What publication stated that there are 7,000 preventable deaths each year from medication errors?
To Err is Human
What publication stated the 6 aims for improvement?
Crossing the quality chasm
DRP
events associated with drug therapies that can interfere with optimal patient health outcomes
What is an integrated health system?
Patient under ONE umbrella of a central organization, and often include inpatient/acute care, primary/outpatient care, long-term care, and home care
Prescribing
through privileging
What is privileging?
an oversight body of health care organization or other appropriate provider body is deemed satisfactory to prescribe
What are the 5 rights of medication administration?
1) right medication
2) right dose
3) right time
4) right route
5) right patient
Drug distribution centered model
- pharmacist primarily distribute drugs and process new medication order
- not actively involved with the health care team or development of therapeutic plans for the patient
clinical pharmacist centered model
There are 2 pharmacists
- clinical pharmacist - involved in clinical activities on the nursing units
- distributive pharmacists - involved in drug distribution
Patient centered integrated model
all pharmacists in the department accept responsibility for all elements of the medication use process
Who manages the formulary system?
P & T
MEC
medical staff in charge of institutional governance and performance
Open formulary
no limitations
closed formulary
limited list of medications
DUE
evaluation of data on drug use against predetermined criteria
MUE
encompasses the goals and objectives of DUE. Emphasis on improving PATIENT OUTCOMES
Floor stock system
- unsecure areas on nursing units
- pharmacist provided bulk containers
- nurse prepared off of physician orders
- no pharmacy verification
Unit dose system
-defined as a pharmacy coordinated method of dispensing and controlling medications in health care institutions
What items were born out of unit dose
Patient medication profile
Medication administration record
unit of use package
ADC
point of use medication storage device
Narcotic distribution (Unit dose system)
- stored in locked cabinet on nursing floor
- limited access
- inventory at the end of shift
- extensive record keeping
Centralized model of distribution
- all activities occur in the central pharmacy
- limited interactions with nursing and physicians
- limited clinical services
decentralized model of distribution
- limited inventory
- faster order filling
- must be supported by central pharmacy
Hybrid model of distribution
- utilization of ADC
- central pharmacy dispensing
- decentral for clincial pharmacy services
