The Impact of IV Automation on Improving Safety, Efficiency and Workflow
|
|
- Reynold Sutton
- 8 years ago
- Views:
Transcription
1 The Impact of IV Automation on Improving Safety, Efficiency and Workflow David Webster, RPh, MSBA University of Rochester Medical Center Department of Pharmacy Associate Director of Operations Director, PGY Residency Program
2 Objectives Overview of URMC and Strategic Plan Compounded Sterile Products (CSPs) risks and changes required at URMC Specific strategies to decrease risk, increase efficiencies and reduce costs for CSPs. Current and projected impact of IV room automation Lessons learned and future plans
3 Overview Fee For Value
4 Overview
5 Overview Supporting a Clinical Practice Model Team-Based Pre-Admission Medication Reconciliation Clinical Pharmacy Practice Getting the Medications Right Patient-Centered Comprehensive Medication Management Hand-offs Evidence-based Guidelines Authorization Inter-professional Accountability Post-Discharge Transitional Care Medication Distribution System Right Drug Right Patient Right Time Dockside Pharmacists - Technology/Operations Specialists Procurement/Contracting Technology/Workflow Management Technicians Smart Pumps Bedside BCMA Systems Interoperability
6 University of Rochester Medical Center Dispensing Models Hybrid ~850 beds Automated Storage and Retrieval Robotics for Central Fill ADCs for Decentralized Inventory IV Robotics IV Workflow and Product Validation TPN Compounder Decentralized ~262 beds Automated Storage and Retrieval ADCs for Decentralized Inventory Automated UD Packaging Decentralized 25 beds ADCs for Decentralized Inventory Central Sterile Compounding Wilmot Cancer Center IV Hazardous Production Robotics IV Workflow and Product Validation Off Campus Infusion Centers (5) ~30% Inpatients ~8%
7 Dispensing Metrics Strong Memorial Hospital Total Doses Dispensed Total Patient Specific IV Doses Total Pre-Mix IV Doses Oncology Doses >7,000 doses/ day 830 doses/day ~5% of doses 50 doses/day ~550 are CSPs 90 doses/day ~8% inpatient ~25% off site
8 Current state of Sterile Compounding State of Pharmacy Compounding. Pharmacy Purchasing and Products. 204; 4: S-S40
9 Current State of Sterile Compounding
10 Current State of Sterile Compounding Pre-Check Post-Check
11 Future of IV Room Production
12 Future of IV Room Production Decision path at URMC to IV Room Technology System needs to deliver core needs All sterile compounded products must incorporate bar code scan verification of correct ingredients All sterile compounded products must incorporate gravimetric checks for accuracy (robotic and human production) Workflow must be managed through a central hub for distributing tasks Must have integration to erecord (Epic) Space constraints and expandability Diverse product line including incorporation of high-hazard production
13 Future of IV Room Production Active Drug Name 2pt Font Bold (Use ISMP tallman) calcium GLUCONATE calcium GLUCONATE cardioplegia Admixture Solution cefazolin cefazolin cefazolin ceftriaxone ceftriaxone EPINEPHrine fentanyl fentanyl fentanyl-bupivacaine heparin Active in Robot Pnd erec Pnd erec Syr Bag Pnd erec Packaging Label Box Around Infusion Type (Syr vs Bag) Plus? Dose? Bag Bag Bag Bag Intermittent Intermittent Continuous Intermittent Intermittent Intermittent Total Dose in Total Volume Final Diluent Fluid 2pt Font Bold (Total Dose or Content in 8 Font Bold) Box Around Concentration? Final Concentration 0pt Font (8pt Bold Font for Cont Inf Conc) HR IV Station Control # erecord NDC Code (to generate barcode) ASTM Anesthesia Class Color Code ISMP Hi-Alert Rx? Y/N Class Warning Statement 2 pt Bold Font Caution: High Risk CardioPLEGIA Solution Bag Bag Intermittent g in D5W Inj 50mL Y Intermittent 2 g in D5W Inj 00mL Y N N Continuous Violet 256 EPINEPHrine Bag 5 mg in D5W 250mL 20 mcg/ml Y Continuous Syr 250 mcg/25 ml (C-II) Blue 297 Pnd Bag Bag Bag No Continuous Continuous 2 mcg/ml % Blue mcg/ml % Y in Sod Chloride 0.9% Inj Final Vol 250mL (C-II) Continuous 4.7 meq in Sod Chloride 0.9% Inj 50mL Equiv approx g Calcium GLUCONATE 9.4 meq in Sod Chloride 0.9% Inj 00mL PlasmaLYTE-A with additional KCL (52.8mEq/576.4ml) g in 0mL g in D5W Inj 50mL 2 g in D5W Inj 00mL 2000 mcg in Sod Chloride 0.9% Inj Final Vol 00mL (C-II) Equiv approx 2 g Calcium GLUCONATE 00 mg/ml Y 50 mcg/ml Y 20 mcg/ml Y 30 units/ml 30,000 units in Sod Chloride 0.9% Inj 000mL Y Y Y Y Y Y Blue 297 N N N N N Y N fentanyl fentanyl fentanyl-bupivacaine EpiDURAL/PeriNEURAL ONLY Heparin for CELL-SAVER HYDROmorphone Continuous Syr 25 mg/25 ml (C-II) Y mg/ml Blue 297 HYDROmorphone
14 Future of IV Room Production
15 Central Compounding Fred Bender, team leader Director, Pharmacy Services Greenville Health System Brian Cotter Director of Pharmaceutical Services UM Baltimore Washington Medical Center Brad Ludwig Assistant Director, Pharmacy Services University of Wisconsin Hospital and Clinics Christopher Murray Manager, Perioperative: Pharmacy Services Duke University Hospital Andrea Nedved Supervisor, Pharmacy Services Mayo Clinic in Rochester Matt Parker Supervisor, Pharmacy Services Greenville Health System, Greenville Memorial Hospital Erinn Rowe Manager, Pharmacy Services UNC Health Richard Taylor Pharmacy Supervisor Beaumont Hospital, Royal Oak Dave Webster Associate Director of Pharmacy University of Rochester Medical Center Sara Wilke Pharmacy Clinical Specialist Rush University Medical Center
16 Central Compounding What do the regulations and standards dictate (DQSA)? Will we be able to supply other facilities within our health care network? How will USP standards evolve (USP 800)?
