Post on 06-Feb-2016
description
WHAT YOU NEED TO KNOW ABOUT
HEALTH SCIENCES
NORTH
Orientation to Pharmacy
Overview
Health Sciences North
Pharmacist Rotations
Medication Orders & Pharmacy Communication Forms
HSN Formulary
The Robot ‘Picksy’ & PickRings
Pyxis
Medication Administration MAR: Medication Administration Record
Patient Charts
MEDITECH
Health Sciences North
Main Pharmacy: 3rd Floor Centre Tower
Pharmacist (ext. 5511) 8:00 - 21:00
Pharmacy technician on-site 24 hours daily
Pharmacist on-call 24 hours (ext. 3196)
Pharmacist Rotations
L1: Desk A: Emergency Department B: ICU C: Oncology D: E: Evening G: M: N: R: S: 4th & 5th Floor South Tower X: Cardiology
Medication Orders
Orders can be written by: Physician: MD or Medical Resident with privileges Clinical Clerk : 3rd or 4th year medical student , co-signed by
physician RN Extended Class/Nurse Practitioner Physician Assistant (PA) under a medical directive , which must
be written in the order 2nd year PA students, co-signed by physician
Complete orders include: Patient identification
Name & SH/SI # Date & time Clear legible directives Signature of ordering provider
Medication Orders
Medication Order sheets consist of 3 sections per page 1 white page that remains in the patient chart 1 yellow carbon copy page that is processed
by pharmacy
Orders may be handed to a pharmacist if on the floor or tubed to the pharmacy to be reviewed at the desk
Pharmacy Communication Forms
Pharmacy completes a Pharmacy Communication form when suggesting a change in drug therapy e.g., Initiate, Discontinue, Change
Yellow carbon copy is processed by pharmacy after MD has reviewed suggestion
HSN Formulary
Medications on the HSN Formulary are found using Lexicomp Open Internet Explorer > HSN Intranet > Click ‘LexiComp’
If available the drug will be listed & automatic substitutions as well
The Robot ‘Picksy’ & PickRings
Many Medication Orders that are processed by pharmacy & entered into MEDITECH are assembled by the robot onto plastic PickRings
Picksy, the robot, is located across the hall from the main pharmacy
The Robot ‘Picksy’ & PickRings
PickRings help organize medication administration & prevent omitted or extra dose errors
Medications on the PickRing are organized by administration time & are listed in alphabetical order by generic name
PickRings contain patient medications for a 24 hour period
Pyxis
Pyxis units are used when medications are: missing from PickRings dropped or wasted new orders/first dose
Depending on when the patient arrives to the floor & the bin delivery time, there may not be a PickRing until next delivery time (bins exchanged every 24 hours at specified time for each floor)
STAT orders narcotics benzodiazepines
Pharmacy will send medications not stocked in Pyxis
Medication Administration
Medications are given to patients by the nurse preparing the medication
The nurse administering the medication must confirm patient is wearing a current armband the armband’s patient account number (SI#) & full name
matches the information listed on Medication Administration Record (MAR) prior to administering the medication
Medication Administration
As soon as possible after medication administration, the Medication Administration Record (MAR) should be signed
If medication refused/held/not available, reason for omission recorded in MAR
An asterisk (*) beside an entry in the MAR directs reader to interdisciplinary note for more detailed information
The MAR is a useful toolo e.g., Dosing of sliding scale insulin can be found in the MAR
Patient Charts
Sections:
Emergency Miscellaneous
History / Consults Cardiology
Notes – M.D. Respiratory
Orders Laboratory
Operating Room Blood Bank
Medication ECG
Care Trends Telemetry
IN & OUT Imaging
History / Patient Assessment Legal Issues
Care / Activity
Orders: Physician Order Sheets, Admission Medication Order Record (AMOR)Medication: Medication Administration Record (MAR) (if not in separate binder)Miscellaneous: Long-term care MAR, community pharmacy list
MEDITECH
MEDITECH is the computer program used at HSN for electronic patient records
MEDITECH contains: Patient Demographics Location in Hospital Reason for Visit Allergies Current Medication Orders Laboratory Results Microbiology Results Imaging Reports Notes & Other Reports etc.
MEDITECH
To access information on MEDITECH: Login Pharmacy > Pharmacist Desktop Rounding: allows you to view patients in a specific unit My List: allows you to add patients for quick access
Add > Last name, First name (only partial name needed)
Once a patient is selected, can choose: Patient Profile: demographics, location, allergies, current
orders, etc. EMR: lab results, MD notes, etc. Interventions: to document
MEDITECH
Drug Name
Dose, Route, Frequency
Active, Hold, Discontinued
Start Date
Stop Date
NOTE: This is more of an accounting system, to be sure if patient is receiving medication refer to the MAR
Welcome to Health Sciences North