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Related article: 5) Upon receipt from the pharmacy, a nurse may open the prescription bottle of takehome medications to verify that the contents of the bottle are the same as ordered. If there is any question, as to whether the count of individual doses is correct, the medication shall be returned to the pharmacy for recount. A nurse that verifies the count of a pass medication should take care not to contaminate the medication. 6) The Pharmacy will send?patient drug leaflets with pass medications. These leaflets are to be placed in the bag with the drugs. The nurse should open the bag, review the medications and leaflets to be prepared to present them to the families and answer any questions the family may have. Pharmacists are available to answer questions from the nursing staff during regular hours. B. OffCampus Trip Medication The living area nurse is to be notified of proposed offcampus trips by sponsoring department or individual. At the discretion of the living area nurse, routinely prepared medications may be taken off campus in drug cabinets (for large groups) or drug baskets (for small groups) or the living area nurse may request the pharmacy to specially prepare trip medications. 1) Use of drug cabinets/baskets (a) Use of drug cabinets/baskets to take routinely prepared medications off campus is encouraged for those trips where use of cabinets or baskets is convenient. (b) The cabinets or baskets should be secured either by locking or utilization of the seals as provided by the Pharmacy. They should be maintained in a locked vehicle or in a secure environment. 2) Pharmacy preparation of trip medication (a) If the living area/unit nurse determines that specially prepared trip medication are needed, a trip medication request GSSH Form 397 (Appendix), will be submitted to the Pharmacy at least five (5) days ahead of time. (b) The pharmacy will prepare trip medication for the required doses. The label for these medications shall contain the name of the client, name and strength of the drug, name Picture Of 1mg Clonazepam of the doctor and directions for administration. c) Should a medication order be changed or discontinued between the time the medications are filled and the time the client actually leaves for the trip, the living area nurse shall return the trip medications to the pharmacy for appropriate adjustment and relabeling. C. Birth Control Pills If the consumer is on birth control pills when leaving the institution, the package of birth control tablets originally dispensed from the pharmacy will be sent with the client on vacation or trips. This is to ensure that the cycle will not be altered. If the cycle of tablets will be completed before the client returns to the hospital, then the Living Area nurse will fill out a refill Form 612 (Appendix) and write on the Form "pass". Return this package and the form for an extra cycle of birth control pills. III-21 ECRH PHARMACY AUTOMATION (Medication Renewal Orders, Physician Discharge Reports, Pharmacy Discharge Reports, Vacation Medication Orders, Transfer Medication Orders) Physician renewal orders are rewritten every Picture Of 1mg Clonazepam 30 days for consumers in SNF and Mental Health areas of our facility and every 90 days for consumers in ICF areas. The automation process allows designated ECRH staff to print renewals, transfer orders, vacation orders and discharge reports from computers at nursing stations, nursing offices and physician offices as well as the pharmacy. These reports use the pharmacy WORx computer system to retrieve accurate prescription information and BHIS-consumer identification information to create template designed medication orders. Benefits of automation : 1. To prevent transcription errors on renewal orders. These reports retrieve real time information from the WORx computer system. Physicians can be assured that the renewal orders submitted at periodic health reviews are accurate relative to the date and time printed in the header of the renewal orders, or discharge reports. 2. To save manpower hours (nursing, physician, and pharmacist time). A nurse using automation now only has to insure that medication orders for new start medication are accurate according to label on container received Picture Of 1mg Clonazepam from the pharmacy. IF WHAT IS ON THE LABEL IS CORRECT, THE Picture Of 1mg Clonazepam PHARMACY WORx COMPUTER SYSTEM IS CORRECT; THEREFORE MAR�s, AND THE AUTOMATED MEDICATION ORDERS ARE CORRECT. Nurses do not have to insure medication orders are up-to-date at time of PHR. This process is automated. Clinical Pharmacists will work with nursing staff and physicians to streamline the process. Periodic Health Review implementation will consist of two primary components. a) Periodic Health Review orders (area maintained) consisting of the following: diet, dietary measures, medication/indications, treatments, lab study frequency, supervision/privileges, and other non-medication parameters. b) Automated renewal orders (retrieved from WORx) containing medications, dosages, directions and indications. 3. Renewal reports can also be used as consumer specific vacation/off campus medication requests or as transfer Picture Of 1mg Clonazepam medication orders. In the past nurses and physicians have had to rewrite medication orders for vacations/trial visits. Automated Concept � Print Picture Of 1mg Clonazepam consumer renewal, check vacation box, check drugs for pharmacy to dispense (check the box next to drug name). Fill in number of days for the vacation; fill in effective date (at bottom of renewal order). Sign and send to pharmacy (fax or order pick-up). 4. Physician Discharge Medication Orders: This report retrieves correct medications and displays in ECRH consumer information template. Physicians inputs name of consumer, prints report, checks appropriate boxes (indicates meds to dispense). Enter C if coupon is given to consumer, Rx if prescriptions given, checked box indicates pharmacy to dispense. Physicians will check consumer drug information precautions, referral information, and disability information. Area is available for comments, consumer signature, physician signature and nursing signature. Previous method involved staff writing out this information (time consuming and method has increased possibility for errors). 5. Pharmacy Discharge Report: This report retrieves the same information as the physician discharge report relative to medications and consumer education topics with additional information concerning drug counseling. The automated reports create a checklist for the counseling pharmacist. Previously the counseling pharmacist has had to rewrite medications ordered by MD (labor intensive and increased possibility of errors). 6. Compliance with patient JCAHO safety goal 8: Reconciliation of medications between providers of service. The physician discharge reports provide a method to comply with the safety goal, which will be, enforced 1/1/06. 7. Physicians can utilize their computers to access comment medication profiles from multiple medications, therefore improving the scope and delivery of services. Procedure: Nursing medical, pharmacy staff, and other staff given MAR access rights will be able to run automated ECRH Medication Reports. . Staff with MAR access will have several icons appear on their desktop when they sign on to Novell (Novell application screen). The automated reports can be activated by double clicking the Med Report icon. Information technology will update computer access so that these files can be run in designated locations. Use established process (nursing to fax to pharmacy, file original on chart) Discharge Report is sent with medications (this complies with new JCAHO Picture Of 1mg Clonazepam patient safety goal #8 regulations relative to documentation of all medications discharged on - consumer can take print out to his/her next provider of service). Nurse counsels consumer about meds prior to discharge , signs original. Nursing staff should ask consumer if he/she wants a pharmacist to counsel. If so , a Pharmacist Discharge Report will be generated by pharmacy staff. Individual consumer renewals can be queried and printed by entering name in appropriate retrieval criteria prompts or areas can be queried by entering the area (as it appears in Worx). Clinical Pharmacist assigned to various areas will function as a resource to assist other staff in this endeavor. Note, consumer names must be entered as first and last name appears in Worx or BHIS.(USE CAPITAL LETTERS). SECTION IV IV-1. INFORMED CONSENT The ECRH Pharmacy abides by the Division policy on informed consent for psychotropic drugs. Informed consent is obtained from either the consumers or a next of kin (as appropriate). Except for in the case of emergency, this consent is obtained prior to dispensing of the drug. The Pharmacy will hold the physician responsible for obtaining informed consent as per hospital policy.
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