17 Central Compounding - Regulations Hospitals Other Infusion Centers Medical Center Affiliated Centers In Network Or Enterprise Out of Network
18 Central Compounding - Justification To our Board of Directors Background on the dangers of CSP production Rationale Primary Goal - Insource CSP production to meet patient care needs and safety expectations within the URMC network Outsourcing to Compounding Pharmacies is not currently an option Our current clean room capacity is not able to meet our needs Insourcing allows us to control Q/A for a safe supply chain of CSPs. The costs of outsourcing (once an option) are likely to increase significantly due to new requirements We can reduce our operating costs compared to outsourcing
19 Central Compounding - Justification Savings from Insourcing Year Year 2 Year 3 Year 4 Year 5 TOTAL SMH $,590,297 $,622,03 $,654,545 $,687,636 $,72,389 $ 8,275,969 HH $ 30,77 $ 36,38 $ 322,708 $ 329,62 $ 335,746 $,64,74 FFT $ 83,000 $ 84,660 $ 86,353 $ 88,080 $ 89,842 $ 43,935 Total $,983,474 $ 2,023,43 $ 2,063,606 $ 2,04,878 $ 2,46,976 $ 0,322,078 Annual Costs $,56,887 $,544,066 $,572,06 $,600,896 $,630,595 $ 7,864,505 Incremental Margin $ 466,587 $ 479,077 $ 49,545 $ 503,982 $ 56,38 $ 2,457,573 Cummulative Margin $ 945,664 $,437,20 $,94,92 $ 2,457,573 Incremental Margin $ 466,587 $ 479,077 $ 49,545 $ 503,982 $ 56,38 Depreciation $ 09,596 $ 09,596 $ 09,596 $ 09,596 $ 09,596 TOTAL Sources Cash $ 576,83 $ 588,673 $ 60,4 $ 63,578 $ 625,977 Renovations/IT $,560,64 $0 $0 $0 $0 Inc/Dec Cash $ (983,98) $ 588,673 $ 60,4 $ 63,578 $ 625,977 Cummulative Cash Flow $ (983,98) $ (395,308) $ 205,834 $ 89,42 $,445,389 Net Present Value (at 4%) $,7,536
20 Central Compounding - Justification Drug Item Bag/Syr Annual Usage Cost Savings Annual Low Volume/High Return Atropine 0.4 mg/ml in 0.9% NaCl, 2.5 ml S 4800 $ - 0 Aztreonam gm bag B 728 $, Aztreonam 2gm bag B 296 $ 8, Calcium Gluconate gm 50ml B 925 $ 37, Calcium Gluconate 2gm 50ml B 4563 $ 8,5. Cefazolin gm Frozen B 2736 $ 7, Cefazolin gm Syringe S 5940 $ 9, Cefazolin 2gm Syringe S 2804 $ 6, Cefepime gm Frozen B 3048 $ 3, Heparin 30 units/ml in NS 000ml B 236 $ 4, Cefepime 2gm Frozen B 7476 $ 48, Hydromorphone 0.2 mg/ml in 0.9% NaCl, 0 ml, PF S 8600 $ 5, Ceftriaxone gm Frozen B 4920 $ 27,483.2 Hydromorphone PCA S 208 $ 70, Ceftriaxone 2gm Frozen B 3936 $ 39, Ketamine HCl 0 mg/ml 2in 0.9% NaCl, 0 ml S 700 $, Clindamycin 600mg 50ml D5W B 266 $ 27, levetiracetam.5gm/00ml 2 B 640 $ 5, Clindamycin 900mg 50ml D5W B 824 $ 23, levetiracetam gm/00ml 3 B 2480 $ 48, Ephedrine Sulfate 5 mg/ml in 0.9% NaCl, 0 ml S 000 $ 36, levetiracetam 500mg/00ml B 630 $ 20, Epinephrine 0 mcg/ml in D5W PF, 0 ml S 296 $ - Lidocaine 2%, 5 ml, PF 0 S 6450 $ 9,873.0 Epinephrine 5mg/250ml B 3968 $ 23, Magnesium gm in D5W 50ml B 0 $ - #DIV/0! Esmolol HCl 0 mg/ml, 0 ml S 2200 $ 8,77.84 Magnesium 2gm in D5W 50ml B $ 70,0.90 Magnesium 40gm in LR 000ml B 80 $, Famotidine 20mg 50ml B 7392 $ 2, Methohexital 0 mg/ml in SWFI, 0 ml, PF S 540 $ Fentanyl 20mcg/ml 00ml Bag 00ml B 298 $ 27, Midazolam mg/ml in 0.9% NaCl, 2 ml S $ 8, Fentanyl 2mcg/ml- Bupiv % 50ml B 800 $ 23, Midazolam mg/ml in NaCl 00ml B 4668 $ 20, Fentanyl 2mcg/ml- Bupiv 0.% 50ml B 0 $ - Morphine #DIV/0! PCA S 350 $ 7, Fentanyl 2mcg/ml- Bupiv 0.25% 50ml B 0 $ - Neostigmine #DIV/0! Methylsulfate mg/ml, 5 ml S 500 $ 30,87.50 Fentanyl 50 mcg/ml, 2 ml, PF S $ 90, Nicardipine 20mg in NS 200ml B 680 $ 29, Fentanyl 50 mcg/ml, 5 ml, PF S 3300 $ 49, Oxytocin 30units in NaCl 500ml B 399 $ 4, Fentanyl 50mcg/ml 25ml S 836 $, Penicillin 2MU FRZ B 52 $ 7, Glycopyrrolate 0.2 mg/ml, 5 ml S 3400 $ 37, Penicillin 3MU FRZ B 752 $ 0, Heparin 00units/ml in D5W 250ml B 9384 $ 36, Phenylephrine 0.32mg/ml inns 250ml B 060 $ 5, Heparin 2 units/ml 500ml B 728 $,558.3 Phenylephrine HCl 00 mcg/ml 0 in 0.9% NaCl, 0 ml, PF S 400 $ 57,86.96 Rocuronium 0 mg/ml, 5 ml, PF S 8700 $ 77,48.00 IV Room Workload Reduction Succinylcholine Chloride 20 mg/ml, 5 ml S 9300 $ 25, Vancomycin gm Frozen B 926 $ 34, Vancomycin 500mg B 2628 $ 7,36.03 Vancomycin 750mg B 3000 $, Vecuronium Bromide mg/ml in SWFI, 0 ml, PF S 500 $ 34, Zosyn 2.25gm Frozen B 9336 $ 8, Zosyn 3.375gm Frozen B $ 66, Financial Return/Productivity Zosyn 4.5gm Frozen B 4364 $ 40,362.84
21 Central Compounding - Design
22 Central Compounding - Design Hospital Batch CSPs Ambulatory Batch CSPs Central Compounding Facility Oncology Infusion Centers (patient specific)
23 Next Phases in IV Automation at URMC Ø Interface to erecord system Ø High hazardous automated production Ø Semi-automated human CSP production Ø Goal to have 00% of IV production include bar code verification and gravimetric checks Ø Smart Pump integration
24 Lessons Learned " Focus of business plan must be patient safety " Site visits are critical sharing information " Drug shortages anticipate the unanticipated " Contingency planning " Be flexible in your design " Evaluate technology support (efficiency and safety factors) " Logistics (impact on BUD and testing)
