RX100 Willow Inpatient Fundamentals - Chapter 8: Dispensing from Central Pharmacy

Question 1

cart record

Answer 1

aka CRT record

Question 2

CRT record

Answer 2

aka cart record

Question 3

cart interval

Answer 3

defines the due times of doses to be included on a cart

the schedule for a cart is configured based on the time the doses are due (the cart interval) and how much time is needed for pharmacy to prepare and deliver this group of medications (the finalize time)

Question 4

cart start

Answer 4

the number of minutes before the interval that the system identifies doses to be included on the cart. only verified orders will be included. labels can print for these doses, and/or they can appear on a paper report. this is OPTIONAL and not used by all carts.

for some carts (typically unit dose carts for meds that are stocked in ADS cabinets, robot, or carousel and need to be manually picked), technicians may prefer to begin gathering ahead of time (start time) and have some updates about changes (like new, modified, or discontinued orders) before the finalize time

Question 5

cart update

Answer 5

the number of minutes before the interval that the system identifies any new or discontinued orders since the previous update. you can run any number of updates between the start and finalize time (use a semicolon between each desired update). labels can print for these doses, and/or they can appear on a report. this is OPTIONAL and not used by all carts.

for some carts (typically unit dose carts for meds that are stocked in ADS cabinets, robot, or carousel and need to be manually picked), technicians may prefer to begin gathering ahead of time (start time) and have some updates about changes (like new, modified, or discontinued orders) before the finalize time

Question 6

cart finalize

Answer 6

the number of minutes before the cart interval that the system stops scheduling doses to this cart. labels and/or paper reports may print.

the schedule for a cart is configured based on the time the doses are due (the cart interval) and how much time is needed for pharmacy to prepare and deliver this group of medications (the finalize time)

Question 7

cart fill update report

Answer 7

organized by patient and include order details such as dose and order start time

typically generated at east start, update, and finalize time

shows changes that occurred since the previous report

used as a “pick list” for technicians to add/remove meds from the cart

Question 8

full cart fill report

Answer 8

typically generated at the finalize time

shows a full list of orders that should be on the cart

used as a final check list for pharmacists reviewing the cart before delivery

Question 9

first dose

Answer 9

doses ONLY generate dispense (cart fill) actions if:

1. the doses are due to be administered during the cart interval

AND

2. the order is verified BEFORE the finalize time of that interval

OTHERWISE, all other doses are considered “first doses” and labels will print when the order is verified so those doses will be filled by main pharmacy

there may be multiple first doses based on the cart interval and finalize times

Question 10

cart dose

Answer 10

doses that are included in the cart delivery

Question 11

how to distinguish between production label and dispense label?

Answer 11

production labels are used for orders that require preparation, like mixtures or custom-drawn syringes
- this label does not include a barcode

dispense labels are attached to the dose being sent to the nurse.
- typically includes a barcode

Question 12

how to identify the number and due times to the doses that a label applies to?

Answer 12

a grouped dispense label will indicate the number of units dispensed (eg. 3 tablets) and this can be compared to the dose (eg. 1 tablet)

Question 13

how to determine if there will be first doses and/or cart doses for an order?

Answer 13

refer to the cart schedule

the schedule for a cart is configured based on the time the doses are due (the cart interval) and how much time is needed for pharmacy to prepare and deliver this group of medications (the finalize time)

Question 14

how is a cart run initiated?

Answer 14

cars run automatically, with no manual intervention

Question 15

how are CRT records designed?

Answer 15

cart (CRT) records can be designed for different types of medications and schedules

Question 16

what “time” parameters are required for a CRT record?

Answer 16

cart (CRT) records must have finalize times

they may optionally have start and update times

Question 17

when are first dose labels printed?

Answer 17

may also be sent to dispense queue

Question 18

how is the number of first doses determined?

Answer 18

reference the cart

Question 19

how and when is each cart fill started, updated, and finalized?

Answer 19

start - when technicians start to pull meds for a cart

update - pre-set times when the report updates so technicians can adjust cart meds based on orders that are new, modified, or discontinued

finalize - cut off time for new verified orders to be included on the cart if doses fall in that interval; orders verified AFTER the finalize time may be first doses if due in that cart’s interval

Question 20

when are dispense (cart fill) actions generated?

Answer 20

ONLY if:

1. the doses are due to be administered during the cart interval

AND

2. the order is verified BEFORE the finalize time of that interval

Question 21

when will labels print in relation to cart fills?

Answer 21

labels are configured in the pharmacy ﴾PHR﴿ record, rather than the cart (CRT) record

the system can be configured to have a production label print if needed, and to print either one label per dose, or one label for a group of doses

labels for cart doses appear with a [CF] in the bottom left corner