Floyd Valley Hospital (FVH) patients never see the Le Mars man in the white lab coat who works with nurses and doctors to offer quality care when medication is needed.

Jerry Ashenfelter, FVH pharmacy manager, leads a staff of three to provide patients with different kinds of medication from pills to IVs.

Ashenfelter spends more time at a computer than he did when he started his career at the hospital using a typewriter 30 years ago.

"Everything was done manually -- paper receipts, paper records," Ashenfelter recalled. "Now it's all done by computer so we're on the keyboard a lot."

He said a computer helps him look for drug interactions and dosages for patients who come through the emergency room receive.

Ashenfelter also said he uses computer technology to set up schedules for medications to be given to patients including IV medications.

He considers computer technology a safer system because some issues with handwritten instructions for patient medications have been eliminated.

Another way he uses computers today is an automated dispensing cabinet for medication.

"When we have a patient with an order for medication we assign the schedule for frequency for the medicine in the computer," Ashenfelter said.

The information entered in the pharmacy department computer is automatically entered in the computerized medication dispensing machine, he said.

"The nurses can see the information, they can bring up the patient's name, see the medication, select it and remove it right from the cabinet," he explained.

The quality control part of the system warns nursing staff if the time the medication is selected is too close to a previous dose and show nurses when the medication is to be given, according to Ashenfelter.

Billing is another part of the automated dispensing cabinet.

"When the nurses remove the medicine from the machine that is recorded and the information is sent to the hospital's billing department," Ashenfelter said.

For security, FVH employees sign in with their identification and the system has a fingerprint recognition for accessing the medication.

Not only has the way medication is stored for patients changed, there are changes in the medication itself since Ashenfelter started his work at the hospital 30 years ago this month.

At that time, diabetics received insulin which had been extracted from animals such as beef and pigs.

"Insulin from pigs is very similar to humans in chemical structure," he said.

Now, a synthetic product is used and is considered identical to human insulin because it is made from recombinant DNA, which is a form of artificial DNA.

The number of medications such as classes of antibiotics has also increased in the three decades he's headed the hospital's pharmacy department, he said.

"As bugs become resistant to it, a new class offers opportunities to treat bacteria that become resistant to other antibiotics," Ashenfelter said.

There's an aspect of his work at the Le Mars hospital he considers especially rewarding.

"That would be when we find issues with patients' medication regime that aren't working well and we can make changes to improve the benefit they have from their medication and prevent interactions, side effects," Ashenfelter said.

Pharmacy services are available 24 hours a day at FVH.

A contract with the hospital's management partner, Avera, of Sioux Falls, S.D., offers electronic processing of medication orders at night and on weekends, he said.

"Sometimes we still get called back in for things like preparing IVs or mixing things but the routine things can be done with a computer and automated dispensing," Ashenfelter said.

Working with medicine wasn't the pharmacist's first career choice.

After a high school interest in chemistry, he studied chemistry at Fort Dodge community college.

"I decided that the prospects for chemistry jobs weren't that great and I had a friend who was going into pharmacy," Ashenfelter said.

The college chemistry credits transferred to the University of Iowa, in Iowa City, where he completed the pharmacy program, he said.

People may be unaware of the number of years pharmacists study the mechanism, effects and side effects of medication, according to Ashenfelter.

"Pharmacy schools are heavy into the sciences and math, the chemistry, biology and physiology course work," he said.

An opportunity to manage a retail pharmacy brought Ashenfelter to Le Mars and he worked briefly for a company which had a contract to provide pharmacy services to Floyd Valley.

In November 1982, Ashenfelter made the switch to being a hospital employee and has headed the pharmacy department ever since.

A part-time pharmacist, Carina Soppe, and pharmacy technicians Nancy Matgen and Tiffany Vanvoorst, are the other department employees.

Patients, and often times their care givers, receive information from the pharmacy department such as how to take medications or what to look for in terms of side effects, Ashenfelter said.

"We always tell our patients we're the community hospital and whether it's at this moment when they're a patient or not, they always have the opportunity to pick up the phone or stop by and ask us questions about their medication," he said. "We don't serve you just if you're in a (patient) bed."

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