Transcript POD Job Action Guides - Alabama Department of Public Health

Just in Time POD
Training Part 2
Roles and
Responsibilities
Facility Manager
Employee of the physical facility
(e.g. school system employee)
with adequate knowledge of
building layout and access to
available equipment, systems and
utilities.
POD Manager
Coordinates and manages all
functions required to set-up,
operate and demobilize a POD
through the Department
Operations Center at JCDH
POD Manager
Duties include but are not limited to:
• Staff direction
• Coordination with EMA and JCDH management
• Coordination of support services (food, supplies)
• Working with facility owner/manager
• Maintain client throughput by adjusting POD
flow as needed
• News media (as directed by PIO)
Triage Clinicians
• Every client/representative must go
through Triage to determine where
medication will be dispensed
• MD/CRNP/RPh will triage and mark/initial
appropriate drug for Express dispensing
• DUR, Family and Support Services will be
referred to expedite the triage process
Clinician in Charge
Duties include but are not limited to:
• Staff assignments, orientation and JITT (Just in Time
Training)for triage clinicians
• Communicates staffing and supply needs to POD
manager
• Functions as Triage Clinician if needed
• Maintains smooth flow of operations
• Makes appropriate referral if client cannot receive
medications available at the POD
• Functions as First Aid/Emergency medical services if
needed
• Assists with demobilization
Team Leader-Clinician
Duties include but are not limited to:
• Assist Clinician in Charge with staff assignments,
orientation and JITT for triage clinicians
• Communicates staffing and equipment needs to Clinician
in Charge
• Maintains smooth flow of operations for the team
• Functions as Triage Clinician
• Monitors team for S/S (signs/symptoms) of stress and
fatigue
• Coordinates breaks and lunch with Clinician in Charge
• Assists with demobilization
Clinician
• Reviews client history form for completeness
• Determines and documents what dispensing line
client should be directed to
• If EXPRESS-determines, documents and initials
medication(s) to be dispensed according to the
ADPH Algorithm and directs client to a Guide
• If Support Services, Family or DUR- marks
form and directs client to a Guide
Nurse in Charge
Coordinates with the POD
manager and EMA to help
prepare the site for client
assessment and dispensing
operations-may also function in a
regular nursing role
Nurse in Charge
Duties include but are not limited to:
• Staff assignments, orientation and JITT including
appropriate labeling and documentation of medication
dispensed
• Communicates staffing and equipment needs to POD
manager
• Maintains smooth flow of operations
• Monitors nursing staff for S/S of stress and fatigue
• Schedules breaks and lunch
• Fills in as needed in any other nurse position
• Assist with demobilization
Team Leader-Nurse
Duties include but are not limited to:
• Functions in the nursing role
• Assists Nurse in Charge with staff assignments,
orientation and JITT including appropriate labeling
and documentation of medications dispensed
• Communicates staffing and equipment needs to
Nurse in Charge
• Monitors team for S/S of stress and fatigue
• Coordinates breaks/lunch with Nurse in Charge
• Assists with demobilization
Dispensing Nurses-Express
• Reviews client history form and determines if
antibiotic chosen is appropriate (e.g. Client has
marked allergy to Cipro and Cipro has been
ordered-take the client history form to the Nurse
Team Leader)
• Provides abbreviated counseling to client and
reinforces verbally the importance of completing
the entire regimen and follow-up instructions
Dispensing Nurses-Express
• Answers any client questions
• Instructs the client to sign the client history form
• Completes documentation and labeling including
BCP precaution sticker
• Dispenses medication, drug information sheet
and PCP referral form (green form)
• Requests supplies as needed using “Supplies
Needed” Sign
Dispensing-Family
• Client history form will be reviewed by
Pharmacist/Pharmacy Student and appropriate
medication determined
• Review Doxy crushing instructions and dosing chart
based on weight for children. If weight is unknown,
estimate.
