Pharmacy Collection Form

This is the original instruction for the PAPER COLLECTION FORM that was used to by the Data Collectors to tally pharmacy data.

original 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.

TISS / Pharm corellation

The following items on your pharmacy form should be confirmed against the corresponding items on the TISS:

• inotropes, heparin, antiarrythmic marked in you history notes and pharmacy form <what TISS items?>

Discussion

• Are there other lab entries that have TISS or other corellations? We should list them here, and we should include checks for them. Ttenbergen 21:32, 4 June 2008 (CDT)

• Do some collectors still use the PAPER pharmacy collection form to collect their data before inputting into PDA?--TOstryzniuk 13:52, 25 March 2009 (CDT)