3_Enabling Safe and Efficacious Medication Use

Question 1

a system of interconnected parts that work together to achieve the common goal of safe and effective medication therapy.

Answer 1

Medication Use Process (MUP)

Question 2

Parts of MUP

Answer 2

• people
• system
• procedures
• policies

Question 3

MUP is commonly ______ and uses several forms of health information technology (HIT)

Answer 3

cyclical

Question 4

MUP is commonly cyclical and uses several forms of _________

Answer 4

health information technology (HIT)

Question 5

Name the 5 steps in the MUP

Answer 5

Prescribe > Transcribe > Dispense > Administration > Monitoring > back to prescribe

Question 6

identify the HIT:
computer programs that use electronic data and predetermined set of rules or guidelines to IDENTIFY ADE when occurs or is about to occur.

Answer 6

Adverse Drug Event (ADE) Monitoring

Question 7

identify the HIT:
automated devices with a range of function: medication storage and retrieval for administration, medication charging, and automated inventory management.

Answer 7

Automated Dispensing Cabinets (ADCs)

Question 8

identify the HIT:
ensures that the 5 RIGHTS OF MEDICATION ADMINISTRATION is followed at the point of care.

Answer 8

Bar Code Verification

Question 9

identify the HIT:
computer programs that AUGMENT clinical decision making by combining referential information with patient-specific information to prevent negative actions and update providers of patient status.

Answer 9

Clinical Decision Support System (CDSS)

Question 10

identify the HIT:
allows provider instructions (e.g., prescriptions, clinical notes) to be electronically entered for the treatment of patient who are under a provider’s care

Answer 10

COMPUTERIZED PROVIDER ORDER ENTRY (CPOE)

Question 11

what are the 5 RIGHTS OF MEDICATION ADMINISTRATION

Answer 11

drug, dose, route, time, patient

Question 12

identify the HIT:
electronic version of traditional medication administration records with support from CDSS and Bar Coding Verification

Answer 12

ELECTRONIC MEDICATION ADMINISTRATION RECORD (eMAR)

Question 13

identify the HIT:
Enables real-time documentation and billing of medication administration.

Answer 13

ELECTRONIC MEDICATION ADMINISTRATION RECORD (eMAR)

Question 14

identify the HIT:
a process where prescriptions are made electronically, verified and then processed resulting in a labelled medication product with supportive documentation and shareable patient medication profile.

Answer 14

ELECTRONIC PRESCRIBING

Question 15

identify the HIT:
software-driven medication pumps that help eliminate pump programming errors using standardized drug database and dosing parameters.

Answer 15

INTELLIGENT INFUSION PUMPS (SMART PUMPS)

Question 16

identify the HIT:
similar to ADE monitoring, built with logic rules to aid in monitoring specific aspects of patient care.

Answer 16

RULES ENGINES

Question 17

4 focus of The Meaningful Use Program

Answer 17

• improve quality, safety, and efficiency of information transfers
• engage patients and families about important health information
• improve care coordination among healthcare providers
• maintain privacy and security of health information

Question 18

It refers to a form of clinical informatics that focuses on the following:
* use of information,
* use of information technology, and
* use of automation technology to ensure safe and effective medication usage.

Answer 18

Pharmacy Informatics

Question 19

Two Information Categories used in Pharmacy Informatics.

Answer 19

• Patient-specific information
• Knowledge-based information

Question 20

Information Categories used in Pharmacy Informatics created and applied in the process of caring for individual patients

Answer 20

Patient-specific Information

Question 21

examples: medical/medication history, physical assessments, laboratories test
and interpretations.

Answer 21

Patient-specific Information

Question 22

information commonly stored in health care facilities

Answer 22

Patient-specific Information

Question 23

a field where patient generates and manages their health information in addition to traditional settings. This field may include internet-based systems and DTCA.

Answer 23

Consumer Health Informatics

Question 24

forms the scientific basis of healthcare which includes referential information

Answer 24

Knowledge-based Information

Question 25

example: clinical practice guidelines, medication literature

Answer 25

Knowledge-based Information

Question 26

Pharmacist and other healthcare providers makes use of a ________ of patient- specific and knowledge-based information to create safe and effective therapeutic plans.

Answer 26

combination

Question 27

3 key issues in pharmacy informatics

Answer 27

1. Interoperability 2. Lack of Government Initiative 3. Security, Privacy, and Confidentiality of PHI

Question 28

in the PH, there is no coordination of EHRs for patients. It is not even recorded in the community setting. This is most likely to result in uncoordinated medication therapy or even oversight.

Answer 28

Interoperability

Question 29

in the PH, there is no coordination of EHRs for patients. It is not even recorded in the community setting. This is most likely to result in _______________

Answer 29

uncoordinated medication therapy or even oversight.

Question 30

there is no hospital to community or community branch to branch interoperability, every patient is treated like a new patient every time.

Answer 30

Interoperability

Question 31

in the PH, the gov’t with DOH and other health offices are not keen into showing more support for Pharmacy Informatics.

Answer 31

Lack of Government Initiative

Question 32

There are no programs like “The Meaningful Use Program” in the US that pushes for innovation and technological advancements in the general health care.