25 The Paradigm Shift in CSP production From Wait and see what regulations will dictate Our State Board will not allow that Look for answers in Compounding Pharmacies To Apply and anticipate evolution of regulations Have the discussion with a patient safety focus Look for answers within your organization Assume Quality and Safety of Compounding Pharmacies under FDA regulation Wait for more sites to adopt technology (adapters) A financial model that improves safety Ensure and demonstrate Quality and Safety (Who is best positioned to accomplish this?) Be part of the early adoption (innovators) A safety model that have financial support
26 We can t change the human condition, but we can change the conditions under which humans work. -James Reason
Emergency Medications Approved for Use at VAPAHCS
Table 1: Medications (PAD GM&S) Emergency Medications Approved for Use at VAPAHCS PAD GM&S (See HCSM 11-12-35 Attachment A CPR Committee Atropine 1mg/10ml syringe X 3 Normal saline 1000ml bag X 2 Sodium
More informationThe Brigham and Women s Hospital Department of Pharmacy
Using Bar Code Verification to Improve Patient Care and Tracking and Traceability William W. Churchill MS, R.Ph. Chief of Pharmacy Services Brigham and Women s Hospital The Brigham and Women s Hospital
More informationDriving Patient Safety and Pharmacy Efficiency
CASE STUDY Driving Patient Safety and Pharmacy Efficiency Sterile Compounding, Error Reduction and Workflow Management at Indiana University Health Bloomington Hospital Steve I am totally sold on the benefits
More informationEvolution of a Closed Loop Medication Use Process
Evolution of a Closed Loop Medication Use Process Paul J. Vitale, Pharm.D. pvitale@mdmercy.com Vice President and Chief Pharmacy Officer The Mercy Medical Center Baltimore, Maryland Agenda Hospital Background
More informationSafe IV Compounding Procedures: The Release of ISMP Guidelines
Safe IV Compounding Procedures: The Release of ISMP Guidelines Matthew P. Fricker, Jr., MS, RPh, FASHP, Program Director Institute for Safe Medication Practices 1 Objectives List system based causes of
More informationRECONSTITUTING MEDICATIONS: HOW TO FLUFF UP MEDICATIONS
RECONSTITUTING MEDICATIONS: HOW TO FLUFF UP MEDICATIONS After the completion of this module you will be able to: Define medication reconstitution. Read a medication label. Reconstitute a medication. Calculate
More informationMEDICATION MANUAL Policy & Procedure
MEDICATION MANUAL Policy & Procedure TITLE: High Alert Medication NUMBER: MM 50-010 Effective Date: September 13, 2013 Page 1 of 6 Applies To: Holders of Medication Manual This policy is applicable to
More informationMedication Calculation Practice Problems
1 Medication Calculation Practice Problems Dosage Calculation 1. The order is for 60 mg of furosemide (Lasix) po daily. Available to the nurse is Lasix 40 mg/tablet. The nurse would administer how many
More informationPharmacy Practice in U.S. Hospitals. Douglas Scheckelhoff, MS, FASHP Vice President Practice Advancement
Pharmacy Practice in U.S. Hospitals Douglas Scheckelhoff, MS, FASHP Vice President Practice Advancement Objectives Discuss ASHP and its mission Discuss the goals of hospital pharmacy Describe the historical
More informationAutomating the Pharmacy Medication Cycle in Acute Care Settings
Automating the Pharmacy Medication Cycle in Acute Care Settings Costs, Benefits and Potential Unintended Consequences Enterprise Information Systems Steering Committee Nursing Informatics Committee and
More informationActivity Objectives. Activity Objectives. Crucial Considerations to Ensure the Safety of I.V. Therapy
Rita Shane, Pharm.D., FASHP, FCSHP, Activity Chair Chief Pharmacy Officer Cedars-Sinai Medical Center Assistant Dean, Clinical Pharmacy UCSF School of Pharmacy Los Angeles, California Ryan A. Forrey, Pharm.D.,
More informationBuilding a Business Case for a Central Sterile Compounding Pharmacy. UHC Pharmacy Financial Performance Committee
Building a Business Case for a Central Sterile Compounding Pharmacy UHC Pharmacy Financial Performance Committee Introduction: In view of recent catastrophic events involving national and regional sterile
More informationSubject: Unit Dose PLUS Outsource Re-Packaging Service from Healthmark
Subject: Unit Dose PLUS Outsource Re-Packaging Service from Healthmark The only fully integrated contract outsourcing of standard and customizable unit-dose, bar code ready packaging for oral solid and
More informationSection 2 Solving dosage problems
Section 2 Solving dosage problems Whether your organization uses a bulk medication administration system or a unit-dose administration system to prepare to administer pediatric medications, you may find
More informationPharmacy. Page 1 of 10
Department: Pharmacy PP # RX 6007.1 Policy and Procedure Effective Date: August, 2010 Page 1 of 10 Subject/Title: Pharmacy Tech-Check-Tech Program Dates of Review/Revision: Approved By and Title: Director,
More informationCASE STUDY. Spencer Hospital, Iowa Advanced Technician Practice Model Tech check Tech (TCT)
Spencer Hospital, Iowa Advanced Technician Practice Model Tech check Tech (TCT) Submitted By: Gayle Mayer, RPh, BPharm, Director of Pharmacy Spencer Hospital Pharmacy Staff Primary Intended Outcome(s):
More informationPharmacy Technician Web Based Calculations Review
