Pharmacy collection: Difference between revisions

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*Collect pharmacy data for '''critical care patients''' admitted after midnight 2012-01-01 into the Pharmacy Flowsheet.
The Critical Care Database collects [[Drugs Collected]] for '''critical care patients'''. The Medicine Program does '''not''' collect any pharmacy information.  
*Stop collecting pharmacy the old way at the same time. 
*If a profile has some collected by the old method and some by the new method that is OK.  Consolidation, if required, will happen behind the scenes.  
*For HSC where no manual collection was done prior, the '''new admissions''' starting Jan 1, 2012 will have manual pharmacy collection with the new pharm flowsheet.  
*As of Jan 1, 2012 @ 0001 hrs, only the new flowsheet for pharmacy will be used. 
*values entered over multiple lines will be added up before sending; a listing for the sum wasn't included due to space restrictions


The Data Collector in the Medicine Program do '''not''' collect any pharmacy information.  
== How to enter the data  ==
In the [[Patient viewer]], go to the [[Patient Viewer Tab Pharm_Flow]].  


== How to enter the data ==
For the drugs listed in the row with a date at the start, enter the '''number of days''' for which a [[Drugs Collected | drug]] was given.
In the [[Patient viewer]], go to the Pharm_flow tab. Enter the '''number of days''' for which a drug was given '''(not collecting doses any longer)'''.  


You don't need to list entries for a given day, the lines are there only allow you to break down your work if a patient stays for a long time.  
For the drugs with check boxes, check the box if the drug was given '''even once during the admission'''. These drugs are not counted.
 
Only collect the [[Drugs Collected | drugs]] specifically listed.  


===Hints===
=== Data Entry Hints ===
* double-click into a cell to up it by 1 (or in case of 0/1 drugs, to toggle between 0 and 1
*double-click into a cell to up it by 1 (or in case of 0/1 drugs, to toggle between 0 and 1  
* hover over a cell to get a popup with the drugs that are part of any of the groups we collect
*hover over a cell to get a popup with the drugs that are part of any of the groups we collect  
* When reviewing the MAR for all drugs or flow sheets for infusions you may find it helpful to make a pencil mark after the drugs you have counted up to so that when you look at it again, the same drugs are not duplicate counted.
*today's date automatically is put into the line when you enter a new line. This also helps to keep track of when you last counted drugs.  
* The date automatically is put into the line when you enter a number under the specific drugs. This also helps to keep track of when you last counted drugs.
*you can change the date using the "+" and "-" buttons, and enter today's date using the "*" button
* For the blue colored drugs you only need to put a "1" in the box (or double-click the box) if it ever was used during the patient stay.  If it is left blank it means it was not used.  We do not need the number of days for these specific drugs.


== Drugs Collected ==
=== Data Collection Hints ===
see [[Drugs Collected]]
*When reviewing the MAR for all drugs or flow sheets for infusions you may find it helpful to make a pencil mark after the drugs you have counted up to so that when you look at it again, the same drugs are not duplicate counted.


== TISS / Pharm corellation ==
=== multiple lines for different days collected ===
The following items on your pharmacy form should be confirmed against the corresponding items on the [[:Category:TISS|TISS]]:
To provide functionality similar to paper flow sheets you can add a line per day of collection. It is not mandatory to use multiple lines, the functionality is there only for data collector convenience.  
* vasoactive drugs, heparin, antiarrythmic marked in your history notes and pharmacy form (Tiss items 67, 68& 69 )
You don't need to list entries for a given day, the lines are there only allow you to break down your work if a patient stays for a long time.  
* check that TISS # 76 or 77 is marked against the antibiotics on the MAR
Values entered over multiple lines will be added up before sending; a listing for the sum wasn't included due to space restrictions.
* check that Tiss 71 is marked when pt had potassium via central line;
* check #70 is marked if patient is on Vasopressin.
=== discussion ===
{{discussion}} '''which of these are still relevant? pls. just remove ones that no longer are.'''[[User:Ttenbergen|Ttenbergen]] 19:02, 8 December 2011 (CST)
* What do we do if a person is on a IV PPI  and an oral is a double count or a single? The same for any drug in the same category given the same day.
**We just need the number of days for a category regardless of which drugs were given. If they were on one PPI or two it doesn't matter, just count the days on any PPI.--[[User:LKolesar|LKolesar]] 15:40, 20 December 2011 (CST)