• Mark appropriate dosage on the instruction sheet and
include each child’s name
• Provide abbreviated counseling to client and reinforce
verbally the importance of completing the entire regimen
and follow-up instructions
Dispensing-Family
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Answer any client questions
Instruct client to sign client history form
Complete documentation and labeling
Dispense medication with drug information
sheet and PCP referral form (green form)
at Pharmacist’s direction
Dispensing-Support Services
• Social Worker, Interpreter or other POD worker may
provide assistance as needed in this area (such as
completing client history form, assisting with
translation or help with unaccompanied minors)
• Client history form will be reviewed by Pharmacist or
Pharmacy Student and appropriate medication
determined
• Provide abbreviated counseling to client and
reinforce verbally the importance of completing the
entire regimen and follow-up instructions
Dispensing-Support Services
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Answer any client questions
Instruct client to sign client history form
Complete documentation and labeling
Dispense medication with drug information
sheet and PCP referral form (green form)
at Pharmacist’s direction
Clinical Supply Coordinator
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Answers directly to POD Manager
Supervises runners
Establishes separate storage area for supplies
In charge of all drugs, forms, supplies and equipment
Receives, organizes and documents drugs/supplies
Maintains adequate security in drug/supply area
Coordinates replenishment orders
Coordinates breaks and lunch for supervised staff
Assists with demobilization
Runners
• Watch for “Supplies Needed” signs to be
displayed at any station
• Provide supplies as requested
• Recycle POD items as needed
• Report any problems with supplies to
Coordinator
• Assist with any additional needs identified
including the Support Services area
Social Worker in Charge
• Responsible for JITT and supervision of non-medical
staff, including volunteers if utilized
• Monitor individuals exhibiting extreme signs of distress,
including staff
• Make appropriate referrals if needed
• Provides assistance with support services
• Assist with client flow if needed
• Provide staff support if needed
• Coordinates breaks and lunch with supervised staff
Social Worker
• Monitor individuals exhibiting extreme signs of
distress, including staff
• Make appropriate referrals if needed
• Provides assistance with support services
• Assist with client flow if needed
• Provide staff support if needed
• Coordinates breaks and lunch with supervised
staff
Clerk in Charge
• Coordinates POD worker registration process (this
includes sign in/sign out and vest pick up/return)
• Responsible for JITT and supervision of clerks in all
areas of the POD
• Maintains clerical supplies (clipboards, forms, pens, etc.)
• Ensures signage is properly displayed
• Maintains staffing/shift rosters
• Observes clerks for signs of stress/fatigue
• Schedules regular breaks
• Assists with demobilization
Team Leader-Clerk
• Assists Clerk in Charge with POD worker
registration process
• Maintains clerical supplies (clipboards, forms,
pens, etc.)
• Ensure signage is properly displayed
• Observe clerks for signs of stress/fatigue
• Coordinate breaks and lunch for clerical staff
with Clerk in Charge
• Functions as a Clerk
Clerk
• Assists with POD worker registration process
• Assist clients with the registration process-this
includes forms, educational material, pens,
labels for medication
• May assist clients with completion of form
• Directs clients to Greeter and POD entrance
• Maintain clerical supplies-request additional
supplies from runner as needed
Greeter in Charge
Duties include but are not limited to:
• Staff assignments, orientation and JITT for Greeter staff
and Team Leaders
• Communicates staffing and equipment needs to Social
Worker in Charge
• Maintains smooth flow of operations (this may include
areas outside of the POD)
• Coordinate breaks and lunch for supervised staff
• Fill in as needed in Greeter position
• Assist with demobilization
Greeter in Charge
*Note: For this exercise only, the Greeter
in Charge will be responsible for Traffic
Control and will answer directly to the
POD Manager. In a real event, traffic
control would be the responsibility of the
Local Law Enforcement Agency.
