elective final Flashcards
(20 cards)
How do we prepare for crisis?
7
1) obtain right meds
2) adequate staffing
3) budgeting
4) stockpiling
5) backorders
6) help from friends
7) don’t burn bridges
what is public health?
4
1) organized community effort
2) prevent disease
3) promote good health
4) rests upon epidemiology
safe medication use is an organizational priority & includes
4
1) event reporting system
2) interdisciplinary med safety team
3) culture of safety built on “just” culture
4) continuous/ongoing evaluation process of all errors that can assess/reduce risks
pharmacy roles in covid-19 vaccination clinics
8
1) procurement
2) logistics
3) metrics
4) DOH reporting
5) reconstitution
6) inoculation
7) recordkeeping
8) maintain integrity of supply chain
ASHP defines significant adverse drug reactions:
to a drug that:
1 & 8
1) unexpected/unintended/undesired or excessive response
requires/necessitates:
1) discontinuing drug
2) changing drug therapy
3) modifying dose
4) admission to hospital
5) prolongs stay in facility
6) supportive treatment
7) negatively affects prognosis
8) harm/disability/death
examples of safety strategies
6
1) barcode technology
2) auxiliary labels
3) SMART infusion pumps
4) commercially available products
5) standard conc., diluents, container size
6) evidence-based standard order sets/protocols
profile of a diverter
7
1) persuasive
2) provide quick explanations
3) chaotic home/personal life
4) has/had legit prescription for drug being diverted
5) in areas where nursing staff have inc autonomy
6) always early/staying late
7) various practice issues (ex. overrides, charting errors, frequent spills)
why divert? (common reasons)
5
1) self med for pain/health issue
2) support addiction
3) cannot manage stress in work/life
4) resell drugs on black market
5) EXPOSURE / EASE OF ACCESS
harm to patient
8
1) sepsis
2) wound infection
3) blood-borne infection
4) contaminated drug
5) transmission diseases
6) undue pain/anxiety
7) unintentional overdose/death
8) substandard care from diverter
efforts to prevent diversion (management level)
6
1) multi-person audits
2) random drug screens
3) drug diversion committee
4) protocol for suspected diversion & next steps
5) staff education on signs/symptoms of diverter
6) report to:
- DEA
- Bureau of Narcotic Enforcement (BNE)
- Department of Health (DOH)
Diversion Examples
4
1) pt gets part/none of prescribed dose while documenting that full dose was administered
2) falsify pt records to steal available drugs
3) inject themselves w drug and refill container w/ water/saline
4) dispense greater amount to pocket leftover meds
red flag warnings
6
1) coming to work when not scheduled
2) dispense meds near/end of shift
3) none/heavy wasting of drugs
4) hold waste until oncoming shift
5) ignore patient med management guidelines
6) medicating pt not under their care or for pt even after they are discharged
common risk points/methods of diversion
5
1) procurement
2) preparation and dispensing
3) prescribing
4) administration
5) waste and removal
return, waste, disposal
6
1) CS in ready-to-use form AKA unit doses
2) expiring products
3) products prepared for administration but not administered
4) drug remaining in transdermal delivery systems
5) maintain chain of custody
6) wasted immediately; as close to time of administration as possible
strategies for handling LASA
5
1) both brand/generic names used
2) tall man lettering / different font
3) indication for use on order
4) limit verbal orders
5) store drugs away from each other and use alerts in storage areas
selection and procurement to decrease risk errors
5
1) formulary assessment/management
2) standard concentrations
3) safety alert monitoring
4) safe procurement
5) medication storage management
examples of pharmacy technology
7
1) CPOE (computerized provider order entry)
2) PYXIS; OMNICELL; unit dose repackage –> (medication/inventory management)
3) MEDEX TraySafe
4) Simpifi 797 - IV Room Management
5) TempTrak
6) Barcode Technology
7) TheraDoc Reporting Tools
ADC Optimization
3
1) Decentralizing Inventory (>90%)
2) Vend:Fill Ratio (8:12)
3) Stock Out Rate (<1%)
Different Types of Drug Alerts in EHR
9
1) Drug-Drug
2) Drug-Allergy
3) Drug-Route
4) Drug-Diagnosis
5) Drug-Age
6) Drug-Laboratory
7) Drug Monitoring
8) Drug Dose Range
9) Excessive Alerts
Pro/Cons of Barcode Technology
Pros:
1) improve operational efficacy
2) enhanced dispensing accuracy
3) decrease med errors
Cons:
1) some barcodes not recognized = overrides
2) relies on barcode scanning equipment to be functional = if broken, cannot scan meds