* Are we just counting IV antibiotics or both IV and oral? What about everything else IV and oral all collected?
=== no double-counting ===
** IV and oral are collected unless specifically indicated like IV infusion of opioids for example.--[[User:LKolesar|LKolesar]] 15:40, 20 December 2011 (CST)
* If 2 drugs are in the same category, only count one day for each category (don't double count).
* If a patient is on a combination of oral and intravenous for the same drug, only count the drug once per day regardless of administration route.


*If I enter my drug counts on a new line on a daily basis (rather than at the end of a patients stay), will the program add up the number of treatment days (like the lab sheets)..or do we have to add/total as we enter??  Could the date line have a "+/-" button so we can change the date to match our date of collection? [[User:Mlaporte|Mlaporte]] 09:17, 20 December 2011 (CST)
=== No PCA  ===
**I asked Tina and she said she didn't put the line to total(as in labs) because there is no space. However the lines will total.  She will look into putting the + or- button when she returns from her vacation in January. Need to manually put in date till then. --[[User:LKolesar|LKolesar]] 15:40, 20 December 2011 (CST)
Do not collect drugs administered via PCA ([https://secure.wikimedia.org/wikipedia/en/wiki/Patient-controlled_analgesia Patient-controlled analgesia]) which is intermittent. As discussed and agreed by ICU task team - Dr. Allan Garland.
**Plus and minus now added.--[[User:TOstryzniuk|TOstryzniuk]] 15:29, 26 January 2012 (CST)


*You do not need to change any prior entries for patients admitted prior to Jan 1, 2012, but stop collecting the old way on everyone after Jan 1. Any pharmacy collection after Jan 1 on all patients should be the new way.  Some patients will end up having a portion of old entries (up to Jan 1) and new pharmacy entries after this.  That is OK, the data will be cumulative.  I hope this helps to clarify.--[[User:LKolesar|LKolesar]] 12:54, 23 December 2011 (CST)
=== No epidural or intravertebral administration ===
We do not collect epidural or intravertebral.


*opioids cont(inous) inf - does this include PCA narcotics?
=== oral/nasogastric tube drugs===
**I would think that because PCA is not CONTINUOUS,then is should not be included in this category.[[User:TOstryzniuk|TOstryzniuk]] 14:31, 24 January 2012 (CST)
Be sure to collect all intravenous and oral preparations for each drug unless otherwise noted (e.g. specified continuous infusions would be an exception).


==January 26, 2012 Feedback New Pharmacy collection==
{{Data Integrity Check List}}
===Pros===
*amount of time collecting has diminished with not having to count exact doses.
*Quicker and easier than previous process.
*Helpful that drugs are categorized rather than alphabetized
*Helpful that list include both generic and trade names
*Very helpful to have printed list as reference.
*Date plus and minus is great additional makes adjusting date much more simple and quick


===Concerns===
== Legacy Info ==
*transition to new process took some time and still taking time to learn all the new drugs that we are not familiar with. 
* after 2012-09-25
*more training about new drug list before implementation
** Reduced number of drugs collected in [[L Pharm Flowsheet table]]
*not enough support for question related to drugs themselves.
** started to collect some as yex/no boolean variables in [[L_Log table]]
*workload increase at HSC site with the ADDITION of drug collection
*in total there is approx. 175 drugs potentially being looked for in charts, however with not having to tally each one separately because they are in once category, once you learn the list it is much quicker than old process. You still have to look all over pharmacy sheets including ICU Flow sheet to find them all.  IV Antibiotics given may not be charted in drug sheets, only on flow sheet in some ICU's. 
*can be confusing for those individual drugs in categories that have both IV and PO.  Not sure if some are available both IV and PO.
*a number of drug names not familiar.  Never see them at some sites.