Team Leader-Greeter
Duties include but are not limited to:
• Assisting Greeter in Charge with staff assignments,
orientation and JITT for Greeter staff
• Communicates staffing and equipment needs to Greeter
in Charge
• Maintains smooth flow of operations (this may include
areas outside of the POD)
• Functions in the Greeter position
• Assists with demobilization
Greeter
• Greet clients as they arrive and answer any
initial questions
• Direct client flow to appropriate areas (may
include areas outside of the POD)
• Identify any issues or needed assistance that
may need to be addressed
• Assist in any other area as directed by Greeter
in Charge
Guide in Charge
Duties include but are not limited to:
• Staff assignments, orientation and JITT for Guide staff
and Team Leaders
• Communicates staffing and equipment needs to Social
Worker in Charge
• Maintains smooth flow of operations-(this may include
areas outside of the POD)
• Coordinate breaks and lunch for supervised staff
• Fill in as needed in Guide position
• Assist with demobilization
Team Leader-Guide
Duties include but are not limited to:
• Assists Guide in Charge with staff assignments,
orientation and JITT for Guide staff
• Communicates staffing and equipment needs to Guide in
Charge
• Maintains smooth flow of operations-this may include
areas outside of the POD
• Coordinate breaks and lunch for supervised staff
• Functions in Greeter position
• Assists with demobilization
Guide
• Serves as gatekeeper and admits
clients into appropriate areas as they
become available
• Assists with client flow-notifies Guide
in Charge of any problems
(bottleneck)
• May escort clients needing assistance
to the appropriate area
Forms
Client History Form
This form is available at http://adph.org/CEP/assets/SNS_NAPH_Form.pdf
Forms Review Flow Chart
Notification to Primary Care
Provider
Referral Form
Doxy client Information Sheet
Patient Information Leaflet
Doxycycline 100 mg tablet
State Public Health Organization:
_________________Alabama Department of Public Health______________
24-Hour Information Telephone Number: _______________________________________________________
Doxycycline is an antibiotic belonging to the group of drugs called tetracyclines. This drug has been given to you
for protection against possible exposure to infection-causing bacteria. This drug prevents ________________.
You have been given a limited supply of medicine. Public health officials will inform you if you need more medicine
after you finish this supply. If so, at your next visit you will be told how to get more medicine. You will be told if
no more medicine is needed. You may also be switched from this medicine to a different medicine based on
laboratory tests. Since the disease associated with _______ can develop quickly and be life threatening, it is very
important that you take all the medicine given to you exactly as recommended by the public health officials.
How should you take this medicine?
 Take one tablet by mouth twice a day unless instructed otherwise.
 Keep taking the medicine even if you feel okay unless your health care provider tells you to stop. If you
stop taking this medicine too soon you might become sick.
 You may take this medicine with or without food or milk, but food or milk may help you avoid stomach
upset.
 If you miss a dose, take the missed dose as soon as possible. If it is almost time for your next dose of
medicine wait until then to take the medicine and skip the missed dose. Do not take two doses at the
same time.
 This medicine has been prescribed for your current condition only. Do not give it to someone else or save
it for use at another time with another infection.
Do NOT take this medication if:
 You have had an allergic reaction to any tetracycline antibiotics such as demeclocycline, doxycycline,
minocycline or oxytetracycline.
 If you have liver disease, if you are or might be pregnant, or if you are breastfeeding, tell the emergency
health care worker before you take this medicine.
Other precautions:
 This medicine increases the chance of sunburn; avoid prolonged exposure to sunlight or tanning
equipment. If you have to be in the sun make sure to use sunscreen (SPF 15 or higher) to protect your
skin.
 Women may get vaginal yeast infections from taking this medicine. An over-the-counter vaginal antifungal
product will help with this problem, or check with your physician or pharmacist.
Serious side effects – call your doctor or go to an Emergency Room:
 If you experience any of these: skin rash, hives or itching; wheezing or trouble breathing; swelling of the
face, lips or throat.
Other side effects:
 Rare side effects can occur that usually do not need medical attention.
 These side effects may go away while your body adjusts to the medicine.
 These side effects include: diarrhea, upset stomach, nausea, sore mouth or throat, sensitivity to sunlight,
or itching of the mouth or vagina lasting more than 2 days. If you get diarrhea consider adding yogurt or
lactobacillus to your diet. A re-hydration solution such as Pedialyte® is helpful if you have severe diarrhea.
Talk with your doctor or pharmacist if any of these side effects become bothersome.
Cipro client Information Sheet
Patient Information Leaflet
Ciprofloxacin 500 mg tablet
State Public Health Organization:
Alabama Department of Public Health____________
24-Hour Information Telephone Number _____________________________________________
Ciprofloxacin is an antibiotic belonging to the group of drugs called quinolones. You have been given this drug for
protection against possible exposure to infection-causing bacteria. This drug prevents ___________________.
You have been given a limited supply of medicine. Public Health officials will inform you if you need more medicine after
you finish this supply. If so, you will be told how to get more medicine. You will be told if more medicine is needed. You
may also be switched from this medicine to a different medicine based on laboratory tests. Since the disease associated
with _____________ can develop quickly and be life threatening, it is very important that you complete the full course
of therapy recommended by public health officials.
How should you take this medicine?
 Take one tablet by mouth twice a day unless instructed otherwise.
