LTC pharmacy woes

[tobie]

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in short, i barely obtained my license this past november after the "incident" on the east coast. I am now managing a LTC pharmacy. We service 3 youth detention centers, 7 nursing homes and about 18 assisted living centers.

I really do like my job. dealing with nursing and doctors, consulting on medication therapies is what i like to do, but we have problems in paradise...

I have having a very difficult time being a new grad, managing a newish staff, and trying to keep my nurses happy with out going insane myself. I have noticed that our work-flow really is lacking and needs a ton of improvement.

I should add that we do compound the occational IV, but I basically play damage control 60% of the day going home each night tired and fustrated.

Are there any pharmacists out there that may have some idea of how i can better my situation?

Our current work-flow consists of phone and faxed-in orders that are 1. entered by a tech. 2. label is checked by the pharmacist 3. filled by the techs 4. medication-checked by the pharmacist and 5. checked again once placed into the delivery bags for the different facilities. I also do #5 because the techs are usually very busy.

Thanks in advance.

 

[PharmDstudent]

My IPPE rotation is at a LTC pharmacy. I enjoy LTC pharmacy too. I haven't noticed a need for "damage control" though.

Here's how their set-up works:
the orders are faxed in
the technicians enter in the prescriptions
the technicians fill the prescriptions from the labels
the pharmacist checks for accuracy
the pharmacist or technician gives the medication to the partner company down the hall or to DHL; they have deliver drivers that take the hospital medications too.

Medications are filled in "carts" for a 7 day period for the hospital patients. The pharmacist will deliver the "cart" medications on Saturday mornings.

Medications for home health patients are usually counted and placed into amber vials. IV's are mostly "party balls". They rarely dispense TPNs. Nebulizer medications are prepackaged into vial quantities of 90's, 120's, 180's (which relates to the typical q 8, 6, or 4 hours). It really saves a lot of time if they can prepackage during the slow periods.
Medications for hospitals are usually in unit dose packaging. Sometimes they have to fill from stock bottles, but it's not very often.