Answer 32

Lack of Government Initiative

Question 33

PHI means

Answer 33

protected Health Information

Question 34

despite presence of data privacy act, it is still a concern on how effective this measures are in the protection PHI of patients.

Answer 34

Security, Privacy, and Confidentiality of PHI

Question 35

professional standards, policies, and regulations must be made to instruct different professionals on their specific roles towards managing PHI.

Answer 35

Security, Privacy, and Confidentiality of PHI

Question 36

restricting access to PHI only to authorized people

Answer 36

security

Question 37

being free from unauthorized intrusion and protection of PHI

Answer 37

Privacy

Question 38

limit of access or restriction to certain types of information.

Answer 38

Confidentiality

Question 39

In a report published by the Institute of Medicine (IOM), 19% of ADEs were due to ___________

Answer 39

medication errors

Question 40

The ADEs were all related to order entry: (3)

Answer 40

* handwritten reports * manual order entry * use of non-standard abbreviations

Question 41

CPOE and Electronic Prescribing eliminates: (3)

Answer 41

* illegal handwriting * decrease medication errors * delay in order completion

Question 42

CPOE must support clinical workflows that results into ____, _____ and _______ advice and warnings.

Answer 42

clear, concise, and actionable

Question 43

should also be paired with other HITs (e.g., CDSS) to ensure safe and effective medication orders.

Answer 43

CPOE

Question 44

CPOE must have secure access with _________

Answer 44

permanent access logs.

Question 45

CPOE may also cause _______ and may require care setting design changes to improve responsible use of CPOE and other HIT.

Answer 45

alert fatigue

Question 46

alerts and warning forms CPOE or other HITs that appear too frequently may lead providers to ignore or override the CDSS messages.

Answer 46

alert fatigue

Question 47

computing systems that provides intelligently filtered information to clinicians and patients to foster better health processes.

Answer 47

CDSS/CDS

Question 48

3 parts of CDSS

Answer 48

Inference engine, Knowledge base, Communication mechanism

Question 49

brain of the CDSSS, it evaluates the available information with consideration to patient-specific information.

Answer 49

Inference engine

Question 50

composed of various clinical knowledge (e.g., clinical guidelines, diagnoses, drug interactions), it feeds information to the inference engine.

Answer 50

Knowledge base

Question 51

where patient information is entered and feedback from the CDSS is communicated to the clinician.

Answer 51

Communication mechanism

Question 52

Support provided by CDSS: (5)

Answer 52

* diagnosis information * evidence-based treatment plans * medication decision support * dose adjustments * ADE monitoring

Question 53

can help decrease ADEs, costs and length of stay of patients and improve clinical workflow and use of information at point of care.

Answer 53

CDSS

Question 54

Pharmacist are expected to interpret medication orders and assess for any drug- related problems.

Answer 54

Transcription

Question 55

common problems for transcription are similar to the problems mentioned with _________

Answer 55

order entry

Question 56

HIT-associated transcribing errors (use of CPOE) (are not/may still be) encountered.

Answer 56

may still be

Question 57

mistaken inventory display for dosage guideline, fragmented CPOE, inflexible formats resulting to wrong orders

Answer 57

HIT-associated transcribing errors

Question 58

CDSS is very useful in checking drug-related problems but pharmacists must remain diligent in __________

Answer 58

reviewing orders.

Question 59

___________ vary depending in the care setting

Answer 59

Dispensing medications

Question 60

carousel cabinets, ADCs, robotic cart filling system, and sterile compounding devices are common forms of HITs.

Answer 60

Acute Care Pharmacy Setting

Question 61

most HITs in this setting depend on properly assigned bar coding system

Answer 61

Acute Care Pharmacy Setting

Question 62

patient information management system (PIMS), Interactive Voice Response (IVR), e-prescribing, automated counting and dispensing systems.

Answer 62

Community Pharmacy Setting

Question 63

the goals are to fill prescriptions efficiently, keep track of prescription records, provide reminders for pick-up, and monitor inventory.

Answer 63

Community Pharmacy Setting

Question 64

carried out by physicians, nurses, pharmacists, caregiver, or the patient themselves.

Answer 64

Medication administration

Question 65

2 Major HITs in administration

Answer 65

* Bar Code Medication Administration (BCMA) * E-prescribing

Question 66

ensures that the 5 Rights of medication administration is followed.

Answer 66

Bar Code Medication Administration (BCMA)

Question 67

eliminates errors from handwritten Rx and allows real-time updates of medication.

Answer 67

E-prescribing

Question 68

end goal of monitoring is to create ____________

Answer 68

CLINICAL INTERVENTIONS

Question 69

activities that intercedes to modify the medication use process.

Answer 69

Clinical interventions

Question 70

promote safety, quality, efficient and cost-effective medication therapy.

Answer 70

monitoring

Question 71

Monitoring process and clinical interventions should be ________ properly.

Answer 71

documented

Question 72

should be easy to use, fits in the workflow, sufficient with details, flexible with modifications, searchable, and shareable.

Answer 72

Documentations

Question 73

The electronic information systems shifted the vision of healthcare into becoming more _________-centered.

Answer 73

patient