Pharmacy Technician Web Based Calculations Review MODULE 3 3 2009 PRESENTED BY: Jenifer Maki, JENIFER PharmD MAKI, PHARMD BRETT SALEM, PHARMD WITH CONTRIBUTIONS DEREK LOMAS, FROM: PHARMD Brett Salem, PharmD
More informationEXACTAMIX Compounding. Systems for Specialty Pharmacies
EXACTAMIX Compounding Systems for Specialty Pharmacies EXACTAMIX Compounding Systems from Baxter Healthcare Corporation are an advanced solution for multi-ingredient compounding. Produce a typical 3L
More informationTOTAL PARENTERAL NUTRITION SOLUTIONS
TOTAL PARENTERAL NUTRITION SOLUTIONS TOTAL PARENTERAL NUTRITION SOLUTIONS Issued 6/98 NOTE: Because of the complexity of these solutions, the customary format of the Guide cannot be used. The double entry
More informationI.V. ADMINISTRATION GUIDELINES All IV meds must be administered by IV pump. Diluent Amount Over (min.) NO D5W 200mL. 500ml. 1000ml.
I.V. ADMINISTRATION GUIDELINES All IV meds must be administered by IV pump Medication Dose Push Acetadote Patients greater than 40 kg Loading Dose: Dose 2: Dose 3: Please use the Online calculator: http://aceta
More information10/1/2015. National Library of Medicine definition of medical informatics:
Heidi S. Daniels, PharmD Pharmacist Informaticist NEFSHP Fall Meeting: Pharmacy Practice Updates 2015 Daniels.Heidi@mayo.edu Mayo Clinic Florida Campus Jacksonville, Florida I have nothing to disclose
More informationMEDICAL CENTER ADMINISTRATIVE POLICY AND PROCEDURES SCOPE KFH Hospital, City Section No.
of 22 I. Purpose To establish safe medication practices for High Alert medications to maximize the safety of the medication processes associated with these medications. II. Policy. High alert medications
More informationDISCLAIMER OBJECTIVES IV ROBOTICS IV ROBOTICS
DISCLAIMER NEW PHARMACY TECHNOLOGY AND AUTOMATION UPDATE Christopher R. Fortier, PharmD Manager, Pharmacy Support Services Clinical Assistant Professor Medical University of South Carolina Charleston,
More informationCritical Care Calculations Study Guide
Example #1 Your 65 kg patient has dopamine ordered at 6 mcg/kg/min. The IV has 400 mg of dopamine in 250 ml. What IV rate is correct? 1. Always determine the dose of medication per ml (Drug Concentration)
More informationCOUNTY OF SAN DIEGO EMERGENCY MEDICAL SERVICES No. P-117a POLICY/PROCEDURE/PROTOCOL Page 1 of 6
POLICY/PROCEDURE/PROTOCOL Page 1 of 6 GREY/PINK Kg range: < 8 kg Approx Kg: 5 kg 1 st 2 nd 3 rd Approximate LBS: 10 lbs Defib: 10 J 20 J 20 J ET uncuffed tube size: 3.5 Cardiovert: 5 J 10 J 10 J ET cuffed
More informationPharmacy Technicians: Case Studies in Preventing Medication Errors
KPhA s 134th Annual Meeting and Trade Show The Future is Now: Envision, Educate, Empower KU Memorial Union Lawrence, Kansas Pharmacy Technicians: Case Studies in Preventing Medication Errors September
More informationNational Patient Safety Agency. Risk Assessment of Injectable Medicines. STEP 1 Local Risk Factor Assessment. STEP 2 Product Risk Factor Assessment
NPSA Injectable Medicines Risk Assessment Tool National Patient Safety Agency Risk Assessment of Injectable Medicines STEP 1 Local Risk Factor Assessment. Carry out a baseline assessment in a near patient
More informationBuilding a Business Case and Selling Your Automation Plan
Building a Business Case and Selling Your Automation Plan Dave Hicks, BS Pharm, MBA Vice President and Chief Pharmacy Officer University of Chicago Medical Center Neither I or my spouse have any actual
More informationAppendix 4: Guidelines for Prescribing and Administering Drugs:
Appendix 4: Guidelines for Prescribing and Administering Drugs: A midwife may prescribe and administer the following substances in accordance with the guidelines approved by the Board. This list indicates
More informationCreating a Hospital Based Bedside Delivery Program to Enhance the Patient Experience at Cleveland Clinic s Community Hospitals
Learning Objectives Creating a Hospital Based Bedside Delivery Program to Enhance the Patient Experience at Cleveland Clinic s Community Hospitals Describe the 5 steps needed to create an effective hospital
More informationMEDICAL SIMULATION A HOLISTIC APPROACH
March/April 2013 Volume 10, Issue 2 MEDICAL SIMULATION A HOLISTIC APPROACH IV Medication Safety Patient Experience Mentoring Programs Fall Prevention INTRAVENOUS INFUSION MEDICATION SAFETY: The Vision
More informationMulti-Therapy Smart Infusion for Home Care
Multi-Therapy Smart Infusion for Home Care 100 ml Running 1,200 ml Running 100 ml Running 265 ml Running 500 ml Running 7:16 AM 7:13 AM 7:15 AM Intermittent 7:14 AM 7:39 PM Dosing Dosing Up Current rate
More informationHealth Canada Manufacturing and Compounding Drug Products in Canada: A Policy Framework Guidelines for P.E.I. Community and Hospital Pharmacists
Health Canada Manufacturing and Compounding Drug Products in Canada: A Policy Framework Guidelines for P.E.I. Community and Hospital Pharmacists October 2001 In response to pharmacists questions about
More informationDilution and. Concentration. Chapter 10 TERMS OBJECTIVES % C 4 5 6 X
Chapter 10 Dilution and TERMS % C 7 8 9. 4 5 6 X Alligation Alligation alternate Alligation medial Diluent Stock solution Concentration OBJECTIVES Upon completion of this chapter, the technician student
