test 3 Flashcards
5 parts of medication use process
Medication prescribing, transcribing/verifying the order, medication dispensing, medication administration, medication monitoring
mediation reconciliation
identifying most accurate list of medications the patient is taking, name, dosage, frequency, route
current vs list of prescribed meds
nurses station
communication center for patient care - medications stored
LPN/LVN
Licensed practical/vocational nurse
MSW
master of social work
central pharmacy
bulk hospital inventory, open 24/7
satellite pharmacy
smaller pharmacy, located in patient care units, provides first doses of meds, limited hours
outpatient pharmacy
processes prescriptions for patients leaving or visiting the doctor, like retail
formulary
selected by healthcare professionals based on therapeutic factors and cost - committee maintains it
closed formulary
hospital carries only formulary meds
non-formulary meds
not on the formulary - not regularly stocked
P & T committee
doctors, pharmacists, nurses, review medications for the hospital formulary, evaluate medication use, provide guidelines and protocols for medications
therapeutic interchange
allows the pharmacist to change a medication to therapeutically equivalent formulary medication
CPOE
computerized physician order entry
MAR
medication administration record: tracks meds administered to a patient
STAT order
takes priority over standing and PRN
manual order processing
slower, taken by multiple people before pharmacy
automated order processing
computer to send orders to the pharmacy computer system
Organization of medications in a hospital
usually by ROA then dosage form
unit dose system
packaged oral medications for the nursing unit in medication carts- 24 hour supply of drugs for each patient
automated dispensing cabinet
most common unit dose medications in that area - nurses can get meds quickly but only after pharmacist reviews and verifies order
TPN
total parenteral nutrition - essentials given to patient through IV
TJC
The Joint Commission
CMC
Centers for Medicare and Medicaid
DPH
Department of Public Health
BOP
State Board of Pharmacy
USP
US pharmacopeia
DEA
Drug Enforcement Administration
OSHA
Occupational Safety and Health Administration
code chart
different meds and equipment commonly used in emergency situations
each code has a lock to be broken when needed to be used, medication drawer must be replaced, techs fill the med trays and charge the missing medications to the appropriate patients
main drivers for home health care services
DRG and hospital reimbursement - pt quality of life better at home - high-tech infusion devices
drugs in home infusion therapy
antibiotics, nutrition, chemo, iontropic therapy (inc heart), pain management, other: hydration, steroids, aniemetics
pharmacists role in home health care pharmacy
patient admin , care coordination and planning, sterile product prep, clinical monitoring, patient edu, documentation of activities, on-call responsibilities
process in home health care pharmacy
Plan, implement, follow-up: monitor and evaluate
appropriate therapy and patient selection for home infusion
professional issues: know what drugs are for home admin and how to monitor patients at home, confidentiality and HIPPA
social issues: edu level, candidate suitability
economic issues
cost-effective or alternative treatments for physicians
strategic objectives for providing home health care
improve safety and qulity, profitable and charitable relationship, patient and employee satisfaction
ambulatory care definition
medical services in outpatient basis without admin to a hospital or other facility
settings of ambulatory care
surgical centers, hospital outpatient, offices of physicians
role ambulatory care pharmacist
direct patient care and medication management, long-term relationship with patients, coordinate patient care, advocate for patients, promote patient health and wellness, educate patients and train the to self-manage, perform triage and referral services
prescriptive authority
limited authority to prescribe certain medications for pharmacists
collaborative practice/collaborative drug therapy management (CDTM)
relationship between pharmacists and prescribers to manage drug therapy within a defined protocol
requirement of ambulatory care
PGY-1 residency, PGY-2, Board of Pharmacy Specialties (BPS) certification preferred (BPS)
MSL responsibilities
form relationships with Key Opinion Leaders (physicians or others with influence) - unbiased exchange of information
concentrate on a specific therapeutic area and disease state
work through product’s lifecycle to ensure products utilized effectively
MSL can talk about off-label use and research outside approved FDA indications
nuclear pharmacy
prepares and dispenses radioactive material tagged to a pharmaceutical drug - used to diagnose and treat specific diseases
CT
computerized tomography detailed picture of body tissues - 3D image
MRI
Magnetic Resonance Imaging- structural image created - healthy and diseased tissue- cant use if pt has metal in body - pulse of radio waves cause water molecules in the body to align
PET
Positron Emission Tomography, shows actual function of the body, requires radiopharmaceutical: releases two gamma particles at exactly 180 degrees
Gamma Imaging
Mo-99 to Tc-99 m, useful for stress test (heart), bone, gall bladder, lung, kidneys
where most nuclear pharmacies located
large medical centers, most outside of a hospital or clinic - 14 in AL
ALARA
As low as reasonably achievable - special equipment to work
training for this area
200 classroom ( contact hours), 500 hours supervised learning
LTC facilities
nursing homes, assisted living facilities, intermediate care facilities, group homes, psychiatric, rehabilitation, juvenile detention centers
consultant pharmacists
maintain quality assurance, medication distruction, maintain individualized plan for every resident
certification of LTC nursing homes and assisted living facilities
every year- every 3 years,
beers list
inappropriate for the elderly- undesirable side effects, increased conc on the geriatric patients
STOPP
Screeing Tool of Older Person’s Potentially inappropriate prescriptions, considers diagnosis, psych status, activities of daily living of the patient to gauge appropriateness of a medication, not the one-size-fits-all approach of the beers list
