EXAM 3 lecture 21 Flashcards
(27 cards)
Cabinet
a mechanical storage device for dispensing drugs
consultant pharmacist
a pharmacist who practices pharmacy at a LTCF or other residence other than as a supplying pharmacist
consulting
provision of nonsupply related cognitive services
(not dispensing drugs)
emergency drugs
drugs that are required to meet immediate therapeutic patient needs, and are not available from another source in sufficient time to prevent risk of harm to patients
pharmacist in charge
pharmacist who directs the activities of the institutional pharmacy
Events and conditions definition
quality-related event: inappropriate provision of pharmaceutical services which may result in adverse health incident
reversible condition: condition that requires intervention to resolve in a reasonable time
sentinel event: unexpected occurence involving a serious adverse effect
temporary condition: condition that resolves in a reasonable time without intervention
pharmacist in charge responsibility
- establish and carry out performance improvement program
- develop a policies and procedures manual of sufficient scope and detail to allow safe and effective pharmacy practice, and include: continuous improvement committee and committee review every 3 months
- develop policies and procedures that specify duties to be performed by pharmacy technicians
absence of a pharmacist - cabinet access
Cabinets as a source of drugs:
all cabinets must be properly labeled, packaged in amounts for sufficient maximum of 24 hr use
when drugs are used from the cabinet, they MUST HAVE physician order or accountability record
drugs in cabinets must be reviewed by RPh upon return to duty, not more than 24 hrs later
policies and procedures must be established to implement this section
absence of a pharmacist - pharmacy access
One supervisory licensed nurse in any shift may have access to the pharmacy and may remove drugs
That nurse must record on a form:
Name & strength of drug
Amount
Date & Time
Signature of nurse
Must leave a copy of the order
absence of a pharmacist - emergency drugs
For any emergency drugs, pharmacy policy and procedures must assure the;
Availability, control, and security
of emergency drug carts, kits, or boxes in the pharmacy and patient care areas
procedures must include at minimum:
determination of drugs and quantities of drugs to be included
labeling for expiration date
process for restocking
security measures to prevent unauthorized access
LTCF Emergency Drug Kits
Drug kit for LTCF must be labeled with:
Drug name
drug strength or size
name of manufacturer, packer, or distributor
lot number
expiration date
A nurse removing drugs from emergency kit must document:
Name of patient
Name of the drug
Strength of the drug
Quantity removed
Date and time of removal
Quality Related Events
Any quality related or sentinel event shall be cause for intensive
analysis of causal factors and plans for corrective actions.
Records of processes, analysis, and corrective measures related to
these events must be maintained for at least 2 years.
Quality related events documentation must include:
Each quality related or sentinel event is documented by the pharmacist to
whom it is first described on the same day as it is described
A description of the event sufficient to permit analysis
Pharmacist in charge shall summarize efforts to improve processes
No patient or employee names shall be included in the reporting
A member of the board may review this documentation to assure compliance
Institutional Drug Labeling Requirements
All drugs, other than unit-of-use packages, dispensed by an institutional pharmacy must be labeled with:
A. Patient identification
B. Drug name
C. Strength if applicable
D. Route of administration
E. Quantity
F. Pharmacist’s initials
G. Location of patient within the institution
Institutional Drug Labeling Requirements: Unit-of-use
Unit-of-use packages in an institutional setting must have on their label, at minimum:
A. Drug name
B. Strength, if applicable
C. Control number and/or expiration date
A patient may only self-administer drugs at an institutional facility if specifically authorized by the treating or ordering physician and:
- the patient’s knowledge on self-admin has been evaluated
- the patient has received training in the proper manner of self-admin
- and there is no risk of harm to the patient
May the institutional pharmacy touch drugs that are brought into the institution
NO
only able to destroy the medication
only able to hold rx for 7 days if patient accidently leaves it behind
Use of a patient’s own medication may be permitted if
- the patient can maintain their own medication at beside at the control of nursing personnel if special storage requirements
- nurse in charge of that patient must maintain records of medication use
sterile pharmaceutical
drug free from microbes and chemical or physical contamination
class 100 environment (ISO class 5)
environment containing less than 100 particles 0.5 microns in diameter per cubic foot of air
sterile pharmaceuticals: physical requirements
- environmental control iso class 5
- a sink with hot and cold running water outside the buffer area
- disposal containers
- biohazard cabinetry if hazardous drugs are prepared
- a fridge with a thermometer
- infusion devices if appropriate
- documentation of adequate cleaning and santitizing of environment
- environmental control capable of at least ISO class 8
sterile pharmaceuticals: supply requirements
- needles, syringes, supplies for aseptic mixture
- disinfectant cleaning tools and solutions
- antibacterial hand washing
- disposable towels or wipes
- filters and filtration equipment
- a hazardous drug spill kit
- disposable gowns and gloves
sterile pharmaceuticals: supply requirements
The handbook on injectable drugs
The king’s guide to parenteral admixtures
another board approved electronic database
if there are hazardous drugs being prepared –> need copy of OSHA
