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May 8, 2018Awhile a go, I summarized our hospital policy for the unit-dose issuance system in the inpatient pharmacy, and Below are the listed focus points regarding set ot daily work parameters as mentioned in the guidelines and our standards of care.
| # | SUMMARIEZED | FOCUS POINTS |
| 1 | Unit dose orders: | · Authorized licensed physician
· Ready to be dispensed for admitted patients. |
| There is prescribing Privilege of some medications based on the physician specialty. | ||
| Radioactive Substances are handled and controlled completely by
Nuclear Medicine Department only. |
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| Ordering of Non Formulary medication(s) must be through Formulary
Exception Request Form. |
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| 2 | STAT Order | 20 minutes |
| 3 | New Order | new medication |
| 4 | Re-Order: | After reaching the stop date. |
| 5 | verbal order: | 4 hours |
| Received and documented by the following health care professionals registered licensed nurses, dieticians, respiratory therapists, radiology technicians, dental technicians, ECG technicians and laboratory technicians. | ||
| only during extreme emergency when immediate action is required and the doctor is unable to write the actual order. | ||
| Verbal orders are not permitted for:
a) Narcotic / controlled medications b) High Alert Medications (except in ICU). |
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| • Dopamine inj. (Changing the infusion rate).
• Dobutamine inj (Changing the infusion rate). • Chlorpheniramine inj. • Atropine inj • Naloxone inj • Hydrocortisone inj • Labetaolol inj • Verapamil inj • IV fluids • Glyceryl Trinitrate inj |
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| 6 | telephone order: | 24 hours |
| Received and documented by the following health care professionals registered licensed nurses, dieticians, respiratory therapists, radiology technicians, dental technicians, ECG technicians and laboratory technicians. | ||
| Telephone orders are not permitted for:
a) Narcotic / controlled medications b) High Alert Medication except in ICU |
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| • Analgesics/Pain Killer
• Antipyretics. • Antispasmodic • Oral antihypertensive medication • Oral hypoglycemic agents • Laxative • NSAID • IV fluids • Anti flatulent drugs • Cough syrup. • Antiemetic |
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| 7 | discontinue Order: | Stop the medication. |
| Medication Discontinue should be done Electronically and Signed stamped by Physician and return back to pharmacy with all patients medication plastics. | ||
| 8 | Out Patient medications prescribing: | · authorized by licensed physician
· Outpatients. |
| 9 | Narcotic& Controlled medications ordering | · Narcotic & Controlled
· Authorized licensed physician. |
| Physicians are not allowed to prescribe controlled drugs for them self or their families. | ||
| 10 | Floor stock medication ordering | · medications / IV Fluids and Nutrition
· licensed registered nurse · Approved floor stock list. |
| 11 | All medication orders should have all patient’s information and the name of the nursing unit | · date and time ordered,
· Diagnosis, · Allergies, · drug name, · dosage in metric units and per Wight for specific medication(s) in pediatric population, · route of administration, · frequency · Start and stop date (ASO). |
| 12 | PRN | · Instruction for the PRN medications use
· frequency and the dose range · indications · No Administration time |
| 13 | Pharmacist | review, check and verified before dispensing for the following:
• appropriateness of the drug, • dose, frequency, • rout of administration • Therapeutic duplication • allergies or sensitivities • drug-drug/drug-food • Patient weight and other physiological information • Other contraindication • Complying with hospital drug protocol (criteria for use) • All Orders must have all data completed. |
| 14 | Patient transfer | Different level of care |
| 45 | Going to surgery | Hold and revive |
| 16 | unclear, illegible and incomplete prescriptions/orders | Contact the physician |
