Pharmacy Collection Other Sites

The Critical Care database collects counts for the items listed in S_Drugs.

How to collect pharmacy

Only sixteen entries can be sent for Pharmacy. You can collect as many as you want, but only the 16 with the highest priority will actually be sent.

Pharmacy Items Collected

• HSC - list of items needed here
• All other sites (STB, VIC, GRA, OAK, CON)- list of items needed here

• check that there are not more drug days than LOS
• check that doses is not greater than s_drugs MaxDoses for a given drug
• run comparative checks to ensure drugs and priority unique for this patient

Discussion

• we appear to be collecting "items" rather than drugs. Could we have an explanation either here or in the S_Drugs article as to what types of items? Ttenbergen 13:14, 12 August 2008 (CDT)

GRACE ICU

• I have a couple of things that I would like to get clarified.

1. Imipenem is listed on the pharmacy list of drugs. I have not seen this used in a long time but they are using meropenem. I gather that I should be capturing meropenem, is this correct?

2. Second, I was going over things with Jan Kothuber (OAK ICU, casual GRA) because she is going to help Chris Scoville (GRA Casual)cover for me while I am on vacation and an interesting discovery was made.

• Jan was orientated to count bags signed for on the medication sheet when it comes to inotropes and to calculate the amount of drug used that way regardless if the entire bag was used before hanging another or when it was discontinued.
• I was orientated to add the amount of the drug used indicated on the in and out sheet and calculate how much of the drug was actually used that way. One is easier than the other but one is more accurate than the other.
• Can you clarify which way you would like it to be done?

Thanks, Mary Lou (GRACE ICU)

• I have access to it and have read the issue about syringe use - I'm in Mary-Lou's camp - counting mg's then converting into a syringe count of how much the patient actually received - I've been doing that for years.

Chris Scoville (GRACE CASUAL)

VIC ICU

• I just received a phonecall from Jan Kothuber (OAK ICU)about the IV drug calculations.
• I know I am on holidays but I just want to clarify what we have been doing at the VIC since we started data collecting. Norine does it the exact same way.

1. When an IV dug is mixed in a sage, or drip, ou use a vial, let's say amiodorone 300 to add to the bag. We would calcualte that as 1 dose for the one day (if they only hung one bag) If there were consecutive bags it would be 2 or 3 or however many bags over however many days. We were told in orientation it was was cost measures. So it didn't matter how much of the bag was used up , we still had used up the vial, it can't be used for anyone else............

• It's easier to figure out oral meds in a more exact mgs. The only exception was propofol where we had to figure out the exact amount of mgs.
• Anyway, this is what I had told Jan during her orientation.

So just so you exactly how you told us a long, long, long time ago.

Jackie W. (VIC ICU)

>>> Norine Miller 07/09/08 10:07 PM >>> I agree with the exception of the propofol when there is an infusion, bottles of 1000 mg are hung counted as one no matter how much is used as it was not reusable-exception are boluses (which we can choose in the dropdown menu) -I am looking at it right now...........

Norine M (VIC ICU)

CON ICU

• I was trained to count bags, so that is what I have been doing here....exactly what Vic is doing. Re: meropenem...I have never counted this in the pharmacy section.

Betty (CON ICU)

STB ICU

• At St. Boniface we count the number of bags/bottles used and not the amount in the bag used, as was previously pointed out by others, the unused portion is thrown away, and the cost is what is being calculated. That's how we do it here.DFriesen 15:57, 15 July 2008 (CDT) & Kym Wiebe

GRA ICU

• Hi Trish - I have access to it and have read the issue about syringe use - I'm in Mary-Lou's camp - counting mg's then converting into a syringe count of how much the patient actually received - I've been doing that for years. Christine Scoville - GRA ICU casual.

• Okay, Trish here, waiting to hear from STB and HSC ICU TOstryzniuk 20:48, 14 July 2008 (CDT)

OAKS MICU

My collection process @ The Oaks has been outlined by Jackie and MaryLOu. I was oriented to counting the # of bags and it was explained to me that it was the cost that we were reflecting in our count. I am glad this discussion came up as I would prefer that we collect the same way across the Region in whatever process is correct.Jan Kothuber

• so what is the end result of this discussion?JWinestock 16:43, 6 October 2008 (CDT)

Heparin

• I seem to remember that some heparin is no longer included on the TISS. Does that affect these instructions? Ttenbergen 21:32, 4 June 2008 (CDT)
  • we no longer put subcutaneous heparin on the TISS (item 72 & 73). Only IVJWinestock 15:56, 10 July 2008 (CDT)**

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