institutional pharmacy

terms to know----ADS---automated dispensing systemcrash cart---has O2, meds, AED, ectEMAR--electronic medication administration recordfloor stock--most common hosp drugs ready to goprn-pro re nata-- as neededthe joint commission --nonprofit org that accreditshosp for Medicare Medicaidformulary--approved list of meds we carry

aka--hospital pharmacy. prepare IV meds, load Pyxis medstation,enter datalarger hospitals have satellite pharmacies(ICU, burn, CCU, NICU,cancer, ectdischarge pharmacy--in hosp rx sent by staff, tube, fax, computer

https://www.youtube.com/watch?v=qpUEaChXz3w

agencies for inst pharm• the joint commission---unannounced visit

every 39 months • CMS---center for Medicare and Medicaid

services. give payment approval and amount• HHS--health and human services• DPH--dept public health • BOP--board of pharmacy

hosp rx• medication order---rx in a hospital written on pt file • CPOE--computerized physician order entry---sent to pharmacy • or pneumatic tube or hand delivery• person in hosp will not have name, address,ect. they have pt med record

number.• Dpharm will likely enter the rx order and machine print out label for cpht to fill

order.• scan the NDC to verify correct item.• dpharm verifies then off to the pt.• STAT order--do it now=priority• ASAP--priority over new orders• standing order---list of basic meds to be used for xxxx surgery so dr doesn't

keep writing same rx for same surgery.

POE system(point of entry)• electronic access of medical info/meds for med staff to

limit error.maybe handheld scan• computer will discover dangerous drug interaction,

recommend dosage for dr, medication order goes right to pharmacy, pt notes can be entered.

• COW=‘computer on wheels’ at pt bedside• bar code BPOE---nurse can scan in unit dose med.

linked to pharm and EMAR(electronic medication administration record) to alert nurse of problems. nurse can ‘email’ pharm of problems and enter pt status.

• CADM-computerized adverse drug monitoring

institution job details• work holiday and overnight?

• maybe IV tech, nuclear tech, investigational drug research(special storage,disposal

• show job descr pg 213

cassette drawers• new pt gets started dose, meds needed for the

day are loaded into cassette drawer. normally 2 carts per floor that are rotated for use.

• ADS--automated dispensing system. pyxis medstation 4000 uses employee fingerprint. keeps track of who got meds and what med.

• UD meds=unit dose meds. must be made by pharm tech. only meds used constantly.

• UD liquids=TJD requires hosp make the dose patient specific, then labels, and sent to pt.

controlled substances• cpht restock and fill narcotics.

• nurse count narcs every shift.

• PAR--periodic automatic replenish.cpht will make drug order when drug gets low.

• hosp will have their own method for controlled substances. in brown bag if no ADS.

• you will be signing paperwork with nurse about drug inventory.

IV prep• Certified in IV—makes parenteral meds. Required to

have ‘clean room’before entry to compounding area. This is USP 797.

• Horizontal laminar flow hood• Biological safety cabinet(vertical flow hood for chemo

agents)• Glove box• These need HEPA filter• ISO class I is cleanest room• Tech must initial on label, pt name, pt record #, room

#, drug name, strength, name of mixed solution, infusion rate, does time, date made, exp date

• Expired IV are logged out, disposed.

Hospital terms• Show pg 222

• Cpht will know what drugs are most used in hosp sections

• Crash cart—show meds pg 223-adult, pediatric, neonatal

• If used cpht gives new cart and refills old cart, look for expired

• Central supply—hosp room that has instruments, bandages, sterile water, kcl bags. Lactated ringer. Drugs not stored in central supply.

advanced pharm tech jobs

pharmacy purchasing agent---order needed drugs dailymeet c sales repsnegotiate pricesfind cost-efficient practice2yr exp, certification

medication reconciliation technician---compare pt med orderswith previous meds.interview pt about meds and vitamins/herbsdata entry for providermuch experience, get cert if possible

managed care pharmacy technician---work for PBM company(pharmacy benefit management)develop drug benefits for a large group.build formularies, negotiate contracts, tell pts their benefitsprocess claims, do mailorder rx.

advanced pharm tech jobs

pharm tech trainer---work in college or or big chain train new techs.need to have ASHP certificateyears exp, BA pharm

pharmaceutical sales rep---travel to sites to promote medsknow the drug wellBA in chem or similar, business,pharm knowledge, pays well

nuclear pharm tech---compound and dispense radioactive materials for use in medical procedures.special training program at a few univrare but pays well

telepharmacy---internet comm with dpharm. rural areapharmacy infomatics--build med info for pharmacy, computer and pharm exp