More informationReducing the risk of patient harm: A focus on insulin
Reducing the risk of patient harm: A focus on insulin New York State Partnership for Patients (NYSPFP) Initiative Regional Educational Session November 2013 1 1 Disclosure Matt Fricker, Matt Grissinger,
More informationOptimizing medication safety:
Optimizing medication safety: At King Abdullah Medical City advanced technologies help improve safety, security and control of N&C medications Authored and produced by CareFusion, June 2015 Summary At
More informationParamedic Pediatric Medical Math Test
Paramedic Pediatric Medical Math Test Name: Date: Problem 1 Your 4 year old pediatric patient weighs 40 pounds. She is febrile. You need to administer acetaminophen (Tylenol) 15mg/kg. How many mg will
More informationPGY-2 ONCOLOGY PHARMACY RESIDENCY
PGY-2 ONCOLOGY PHARMACY RESIDENCY Program Description and Requirements Providence Health System (PAMC) in Anchorage consists of 394 acute care beds and is part of an integrated health system including
More informationBarcode Scanning and Infusion Pumps: The Journey to Safety with Wireless Devices
Barcode Scanning and Infusion Pumps: The Journey to Safety with Wireless Devices Stephanie Altavilla, MSMI, RN Jennifer Taylor, MsEd, RN November 1, 2013 Objectives Define BCMA and the safety benefits
More informationWhen calculating how much of a drug is required, working with the formula helps the accuracy of the calculation.
DRUG CALCULATIONS When calculating how much of a drug is required, working with the formula helps the accuracy of the calculation. Always remember this formula: What you want X Quantity it comes in What
More informationIncorporating Pediatric Medication Safety into your Health System
Incorporating Pediatric Medication Safety into your Health System Julie Kasap, Pharm.D. Margaret CHOI Heger, Pharmacy PharmD, Supervisor BCPS January 2015 Pediatric Antimicrobial Stewardship Conference
More informationAdvanced Pharmacy Technician Practice Model Case Study
Advanced Pharmacy Technician Practice Model Case Study Froedtert Hospital, Milwaukee, Wisconsin Discharge Pharmacy Technician Lindsey Clark, Pharm.D. PGY2 Health-System Pharmacy Administration Resident
More informationDesigned with you in mind.
DRUg NAme 15 mcg/kg/min Designed with you in mind. The Next-Generation SIGMA Spectrum Infusion System DRUg NAme 15 mcg/kg/min The infusion system that moves with your patient, evolves with your facility
More informationSpecial Types of Intravenous Calculations
Predham_CH09_F 7/3/09 5:43 PM Page 3 LEARNING OBJECTIVES. Amount of drug in a solution. Rules and calculations for special CHAPTER 9 Special Types of Intravenous Calculations IV orders 3. Units/hr, mg/hr,
More informationBy Lawrence A. Trissel, B.S., R.Ph., FASHP. Modified from the original presentation March 9, 2006
USP Chapter : Beyond Use Dating, Stability, and Storage Modified from the original presentation March 9, 2006 By Lawrence A. Trissel, B.S., R.Ph., FASHP Supported by an unrestricted educational grant
More informationA CPhT Story: Past, Present, and Future Visions from
A CPhT Story: Past, Present, and Future Visions from a PTCB Certified Pharmacy Technician Sylvia Banzon, CPhT, CQiA, PMP Sutter Health Sacramento, CA Objectives Explain new or modified roles for pharmacy
More informationCrucial Considerations to Ensure the Safety of I.V. Therapy
Crucial Considerations to Ensure the Safety of I.V. Therapy Presented as a Midday Symposium and Live Webcast at the 48th ASHP Midyear Clinical Meeting and Exhibition Tuesday, December 10, 2013 Orlando,
More informationPREPARATIONS: Adrenaline 1mg in 1ml (1:1000) Adrenaline 100micrograms in 1ml (1:10,000)
ADRENALINE Acute hypotension Via a CENTRAL venous line Initially 100-300 nanograms/kg/minute 0.1-0.3 microgram/kg/minute adjusted according to response up to a maximum of 1.5 micrograms/kg/minute. Increase
More informationAdvance IV Therapy Module. Example 1. 3mg. 3mg min = 45
Advance IV Therapy Module Eample A patient is to receive Lidocaine at 3mg/. Supplied is a one liter bag of D 5 W containing Lidocaine 4g. Calculate the infusion rate in ml/. First, identify the doctor
More informationSafe Medication Administration Preparation Guide C.O.R.E Essentials
Safe Medication Administration Preparation Guide C.O.R.E Essentials As a new IU Health employee, a portion of your orientation will focus on Safe Medication Administration practices. You will participate
More informationThe 2012 Landscape of I.V. Medication Safety: Processes, Tools, and Training
The 2012 Landscape of I.V. Medication Safety: Processes, Tools, and Training Presented as a Midday Symposium and Live Webcast at the 47 th ASHP Midyear Clinical Meeting and Exhibition Tuesday, December
More informationHEALTHCARE SOLUTIONS INTEGRATED MEDICATION MANAGEMENT SOLUTIONS FOR INNOVATIVE HOSPITALS
HEALTHCARE SOLUTIONS INTEGRATED MEDICATION MANAGEMENT SOLUTIONS FOR INNOVATIVE HOSPITALS A LONG HISTORY OF INNOVATION IN SAFE AND EFFICIENT TAILORED AUTOMATED DRUG MANAGEMENT SYSTEMS «SWISSLOG, AN ESTABLISHED
