Exam 3 lecture 7 Flashcards
Which section of the law applies to category II and III permit holders serving institutional patients
856 IAC 1-28.1
Define cabinet, consultant pharmacist, consulting, emergency drugs, pharmacist in charge
cabinet- mechanical storage device
consultant pharmacist- pharmacist who practices pharmacy at a LTCF or other residence other than as a supplying pharmacist
Consulting- provision of nonsupply related cognitive service
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
Define quality related event, reversible condition, sentinel event, temporary condition
Quality related event- inappropriate provision of pharmaceutical service which may result in an 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 thta resolves in a reasonable time without intervention
What must a pharmacist in charge do
- establish and carry out a performance improvement program
- Develop a policies and procedures manual of sufficient scope and detail to allow safe and effective pharmacy practice
- Develop poicies and procedures that specify duties to be oerformed by pharm techs
what are things that must happen when using cabinets in hospitals
All drugs in cabinet must be properly labeled and prepackaged in amounts suffieient for a ax of 24 hours of use
What must drugs from the cabnet need to be tied to
need to be tied to physicians order or accountability record.
WHen should drug in cabinets be reviewed by a pharmacust
Up on return to duty and no more thaan 24 hrs later
In the absence of pharmavist, when a drug is not available i the cabinet what must happen?
One supervisory nurse in any shift may have access to the pharmacy and may remove drugs. That nurse must record on suitable form
What are things the supervisory nyrse that has access to pharmacy do and took meds do?
The nurse must record ona suitable form
What are things nurse needs to write downi if drug obatined from pharmacy
Name and syrength of the drugamount
date and time
signature of nurse
copy of the srder
for emergency drugs, pharmacy policy and procedure must assure what
Availability
control and
security of emergency drug carts, kits or boxes in the pharmacy and patient acre areas
What should pharmacy procedures include at a minimum
determination of drugs and quantities of drugs to be included
Labeling for expiration date
process for restoicking
Security measures to prevent unauthorized access
in <TCF emergency drug kits, what must they be labeled with
drug name
strength or size
quantity included
exp date of the kit (earliest expiration of any of the drugs in the kit)
What are drugs contained in ana emergency drug kit for a LTCF be labeled with
Drug name
strength or size
Name of manufacturer, packager or distributon
lot number
exp date
A nurse moving drugs from an emergency kit must document
Name of pt
Name of drug
Strength of drug
Quantity removed
Date and time of removal
What do sentinel events require
Any quality related or sentinel event shall be caused for intensive analysis of causal factors and plans for corrective actions
How long must corrective events need to be documented and kept
at least 2 years
Documentation requirements of quality related events
- each quality related t snetinel event is documented by phar,acist to whom it is first described on the same day it is described
A description of the event sufficient to permit analysis
pharmacist in charge shall summarize efforts to improve process
No patient or employee names shall be included in the reporting
A member of the board of pharmcy
institution drug labeling requirements for all drugs other than unit use packages (inpatient)
patoent identification
drug name
strength if applicable
ROA
Quantity
pharmacist initials
Location of pt within institutuion
drug labeling requirements for unit of dose packages in an institutional setting must have what on their llabel
drug name
strength if applicable
control number and/or exp date
when can a patient self administer drugs in an institutional facotlity
Specifically authorized by th etreating or ordering physician
The patients knowledge of self administration has been evaluated
The patient has received training in th eproper manner of self administration
There is no risk to harm to patient (excess risk between nurse administering it vs patient)
Can an institutional pharmacy tough drugs that are brought into the institution by the patient
It may be an adulterated product
Use patients own meds may be permitted
use of a patients own medication may be permitted if
- patient can maintain their own medications at th ebedside or under xontrol of nursing personnell if special storage requirements apply
- The nurses in charge of that patients care witness the administration and maintain records of med use
biological safety cabnet definition
class 100 environen (ISO class 5 ) definition
syerile pharmaceutical meaning
Bioogical safety cabinet- specialzed enclosed ventilated workspace suitable for preparation of low-moderate fisk agents (hood)
Class 100 environment- environment containing less than 100 particles 0.5 microns in diab=meter in cubic foot of air
Sterile pharmaceutical- a drug which is free from living microbes and chemical/physical contamination
For sterile pharmaceuticals, what are hysical requirements
- environmental control capable of iso class 5
- sink with hot and cold water outside the buffer area for hand washing purposes
- Disposal containers for hazardous drugs
6 refirgerator with thermometer
- Infusion devices if appropriate
- Documentation of adequate cleaning and sanotzing envt
- envtal control capable of at least ISO class 8 conditions in the buffer area
how many particles in class 8
100,000
supply requirements for sterile harmaceuticals
- needles, syringes, and supplies needed for asceptic admicxtures
- disinfectant cleaning tools and solutions
- Antibacterial hand washing agent
- disposable towels or wipes
- Filters and fi;tration equipment if utilized
6 a hazardous drug spill kit if hazardous drugs prepared - disposable gowns and gloves
reference requiremets for sterile pharmaceutica;s
-The handbook on inj drugs
-kings guide to paratentral admixtures
- another board approved printed or electronic database
if a pharmacy is preparing a hazardous drugs, what must they have a copy of
The OSHA requirements for handling hazardpus drugs
sterile product label
- date of rpeparation
- patient name and bed number
- Name of each drug in preparation, strength and amount
- exp date
- identification of ispensing pharmacist and personell responsible for preparing the strile oharmaceutical
- Storage requirements or special warnings as required
What to have on label for sterile product when patient resides at home
Prescription number
prescribers full name
Name, address and telephonenumber of the pharmacy
Directions for use, including infusion rate and date and time of administration
and previous 10 things
When checking drugs that require a exp date what do we consider
IV is sterile so always include exp date
Unt of use packages all need an exp date
where do we need facsiile machine be located
in a non public area of the licensed pharmacy
IAC says that we do NOT transfer C IIs, IC says we may, what do we do
IC»IAC
Make sure that you adhere to electronic transfer method
What is unique about indiana in terms of transfering orescriptions
Uniquely, IN requires DEA numbers to be recorded for all types of yransfers, not just controls.
4 ways to satidyy requirement fpr couseling patoent
Pharmacist counseling ot
Intern/extern counseling and then making a bonafide offer for pharmacist to counsel
If patient is not present and did not authorize individual to receive the info or if the product is delivered a written notice containing the pharmacy phone number and a bona fide offer
any person in the pharmacy making an offer for phar,acist to consel
Where shall counseling take place? WHen should offer take place?
Shall be conducted in person whenever practicable or over telephone if not practicable.
Offer should take place every timr
security features for paper CS blanks (prescriptions)
Void copy appears once it is photocopied
Reflex blue inc
RX on right corner
“Indiana security prescription” watermark on back of the rx blank
can you take a paper CS prescription from another state
Yes
