T3: IPC Final New Stuff Flashcards
What are the steps to resolve TPRs?
- Rx accepted/entered at your pharmacy
- Insurance company returns a rejection in real time
- Inform the patient/caregiver
- Notify prescriber and provide guidance for next steps
- Communicate outcome to patient/caregiver
What needs to be provided by the prescriber to resolve a prior authorization rejection?
Documentation
What are the characteristics of a prior authorization rejection?
- May take several days to resolve
- No guaranteed approvals
- May have higher copay
- Communication with prescriber via fax, phone, e-message
- Communicate with patient/caregiver via preferred method
What is a third party payer?
An organization that reimburses a pharmacy or patient for all or part of the patient’s prescription drug costs
What is a private third party payer?
- Insurance company
- May be a manufacturer or other discount programs
What is public third party payer?
Government entities that pay for prescriptions through a government program (Medicaid)
What is medicaid?
Funded jointly by federal and state the governments with each state determining its own prescription drug reimbursement rates
What is medicare?
Government program that provides health insurance for the elderly and disabled, implemented a voluntary Medicare Part D program in 2006
What are the types of third party payers?
- Private
- Public
What is a PBM?
Hired by third parties to provide prescription claims processing and other services
What is the number for poison control?
800-222-1222
What are examples of safe medication practices?
- Be proactive
- Minimize distractions
- Store drugs properly
- Throughly check all prescriptions
- Provide patient counseling
- Repeat and verify phone prescriptions
- Develop positive ways of managing stress
- Organize the workplace and develop routines
- Watch zeros and abbreviations
- Clarify any uncertainties or doubts
How can we be proactive?
- Create a culture of safety
- Report great catches and near misses
How should we patient counsel?
- Show and tell method
- IHS questions
How much of errors are discovered during patient counseling?
83%
How should we repeat and verify phone prescriptions?
Repeat back each piece of information and place a check mark next to that information
How should we organize the workplace and develop routines?
This includes the space, environment, and workflow
How should we clarify any uncertainties and doubts?
Don’t guess
Where do we reports for voluntary practitioner/med errors?
MERP (medication error)
Where do we report vaccines?
VERP
Where can consumers report errors?
C-MERP
What is ISMP?
Used to report med errors
1. MERP
2. VERP
3. C-MERP
What is FDA MedWatch?
Used to report errors and adrs
Online voluntary reporting for health professionals, consumers, and patients
What do you report to the FDA MedWatch?
- Unexpected side effects or adverse events
- Product quality problems
- Product use/medication errors that can be prevented
- Therapeutic failures
How should you report Vaccine adrs?
VAERS
What is VAERS?
- Anyone can submit reports
- Professionals are encouraged to report admin errors and any ADRs that occur after admin whether or not it is clearly vaccine related
What are healthcare professional required to report by law?
- Any adverse event listed in the VAERS table of reportable events following vaccination
- Any adverse event listed by the manufacturer as a contraindication to further doses
What are the common causes of pharmacist errors?
- Prescribing/ordering errors
- Dispensing errors
- Admin errors
What is the prime problem of admin errors?
Communication
What are examples of dispensing errors?
Wrong drug/wrong dose make up about 75% of liability claims
How much does prescribing and ordering errors make up?
50%
What is burnout?
Unproductive occupational stress that does not go away and cannot be managed by the individual alone
How does burn out affect us?
- Impact our own mental health
- It impacts decision making, patient safety, and clinical outcomes
- Health professional are at higher risk
What is resilience?
- The capacity to respond positively and adapt to daily stressors by developing personal resources that allow one to transcend immediate issues
- Return to baseline after a period of adversity
How can resilience lead to growth?
A person becomes stronger emotionally, builds better social relationships, or develops stronger character strengths as a result of challenging experiences
Why does resilience matter?
- Key to preventing burnout
- Key to recovering burnout
How can resilience prevent burnout?
- Insulates us from burnout
- Turns unproductive stress into productive stress
- Promotes growth by drawing on personal strengths and adaptive strategies
How can resilience help recover from burnout?
- Provides a healthy defense mechanism
- Helps replenish our cognitive, physiological, and emotional stores
What are the tools for building resilience?
- Vision
- Self awareness
- Self care
- Boundaries
- Connection
- Tenacity
- Hope
- Gratitude
What is vision?
Get a clear picture in your mind of what you want
What is the action step for vision?
- Discover your why
- Keep your vision in front of you
What is self-awareness?
- Helps build resilience
- Resilience helps replenish our emotional stores
What are the action steps of self-awareness?
- Be attentive (Why impacts me)
- Have a plan (What helps me)
What is self-care?
- Not same as self centered
- Aligning your habits with you vision to create whole person health
- All the pieces of self-care are interconnected
What are the action steps of self-care?
- Take inventory
- Start small
What are the concepts of boundaries?
- Stewarding time (TMM)
- Stewarding energy
- Stewarding relationships
- Stewarding finances
What is connection?
- We are wired for connection
- Connection reduces stress levels in the brain
- Social support may be the single most important resilience strategies
What are the action steps of connection?
- Develop supportive relationships
- Ask for help
- Find a mentor
What is tenacity?
- Persistance in seeking something you desire value
- Choose the frame through which you see yourself and your circumstances
What are the action steps of tenacity?
- Be creative
- Don’t give up
- Keep your vision in front of you
What is hope?
- Desire accompanied by expectation of fulfillment
- Those with high hopes cope better
- It influences emotions
What are the action steps for hope?
- Discover your hope
- Fuel hope
What is gratitude?
Increase happiness, mood, and resilinece
What are the action steps of gratitude?
- Be a good finder
- Acknowledge the gifts
How does mental attitude impact resilience?
- Your brain is malleable and adaptable
- Resilience starts in the mind
How do you calculate CrCl?
What type of body weight we use for CrCl?
Actual < Ideal use Actual
Actual ≈ ideal use ideal
Actual > 130% ideal
How do you calculate IBW?
How do you calculate AjBW?
What is the trough goal of vancomycin?
10-20mcg/mL
15-20 mg/L for severe infections
10-15 mg/L for less severe infections
What is the peak goal of vancomycin?
30-40 mcg/mL
What is the AUC goal for vancomycin?
400-600 mcg/mL
When would you use conventional dosing for gentamicin?
- Renal insufficiency
- Pregnancy
- Ascites
- Burns (>20%)
- Synergy in gram positive infections
When would you use extended dosing for gentamicin?
Preferred method unless contraindicated
What is the conventional dose of gentamicin?
3-5mg/kg/day divided every 8 hrs
What is the extended dose of gentamicin?
5-7mg/kg/day
What is are fishbone diagrams?
What is a visual learning styles?
- Observation
- Pictures
- Written directions
What is auditory learning styles?
- Lectures
- Reading outloud
- Verbal explanations
What is kinesthetic learning styles?
- Touching
- Moving
- Acting
What is reading/writing learning styles?
- Expression through writing
- Reading articles