More informationWest Los Angeles College Pharmacy Technician Program
West Los Angeles College Pharmacy Technician Program I. STERILE PRODUCTS EXTERNSHIP - 2.25 Unit(s) Phrmctk 38 Section: 1632 II. PREPARED BY: Pharmacy Technician Adjunct Faculty III. REVISED FOR: Spring
More informationLESSON ASSIGNMENT. After completing this lesson, you should be able to: 2-1. Compute medication dosages by the ratio and proportion method.
LESSON ASSIGNMENT LESSON 2 Pharmacology TEXT ASSIGNMENT Paragraphs 2-1 through 2-34. LESSON OBJECTIVES After completing this lesson, you should be able to: 2-1. Compute medication dosages by the ratio
More informationMATH FOR NURSING AND ALLIED HEALTH Math for Science webpages originally created by
1 MATH FOR NURSING AND ALLIED HEALTH Math for Science webpages originally created by Stephanie S. Baiyasi, D.V.M., Instructor, Science Division, Delta College Karen Constan, B.A., Staff Tutor, Teaching/Learning
More informationSUFFOLK COUNTY COMMUNITY COLLEGE NURSING DEPARTMENT MEDICATION ADMINISTRATION TEST NR 40 Practice test questions READ INSTRUCTIONS CAREFULLY
NR40 MEDICATION MATH TEST Practice questions page 1 SUFFOLK COUNTY COMMUNITY COLLEGE NURSING DEPARTMENT MEDICATION ADMINISTRATION TEST NR 40 Practice test questions READ INSTRUCTIONS CAREFULLY Students
More informationSmart PumpTechnology
Effective Approaches to Standardization and Implementation of Smart PumpTechnology A CONTINUING EDUCATION PROGRAM FOR PHARMACISTS AND NURSES PROGRAM FACULTY Michael R. Cohen, RPh, MS, ScD, FASHP President
More informationPlanning Issues for Hospital Pharmacies with Growing Outpatient Populations
Planning Issues for Hospital Pharmacies with Growing Outpatient Populations In recent years, there has been an increasing emphasis in healthcare on the provision of ambulatory care services. It is predicted
More informationStatement BAR CODE LABEL REQUIREMENTS FOR HUMAN DRUG AND BIOLOGIC PRODUCTS
Statement on BAR CODE LABEL REQUIREMENTS FOR HUMAN DRUG AND BIOLOGIC PRODUCTS Edith Rosato, R.Ph. Vice President Pharmacy Affairs National Association of Chain Drug Stores Alexandria, VA July 26,2002 Submitted
More informationDosage and Calculation
Dosage and Calculation Module for Level 2: Medical-Surgical Nursing TABLE OF CONTENTS: PAGE I. Abbreviation 2 II. Systems of Measurement 4 III. Methods of Calculations: Dimensional Analysis 8 IV. Reconstitution
More informationOperational Recommendations to Support Barcode Scanning Effectiveness across the Medication Use System
Hospital Pharmacies White Paper Operational Recommendations to Support Barcode Scanning Effectiveness across the Medication Use System Industry leaders share their insights to barcode scanning success
More informationAnalysis of the medication management system in seven hospitals
Analysis of the medication management system in seven hospitals James Baker, Clinical Director, Marketing, Medication Technologies, Cardinal Health Marcy Draves, Clinical Director, Marketing, Medication
More informationCase Studies in Change Management: Applied ADKAR
Case Studies in Change Management: Applied ADKAR Jason Glowczewski, Pharm.D., MBA Director of Pharmacy UH Community Hospitals Jason.Glowczewski@UHhospitals.org Objectives Pharmacist Objectives: 1. Explain
More informationCase Studies in Change Management: Applied ADKAR
Objectives Pharmacist Objectives: Case Studies in Change Management: Applied ADKAR Jason Glowczewski, Pharm.D., MBA Director of Pharmacy UH Community Hospitals Jason.Glowczewski@UHhospitals.org 1. Explain
More informationBD Cato Medication Workflow Solutions
BD Cato Medication Workflow Solutions IV cleanroom BD Cato Medication Workflow Solutions provides enhanced safety and quality assurance to help you achieve the highest level of quality, efficiency and
More informationHospital Pharmacy Automation: Drug Storage and Retrieval
WHITE PAPER USP CHAPTER 797 CLEAN ROOM APPLICATION Hospital Pharmacy Automation: Drug Storage and Retrieval The technical information regarding USP Chapter (797) and the performance of the Swisslog device
More informationWelcome CareFusion Insider Event HIMSS 2013
Welcome CareFusion Insider Event HIMSS 2013 Agenda Opening Remarks Tim Vanderveen, PharmD, MS, Vice President of the Center for Safety and Clinical Excellence The Future of Closed Loop Medication Administration:
More informationDrug Dosage Practice Problems
Drug Dosage Practice Problems Topics covered: Metric Conversions ---------------------------------------------------------------- pg 2 General Conversions --------------------------------------------------------------
More informationCOMPOUNDING PHARMACY IN THE HOSPITAL SETTING SATURDAY/11:30AM-12:30PM
HOSPITAL FOCUS: COMPOUNDING PHARMACY IN THE HOSPITAL SETTING SATURDAY/11:30AM-12:30PM ACPE UAN: 0107-9999-16-034-L04-T 0.1 CEU/1 hr Activity Type: Knowledge-Based Learning Objectives for Pharmacy Technicians:
More informationBishop State Community College. Dosage Calculation Review Study Booklet
Bishop State Community College Dosage Calculation Review Study Booklet Table of Contents Page Numbers Conversion Table. 2 Conversions Facts. 3, 4 Conversion Practice Problems 5 Oral and Parenteral Calculations..
