Focus points on pharmacy unit-dose system

Awhile 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.

Ordering of Non Formulary medication(s) must be through Formulary

Exception Request Form.

 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).

•        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

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

•        Analgesics/Pain Killer

•        Antipyretics.

•        Antispasmodic

•        Oral antihypertensive medication

•        Oral hypoglycemic agents

•        Laxative

•        NSAID

•        IV fluids

•        Anti flatulent drugs

•        Cough syrup.

•        Antiemetic

 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
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