Transcript Buyers Taking an Active Role in Patient Safety

Buyers Taking an Active Role in
Patient Safety
Patrick Gallagher, CPhT
Pharmacy Buyer
Marian Medical Center
How Buyers can play a Key Role
It’s not just about ordering drugs and processing invoices anymore!
As a Buyer, it is important for us to learn more
How Buyers can play a Key Role
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Past expectations of the Pharmacy Buyer
How the position has evolved (Buyers are
CPhT , full time person, 340B Accounts)
Buyers role in patient safety
Future expectations of Pharmacy Buyer
(National Certification)
What is the bottom line?
High-Alert Drugs
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Identified by ISMP, Joint Commission, IHI and others
High potential for causing errors in the medication
use system
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Selection
Storage
Ordering
Dispensing
Administering
Monitoring
High-Alert Core List
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Concentrated electrolytes
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Potassium chloride
Potassium phosphate
Sodium chloride greater than 0.9%
Insulin
Anticoagulants
Narcotics and opiates
Heparin 10,000 unit vials
Unsafe Storage: Insulin Jumble
CHW High Alert Medications 2010
Insulins
Concentrated Potassium and Sodium Solutions
(KCL, Kphos, NaCl > 0.9%)
Chemotherapy Agents
Therapeutic Heparin
Neuromuscular Blocking Agents
Epidurals & any opiate intrathecal or other analgesic drip administered into the
central system
Any Opiate administered by PCA, NCA or IV drip
(Morphine, Hydromorphone, Meperidine, Fentanyl)
Oxytocin (Pitocin) drip
Magnesium Infusion > 4 Grams
Neonatal or Pediatric medications in facilities
with low volumes of these patients
Additional High-Alert Drugs
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Chemotherapy
Drugs used in neonates and pediatrics
TPN
Sterile Water
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Injection larger than 10 mL
Irrigation bags
Others as determined by the hospital
It’s also not about saving money, it’s
about saving lives!
Objective 1: Identifying a Problem
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Identifying a possible danger to patient
safety.
Verifying/ validating a potential problem to
patient safety.
Alert the person(s) of authority of the
problem ( notify manufacturer, notify ISMP.)
Alert others that may be affected of this
potential problem.
Too many LASAs!
If it doesn’t look right, or you don’t feel
right about it, it probably isn’t right
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Most Pharmacists will thank
you if you question it
You should feel good about
bringing it to someone’s
attention, especially a high
alert drug
It takes a series of little things
to create one big error
The Swiss Cheese Model
Objective 2: Make Change
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Use your own resources.
Talk to your co-workers.
Consult your colleagues / buyers.
Consult other buyers/ wholesalers that you
have met through NPPA.
By speaking up you become a wing
man, no…not Batman!
Fentanyl IV PCA
Morphine IV PCA
Dilaudid IV PCA
Epidural
Objective 3: Going Public with Change
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Getting the word out for change.
Ask for feedback from people that may be
involved in change.
Always be willing to listen and expand on
initial idea.
Monitor / listen to new ideas.
CADD Cassette
CADD Cassette Epidural
Heparin Bag
Patient take home meds from the ER
Department
Any Questions?