More informationMedication Safety and Error Prevention
Medication Safety and Error Prevention 16 LEARNING OBJECTIVES By the end of this chapter, students will be able to competently: 1. Explain the process for reporting errors. 2. Explain the difference between
More informationColor Code Drug Doses L.A. County Kids
3 Kg 1. 3.0 Joules 3.0 Joules 12 Joules 12 Joules 0. 60 mg 0.0 3 meq Add 18 mg (.23mL) to a 100 ml bag of NS. adequate perfusion 6 ml 1. 0.0 0. 0. 60 ml 4 Kg 2 Joules 1 1 0. 80 mg 0.0 4 meq Add 2 (.3mL)
More informationAcetylcysteine Inhalation Solution
Drug Shortage information Action Plan delays and another manufacturer voluntarily suspending production. Hospira has a limited supply available and other manufacturers are unable to estimate a release
More information48 th Annual Meeting. On the Radar: Regulatory Basics. Regulatory Agencies. The Joint Commission. Disclosure. Objectives. The Joint Commission
48 th Annual Meeting On the Radar: Regulatory Basics Alissa Voils, PharmD, MSHA Assistant Director, Inpatient Operations UF Health Shands Hospital Regulatory Agencies The Joint Commission (TJC) Florida
More informationWho is my audience? Pharmacist Objectives. What is a pharmacy technician? Technicians Objectives. Baptist Health Medical Center Little Rock 9/23/2013
Who is my audience? Pharmacy technicians Pharmacist Claire Lieblong, PharmD, MBA Baptist Health Medical Center Little Rock Pharmacy Supervisor Pharmacy managers/supervisors Pharmacy Directors Others Pharmacist
More informationExpanding the Role of Pharmacy Technicians
Expanding the Role of Pharmacy Technicians Jenni Buu, PharmD PGY2 Ambulatory Care Resident Boise VA Medical Center April 13, 2014 2 Objectives Review historical changes in the pharmacy technician profession
More informationNOTICES DEPARTMENT OF HEALTH
NOTICES DEPARTMENT OF HEALTH Approved Drugs for ALS Ambulance Services [43 Pa.B. 3060] [Saturday, June 1, 2013] Under 28 Pa. Code 1005.11 (relating to drug use, control and security), the following drugs
More information!!! BOLUS DOSE IV. Use 5-10 mcg IV boluses STD ADRENALINE INFUSION. Use IM adrenaline in advance of IV dosing!
ADRENALINE IVI BOLUS IV Open a vial of 1:1000 ADRENALINE 1 mg /ml Add 1 ml to 9 ml N/Saline = 1mg adrenaline in 10 ml (or 100 mcg/ml) Add 1 ml 1:10,000 to 9 ml N/Saline = 100 mcg adrenaline in 10 ml (or
More informationMedication Safety Overview
Medication Safety Overview Focus on Look-alike Sound-alike Medications Rita Montone, RPh, MBA Operations Manager Department of Pharmacy Bayhealth Medical Center Medication names and packaging There are
More informationEnhancing Patient Safety Through Integrated Supply Chain Management
Enhancing Patient Safety Through Integrated Supply Chain Management Wu Tuck Seng Deputy Director, NUH Pharmacy Department & Chairman of National Medication Safety Committee Scope Explore innovative workflows,
More information2. Order: Nipride 500 mg IV in 250 ml D5w at 2 mcg/kg/min for a patient weighing 125 lb. Administer at ml/hr
1 Pharmacology Review Quiz: 1. Order: Xylocaine 1 g IV in 500 ml D5W at 3 mg/min. Set the infusion pump at ml/hr 2. Order: Nipride 500 mg IV in 250 ml D5w at 2 mcg/kg/min for a patient weighing 125 lb.
More informationSpecialty Pharmacy? Disclosure. Objectives Technician
Disclosure What s so SPECIAL about? I have no actual or potential conflict of interest in relation to this program/presentation. Michael DeCoske, PharmD, BCPS Associate Chief Pharmacy Officer Duke University
More informationPharmacy Technician. Cost: $999 Total Hours: 50 THREE SESSIONS OFFERED!
Pharmacy Technician C E R T I F I C AT I O N PR OG R AM Cost: $999 Total Hours: 50 THREE SESSIONS OFFERED! January 26 March 16, 2015 June 8 July 27, 2015 September 28 - November 16, 2015 Time: Monday &
More informationDisclosure. Objectives. Did You Know? 7/25/2015. Career Opportunities. Advancing your Pharmacy Career as a Technician
49th Annual Meeting Career Opportunities Tara Lynn McNulty CPhT, RPhT & Roma Merrick CPhT. RPhT Disclosure I do not have a vested interest in or affiliation with any corporate organization offering financial
More informationNote that the following document is copyright, details of which are provided on the next page.
