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- Mar 25, 2008
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I'm looking for some policies/workflow adjustments that would help a pharmacy reduce how often nurses call down for missing meds.
Some of my ideas:
- Day shift IV room should produce and send up enough patient specific IV products/IV antibiotics/pressors/sedation meds to last the patient until 24 hours later for meds that are not stored in the pyxis or that have to be compounded. Have the meds stored on the floor in a med room. The nurse should not be calling down every 6-8 hours for the same ****. Part of my job is to do the PO fill list for the whole hospital for meds that are not in the Pyxis. I send up enough stuff to last them until the next cart fill. When I get an order for a medication, I give them enough supply to last them until the next cart fill. Everyone else seems to send one dose.
- Produce IV meds in the highest concentration possible to ensure each bag as long as possible. My per diem hospital makes fentanyl drip in 2000 mcg/100 mL. My full-time does it in 500 mcg/100 mL.
The reasons I've gotten in resistance to what I propose is they don't want a bunch of meds being returned because of patients being moved around constantly, nursing losing/misplacing meds, medications expiring, cost of losing meds to expiration. It is bizarre.
Some of my ideas:
- Day shift IV room should produce and send up enough patient specific IV products/IV antibiotics/pressors/sedation meds to last the patient until 24 hours later for meds that are not stored in the pyxis or that have to be compounded. Have the meds stored on the floor in a med room. The nurse should not be calling down every 6-8 hours for the same ****. Part of my job is to do the PO fill list for the whole hospital for meds that are not in the Pyxis. I send up enough stuff to last them until the next cart fill. When I get an order for a medication, I give them enough supply to last them until the next cart fill. Everyone else seems to send one dose.
- Produce IV meds in the highest concentration possible to ensure each bag as long as possible. My per diem hospital makes fentanyl drip in 2000 mcg/100 mL. My full-time does it in 500 mcg/100 mL.
The reasons I've gotten in resistance to what I propose is they don't want a bunch of meds being returned because of patients being moved around constantly, nursing losing/misplacing meds, medications expiring, cost of losing meds to expiration. It is bizarre.