Transcript institutional pharmacy

institutional pharmacy
aka--hospital pharmacy. prepare IV meds, load Pyxis medstation,
enter data
larger hospitals have satellite pharmacies(ICU, burn, CCU, NICU,
cancer, ect
discharge pharmacy--in hosp rx sent by staff, tube, fax, computer
terms to know---ADS---automated dispensing system
crash cart---has O2, meds, AED, ect
EMAR--electronic medication administration record
floor stock--most common hosp drugs ready to go
prn=(pro re nata)= as needed
the joint commission --nonprofit org that accredits
hosp for Medicare Medicaid
formulary--approved list of meds we carry
https://www.youtube.com/watch?v=qpUEaChXz3w
agencies for inst pharm
• the joint commission---unannounced visit
every 39 months
• CMS---center for Medicare and Medicaid
services. give payment approval and amount
• HHS--health and human services
• DPH--dept public health
• BOP--board of pharmacy
hosp rx
• medication order---rx in a hospital written on pt file
• CPOE--computerized physician order entry---sent to
pharmacy
• or pneumatic tube or hand delivery
• person in hosp will not have name, address,ect. they have
pt med record number.
• Dpharm will likely enter the rx order and machine print out
label for cpht to fill order.
• scan the NDC to verify correct item.
• dpharm verifies then off to the pt.
• STAT order--do it now=priority
• ASAP--priority over new orders
• standing order---list of basic meds to be used for xxxx
surgery so dr doesn't keep writing same rx for same
surgery.
POE system(point of entry)
• electronic access of medical info/meds for med staff to
limit error.maybe handheld scan
• computer will discover dangerous drug interaction,
recommend dosage for dr, medication order goes right
to pharmacy, pt notes can be entered.
• COW=‘computer on wheels’ at pt bedside
• bar code BPOE---nurse can scan in unit dose med.
linked to pharm and EMAR(electronic medication
administration record) to alert nurse of problems.
nurse can ‘email’ pharm of problems and enter pt
status.
• CADM-computerized adverse drug monitoring
institution job details
• work holiday and overnight?
• maybe IV tech, nuclear tech, investigational
drug research(special storage,disposal
• show job descr pg 213
cassette drawers
• new pt gets started dose, meds needed for the
day are loaded into cassette drawer. normally 2
carts per floor that are rotated for use.
• ADS--automated dispensing system. pyxis
medstation 4000 uses employee fingerprint.
keeps track of who got meds and what med.
• UD meds=unit dose meds. must be made by
pharm tech. only meds used constantly.
• UD liquids=TJD requires hosp make the dose
patient specific, then labels, and sent to pt.
controlled substances
• cpht restock and fill narcotics.
• nurse count narcs every shift.
• PAR--periodic automatic replenish.cpht will
make drug order when drug gets low.
• hosp will have their own method for controlled
substances. in brown bag if no ADS.
• you will be signing paperwork with nurse about
drug inventory.
IV prep
• Certified in IV—makes parenteral meds. Required to
have ‘clean room’before entry to compounding area.
This is USP 797.
• Horizontal laminar flow hood
• Biological safety cabinet(vertical flow hood for chemo
agents)
• Glove box
• These need HEPA filter
• ISO class I is cleanest room
• Tech must initial on label, pt name, pt record #, room
#, drug name, strength, name of mixed solution,
infusion rate, does time, date made, exp date
• Expired IV are logged out, disposed.
Hospital terms
• Show pg 222
• Cpht will know what drugs are most used in
hosp sections
• Crash cart—show meds pg 223-adult, pediatric,
neonatal
• If used cpht gives new cart and refills old cart,
look for expired
• Central supply—hosp room that has
instruments, bandages, sterile water, kcl bags.
Lactated ringer. Drugs not stored in central
supply.
advanced pharm tech jobs
pharmacy purchasing agent---order needed drugs daily
meet c sales reps
negotiate prices
find cost-efficient practice
2yr exp, certification
medication reconciliation technician---compare pt med orders
with previous meds.
interview pt about meds and vitamins/herbs
data entry for provider
much experience, get cert if possible
managed care pharmacy technician--work for PBM company(pharmacy benefit management)
develop drug benefits for a large group.
build formularies, negotiate contracts, tell pts their benefits
process claims, do mailorder rx.
advanced pharm tech jobs
pharm tech trainer---work in college or or big chain train new
techs.
need to have ASHP certificate
years exp, BA pharm
pharmaceutical sales rep---travel to sites to promote meds
know the drug well
BA in chem or similar, business,
pharm knowledge, pays well
nuclear pharm tech---compound and dispense radioactive
materials for use in medical procedures.
special training program at a few univ
rare but pays well
telepharmacy---internet comm with dpharm. rural area
pharmacy infomatics--build med info for pharmacy, computer
and pharm exp