*Entry on laptop most difficulties
* after 2012-01-01
**area of entry so very small
** values collected into [[L Pharm Flowsheet table]]
**very easy to inadvertently enter the count under wrong drug and not notice
** HSC collects like other sites
**font quite small and subsequently is gets tiring on eyes
** change-over based on date of drug, so for profiles that straddle the change date some data could be in old and in new setup
**multiple entries on different days is a problem.  The viewing screen rolls so that you cannot see the drug name, this creates another potential for entry error.
*Long term patients - files can be difficult to collect especially when the MAR has been recopied several times.  The flow of MARS become disjointed, confusing and time consuming.  Takes extra time and ensure accuracy.
*use paper collection form for long stay patients - after 3-4 weeks.
**Since IICU patients can stay 6 months or so that's alot of doses of coumadin or whatever to add up.
*hard to see lighter shades.  Make drug list one color.


== Data Integrity Checks ==
* prior to 2012-01-01
None as of now, but I will add some as we get used to this. For example:
** HSC labs were imported
* each patient has to have at least one line of no entries
** other sites were all collected as counts in [[L_Pharm]] table
=== Date within admission ===
{{discussion}}
* considering how everyone uses the dates in Pharm_Flow, would it make sense to restrict them to only during admission? Would that help make collection more reliable? I don't want to add a check that makes things worse. [[User:Ttenbergen|Ttenbergen]] 11:58, 27 January 2012 (CST)


== Related articles ==
{{Related Articles}}


[[Category: Pharmacy | *]]
[[Category:Pharmacy| *]]

Latest revision as of 11:28, 2022 February 17

The Critical Care Database collects Drugs Collected for critical care patients. The Medicine Program does not collect any pharmacy information.

How to enter the data

In the Patient viewer, go to the Patient Viewer Tab Pharm_Flow.

For the drugs listed in the row with a date at the start, enter the number of days for which a drug was given.

For the drugs with check boxes, check the box if the drug was given even once during the admission. These drugs are not counted.

Only collect the drugs specifically listed.

Data Entry Hints

  • double-click into a cell to up it by 1 (or in case of 0/1 drugs, to toggle between 0 and 1
  • hover over a cell to get a popup with the drugs that are part of any of the groups we collect
  • today's date automatically is put into the line when you enter a new line. This also helps to keep track of when you last counted drugs.
  • you can change the date using the "+" and "-" buttons, and enter today's date using the "*" button

Data Collection Hints

  • When reviewing the MAR for all drugs or flow sheets for infusions you may find it helpful to make a pencil mark after the drugs you have counted up to so that when you look at it again, the same drugs are not duplicate counted.

multiple lines for different days collected

To provide functionality similar to paper flow sheets you can add a line per day of collection. It is not mandatory to use multiple lines, the functionality is there only for data collector convenience. You don't need to list entries for a given day, the lines are there only allow you to break down your work if a patient stays for a long time. Values entered over multiple lines will be added up before sending; a listing for the sum wasn't included due to space restrictions.

no double-counting

  • If 2 drugs are in the same category, only count one day for each category (don't double count).
  • If a patient is on a combination of oral and intravenous for the same drug, only count the drug once per day regardless of administration route.

No PCA

Do not collect drugs administered via PCA (Patient-controlled analgesia) which is intermittent. As discussed and agreed by ICU task team - Dr. Allan Garland.

No epidural or intravertebral administration

We do not collect epidural or intravertebral.

oral/nasogastric tube drugs

Be sure to collect all intravenous and oral preparations for each drug unless otherwise noted (e.g. specified continuous infusions would be an exception).

Data Integrity Checks (automatic list)

 AppStatus
Check Sub PharmCheckCCMDB.accdbimplemented
Query check CCI TISS Pharm VasoactiveCCMDB.accdbimplemented

Legacy Info

  • after 2012-01-01
    • values collected into L Pharm Flowsheet table
    • HSC collects like other sites
    • change-over based on date of drug, so for profiles that straddle the change date some data could be in old and in new setup
  • prior to 2012-01-01
    • HSC labs were imported
    • other sites were all collected as counts in L_Pharm table

Related articles

Related articles:
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