Pharmacy Collection Form

The pharmacy collection form was used to tally daily the labs we count.

Quote Trish's Manual: "Please be careful and collect and total this information in the unit amounts specified on the data collection form. Standard mixtures are dispensed for a variety of drugs at each site. Please be familiar with what they are. i.e. , inotropes

TISS Refer to page 86 to 93 of this manual for more specific TISS guidelines and general information. Will be done by the bedside nurse. Data collector is responsible to retrieve these forms when complete. We will set up a binder at the front desk where unit clerks will put completed forms. Data collector must ensure quality of the first 2 pages (minimum) of the TISS form. There are cross check to be done with procedures, surgery, diagnosis, lab and pharmacy form.

IMPORTANT QUALITY CHECK FOR TISS are as following:

· ensure that mutually exclusive items in shadowed box are not filled

 in

· check that the 24hr and 48 hr items are completed as per TISS

 pointer TABLE  

· blood product items 23, 24, 25 are filled out appropriately and match

 what is recorded  
 for blood given.

· it patient went to the OR had any procedures, or travelled outside

 the unit for tests
 ensure that items 90 to 95 are completed for the appropriate dates. 
  (this is where your
 history with dates of procedures will help you.)

· number of blood specimens, glucometer testing, blood cultures and

  the previous day TISS. 

"