T3 - Pharmacy Workflow Flashcards
What is the medication use process?
A multistep process in which a drug travels from the pharmacy to the patient.
What are the steps of the medication use process?
- Prescribing
- Transcribing/Documenting
- Dispensing
- Administering
- Monitoring
What is the purpose of the medication use process?
- The ultimate goal is to provide safe and effective medication management
- YOU are responsible for patient safety throughout the process.
- This process is a safeguard for patients and a safeguard for you
What is the ordering and verification step in a hospital pharmacy?
The pharmacist reads the order and verifies it in the pharmacy computer system.
What is the ordering and verification step in a community pharmacy?
- A direct copy of the order is transported by the patient, faxed/scanned to the pharmacy, or the prescriber’s computer entry system (e-prescribing) to the pharmacy order entry system.
- Order is read and entered into the pharmacy computer system
What is the preparation and dispensing step in a community pharmacy?
Pharmacist uses the patient counseling session to further assess that the correct medication is being dispensed and that the patient has a condition treatable with the product being provided.
What is the preparation and dispensing step in a hospital pharmacy?
The medications are delivered to the patient’s care area. Medications are stored in a variety of areas that include individual patient cassettes/bins or automated dispensing cabinets (ADCs).
What is the administration step in a hospital pharmacy?
- The nurse obtains the drug and compares the medication and pharmacy label against the copy of the physician’s order, as well as the MAR/eMAR.
- The nurse administers the dose, giving the drug’s name, explaining the drug’s purpose and potential adverse effects, and answering questions and concerns raised by the patient.
What is the administration step in a community pharmacy?
In the community pharmacy setting, pharmacists mainly only administer immunizations, not oral, injectable, or insertable medications
What is a typical community pharmacy workflow?
- Drop off
- Order Entry
- Manual fill
- Verify
- Point of sale
How does community workflow differ?
- Rx must be entered into the system
- Medications are dispensed directly to the patient
- Involves direct patient counseling
- Primarily administer immunizations
How does institutional workflow differ?
- Rx may entered automatically upon ordering
- Medications are dispensed to patient care areas where they are administered by health care professionals
- Counseling may or may not be done by the person administering (often not the pharmacist)
What does drug distribution in an institutional setting look like?
Combination of centralized and decentralized
What is centralized systems?
Include traditional manual systems and fixed robotic systems (i.e., robot or carousel) utilizing bar-code technology (e.g., cart-fill)
What is decentralized systems?
Include medications dispensed directly to the health care provider via automated dispensing cabinets (ADCs), satellite pharmacies, or floor stock systems
What is unit-dose dispensing?
Preferred method because the medication is in a form ready to administer to the patient with appropriate labeling
What medication carousel examples?
Pyxis and Omnicell
What are the ADC examples?
- Pyxis MedStation
- Omnicell XT
- AcuDose
- Cerner RxStation
- NexsysADCTM – Capsa Healthcare
What are ADC advantages?
- Medications are secured until orders are reviewed and verified by the pharmacist.
- Nursing staff spends less time inventorying controlled substances.
- Patient care units receive efficient and timely supply of medications.
- Medication security and controlled substance accountability is increased.
- First doses for stat medication orders are easily accessible.
- Drug administration billing efficiency is increased.
Where are barcode scanners used?
Used in both community and institutional settings
Added layer of safety
Ensure the correct item is removed from stock
Barcoded labels generated
Barcode scanner in patient care units double check that medication added and ADC location are correct
What are pharmacy technicians?
- Support the pharmacist with order fulfillment
- Manage all tasks not requiring a pharmacist’s direct participation or judgment (e.g., third-party reconciliation, general inventory management, etc.)
- Free time for the pharmacist to perform professional responsibilities
- Certification and CE may be required
What are Pharmacy Clerks (Cashiers)?
- Manage certain tasks in the store
- Usually work the cash register in the pharmacy
- May assist with accepting new prescriptions, triaging customer inquiries, and helping to answer general questions
What is the ratio of technicians to pharmacist?
3:1
What can pharmacy technicians do?
- Prepare prescriptions to be dispensed
- Attach labels to bottles
- Obtain and replace medications/supplies from the shelves as part of preparation
- Type in prescription and patient information
- Send and receive prescription refill requests and PAs (primarily by fax)
- Resolve third party insurance claims
- Transfer and pre-package as a unit-dose medication in institutional settings
- Prepare prescriptions in institutional setting
- Ensure proper medication storage in institutional setting
- Record patient information in the electronic health record (EHR)
- Reconstitute oral solutions/suspensions
- Compound sterile solutions, small-volume injectables, etc.
- Prepare IV medications
- Conduct medication histories in institutional setting
What is the stock bottles?
The containers medications arrive in, before they are separated and prescribed to patients
What are the controlled substance labeling?
Must indicate the schedule of the drug on the label
What is national drug code (NDC)?
- Universal drug identifier
- Labeler/vendor, product, package size
- Limited to Rx drugs and a few OTCs
- Unique 10-digit, 3 segment number
What is patient packaging?
Unless requested not to do so, all medication shall be dispensed in child resistant packaging.
What are patient package inserts?
required to be dispensed with specific products or classes of products
What are Instructions For Use (IFU)?
dispensed with specific products that have complicated dosing instructions
What are Medication Guides (MG)?
required each time the medication is dispensed