 Special dosing instructions for children will be provided
 Keep taking your medicine even if you feel okay, unless you doctor tells you to stop. If you stop taking this
medicine too soon, you may become ill.
 You should take this medicine will a full glass of water. Drink several glasses of water each day while you are
taking this medicine. It is best to take this medicine 2 hours after a meal.
 If this medicine upsets your stomach, you may take it with food. However, do not take this medicine with dairy
products such as milk, yogurt, or cheese.
 If you miss a dose, take the missed dose as soon as possible. If it is almost time for your next dose of medicine,
wait until then to take the medicine and skip the missed dose. Do not take two doses at the same time.
 This medicine has been prescribed for your current condition only. Do not give it to someone else or save it for
use at another time with another infection.
Do NOT take this medication if:
 You have had an allergic reaction to ciprofloxacin or other quinolone antibiotics such as gatafloxacin (Tequin ®),
levofloxacin (Levaquin®), norfloxacin (Noroxin®), ofloxacin (Floxin®) or nalidixic acid (NegGram®).
Other precautions:
 If you have epilepsy, kidney disease, or if you are pregnant, become pregnant or are breastfeeding, notify
emergency healthcare workers before you start taking this medicine.
 Until information is obtained about which drug is most effective against _________, medical experts from the
Centers for Disease Control and Prevention and the American College of Obstetricians and Gynecologists
recommend children and pregnant and breastfeeding women receive ciprofloxacin to prevent life-threatening
complications of _________. If you are currently breastfeeding and have concerns about exposing your baby
to ciprofloxacin, you may consider discarding the breast milk until you have finished the medication.
 This medicine may make you dizzy or lightheaded. Avoid driving or using machinery until you know how it will
affect you.
 This medicine increases the chance of sunburn. Avoid prolonged exposure to sunlight or tanning equipment. If
you have to be in the sun, make sure to use sunscreen (SPF 15 or greater) to protect your skin.
Serious side effects – call your doctor or go to an Emergency Room:
 Skin rash or hives; swelling of the face, throat, or lips; shortness of breath or trouble breathing; seizures; or
severe diarrhea.
Other side effects:
 Rare side effects can occur that usually do not need medical attention
 These side effects may go away while your body adjusts to the medicine
Doxy Crushing Instructions
Labeling and
Documentation
Doxycycline 100mg
SNS label includes:
•Name of Drug
•Strength
•Dosage
•Quantity
Doxycycline 100 mg
SNS tear off label
for client History Form
Includes:
•Name of Drug
•Quantity Dispensed
•Lot Number
•Expiration Date
•Prescription Number
•National Drug Code
For this exercise….
Colored-coded labels (shown below) will be used
to simulate the SNS tear off label. *Do not tear
off SNS label.
Doxycycline 100 mg
#20 tabs
Ciprofloxacin 500 mg
#20 tabs
Labeling for Dispensing
ADPH-Donald Williamson, MD
Emergency Prescription-June 5, 2014
For questions call 1-866-543-9899
client________________________
This label will be
provided at
registration-client
will write in name.
In a real event,
this label would
be affixed to the
medication bottle,
but not for this
exercise.
Labeling for Dispensing
This sticker will be
added to medication
if client marks “Yes”
to Birth Control Pills
This Antibiotic may decrease the
effectiveness of birth control pills
Documentation
Client history should be completely filled out.
This includes client name, address, phone
number and medical history on each person
represented on the form. Weights and birthdates
for children may be estimated. Forms should be
checked at every step of the POD process for
completion. Form must be authorized and
signed by the client picking up the
medications at the time of dispensing.
Documentation
At Triage, the Clinician will determine if the client
and all household members are eligible to receive
medication through EXPRESS dispensing. If so, the
clinician will determine the medication to be
dispensed, circle it and initial. Then he/she
will circle EXPRESS at the bottom of the form and
send the client to a Greeter. Clients not eligible for
EXPRESS dispensing will be sent to the
appropriate line for dispensing by a Pharmacist.
Documentation
Documentation
The Dispensing Nurse or
Pharmacist will have the client sign
the form, apply the appropriate
label for the medication dispensed,
print and sign his/her name, fill in
POD location and date.
Questions?
Call or email:
Julie Cobb, RN
Jefferson County Department of Health
Emergency Preparedness and Response
205-558-2124
[email protected]