Please note that the following document was created by the former Australian Council for Safety and Quality in Health Care. The former Council ceased its activities on 31 December 2005 and the Australian
More informationLEARNING OBJECTIVES. 1. Describe the term pharmacist extender. Pharmacist roles, practices, and activities will improve medication use and optimize
LEARNING OBJECTIVES PPMI IN ACTION: OPTIMIZING THE USE OF PHARMACY EXTENDERS Moderator: Dan Newberg MS, RPh, FMSHP, FASHP Director of Pharmacy Beverly Hospital 1. Describe the term pharmacist extender
More informationInpatient Pharmacy Order Processing. January 2012
Inpatient Pharmacy Order Processing January 2012 1 Learning Objectives Explain the difference between inpatient and outpatient medication orders Explain why inpatient and outpatient medication orders must
More informationINTRAVENOUS DRUG QUICKGUIDE
INTRAVENOUS DRUG QUICKGUIDE GENERAL NOTES IMPORTANT THIS GUIDE IS AN AIDE MEMOIRE ONLY, AND SHOULD NOT REPLACE YOUR PROFESSIONAL REQUIREMENT TO USE MANUFACTUER S LICENSED INFORMATION TO INFORM YOUR PREPARATION
More informationSupplementary material: The online version of this article (doi: 10.1310/hpj5004-287) contains the eappendix.
Hosp Pharm 2015;50(4):287 295 2015 Thomas Land Publishers, Inc. www.hospital-pharmacy.com doi: 10.1310/hpj5004-287 Original Article Nursing, Pharmacy, and Prescriber Knowledge and Perceptions of High-Alert
More informationSafe Administration of High-Risk IV Medications
SAN DIEGO PATIENT SAFETY CONSORTIUM Getting Started Kit: Safe Administration of High-Risk IV Medications Intra- and Inter-Hospital Standardization: Drug Concentrations and Dosage Units How-to Guide As
More information- - - β a The Tox 21 programme is pooling federal resources to use robotics technology to screen thousands of chemicals for potential toxicity, using screening data to predict the potential toxicity of
More informationPHARMACY TECHNICIAN COURSE DESCRIPTIONS
PHARMACY TECHNICIAN COURSE DESCRIPTIONS OCCUPATIONAL COMPLETION POINTS AND PROGRAM LENGTH: * Basic Healthcare Worker OCP A 90 Hours (COURSE #HSC 0003) * Community Pharmacy Technician OCP B 360 Hours (COURSE
More informationKey Element V: Drug Standardization, Storage, and Distribution
Key Element V: Drug Standardization, Storage, and Distribution Prescribed medications are accessible to patients and dispensed in a safe and secure manner. Medications and other necessary drug supplies
More informationNOTICES. Approved and Required Medications Lists for Emergency Medical Services Agencies and Emergency Medical Services Providers
NOTICES Approved and Required Medications Lists for Emergency Medical Services Agencies and Emergency Medical Services Providers [45 Pa.B. 5451] [Saturday, August 29, 2015] Under 28 Pa. Code 1027.3(c)
More informationPractice Spotlight. Florida Hospital Orlando Orlando, FL www.floridahospital.com IN YOUR VIEW, HOW WOULD YOU DEFINE THE IDEAL PHARMACY PRACTICE MODEL?
Practice Spotlight Florida Hospital Orlando Orlando, FL www.floridahospital.com Craig Coumbe, R.Ph., M.B.A. Director of Pharmacy Rania El Lababidi, Pharm.D., BCSP (AQ ID), AAHIVP Assistant Director, Clinical
More informationfor Extended Stability Parenteral Drugs Third Edition Caryn M. Bing, R.Ph., M.S., FASHP Editor
Extended Stability for Parenteral Drugs Third Edition Editor Caryn M. Bing, R.Ph., M.S., FASHP 1 American Society of Health-System Pharmacists Bethesda, Maryland Contents Preface Acknowledgments x/ Dedication
More informationNDC HCPCS HCPCS Description NDC Description Effective Date End Date X-Over Only
Updated 5.5.14 NDC HCPCS HCPCS Description NDC Description Effective Date End Date X-Over Only 68152-0103-03 A9543 YTTRIUM Y-90 IBRITUMOMAB TIUXETAN ZEVALIN Y-90 VIAL 9/1/2013 12/31/2013 50419-0320-05
More informationDEPARTMENTOFHEAL1B ANDiiuMAN SERVICES FOOD AND DRUG ADMINISTRATION OATE(S)OI'IHSPECTIOOI. STRE 1' AOIJftEBS
DEPARTMENTOFHEAL1B ANDiiuMAN SERVICES OATE(S)OI'IHSPECTIOOI (973) 331-4900 Fax: (973) 331-4969 Industr Information: Www.fda.gov/oc/indus~ry NAMEI>HO T1T1..E OF INOMDUAI. TO WHOM RePORT ISSUED FIRM NA!oiE
More informationTo outline the components and requirements for Tech-Check-Tech in the inpatient or institutional pharmacy setting.
Tech Check Tech SAMPLE POLICIES AND PROCEDURES Tech-Check-Tech Revision 10/09/2014 I. PURPOSE To outline the components and requirements for Tech-Check-Tech in the inpatient or institutional pharmacy setting.
More informationRFID in Pharmacy Inventory Management
RFID in Pharmacy Inventory Management RFID in Pharmacy Inventory Management S. John Johnson, PharmD Director of Pharmacy - Sharp Memorial Hospital Email: sjjrxprn@pharmdmand.com Outline About Sharp Memorial
More information