Orientation to Pharmacy WHAT YOU NEED TO KNOW

Orientation to Pharmacy WHAT YOU NEED TO KNOW ABOUT HEALTH SCIENCES NORTH

Overview � Health Sciences North � Pharmacist Rotations � Medication Orders & Pharmacy Communication Forms � HSN Formulary � The Robot ‘Picksy’ & Pick. Rings � Pyxis � Medication Administration MAR: Medication Administration Record � Patient Charts � MEDITECH

Health Sciences North � Main Pharmacy: 3 rd 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 � L 1: Desk � A: Emergency Department � B: ICU � C: Oncology � D: � E: Evening � G: � M: � N: � R: � S: 4 th & 5 th Floor South Tower � X: Cardiology

Medication Orders � Orders can be written by: Physician: MD or Medical Resident with privileges Clinical Clerk : 3 rd or 4 th 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 2 nd 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 ‘Lexi. Comp’ If available the drug will be listed & automatic substitutions as well

The Robot ‘Picksy’ & Pick. Rings � Many Medication Orders that are processed by pharmacy & entered into MEDITECH are assembled by the robot onto plastic Pick. Rings � Picksy, the robot, is located across the hall from the main pharmacy

The Robot ‘Picksy’ & Pick. Rings � Pick. Rings help organize medication administration & prevent omitted or extra dose errors � Medications on the Pick. Ring are organized by administration time & are listed in alphabetical order by generic name � Pick. Rings contain patient medications for a 24 hour period

Pyxis � Pyxis units are used when medications are: missing from Pick. Rings 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 Pick. Ring 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 Ø The MAR is a useful tool o 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

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