Pharmacy collection: Difference between revisions

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== How to enter the data  ==
== How to enter the data  ==
In the [[Patient viewer]], go to the Pharm_Flow tab.  
In the [[Patient viewer]], go to the [[Patient Viewer Tab Pharm_Flow]].  


For the drugs listed in black, enter the '''number of days''' for which a [[Drugs Collected | drug]] was given.
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.


For the drugs listed in blue, enter a "1" if the drug was given even once during the admission, and a "0" otherwise. These drugs are not counted.  
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.  
Only collect the [[Drugs Collected | drugs]] specifically listed.  
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Be sure to collect all intravenous and oral preparations for each drug unless otherwise noted (e.g. specified continuous infusions would be an exception).
Be sure to collect all intravenous and oral preparations for each drug unless otherwise noted (e.g. specified continuous infusions would be an exception).


=== Sending ===
{{Data Integrity Check List}}
The Pharmacy items SENT in for each patient does not show up in your EXCEL sheet that opens when [[Sending | sending patients]]. You do not need to check that this data is being sent.


== Pharmacy Format on CCMDB.mdb ==
== Legacy Info ==
'' this discussion is linked in from [[Requested_CCMDB_changes_for_the_next_version#Drugs_Collected Requested_CCMDB_changes]]; please comment here. {{Discussion}}
* after 2012-09-25
** Reduced number of drugs collected in [[L Pharm Flowsheet table]]
** started to collect some as yex/no boolean variables in [[L_Log table]]


I changed the Pharmacy screen to be all on one line to allow people to scroll between lines. There have been several concerns about the new listing; I'll summarize and break into headings so we don't get all muddled.
* 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


{{Potential Change}}Trish, please prioritize this in [[Change Priorities]] as you will.
* prior to 2012-01-01
** HSC labs were imported
** other sites were all collected as counts in [[L_Pharm]] table


=== size and orientation of labels ===
== Related articles ==  
{{Discussion}}
{{Related Articles}}
Collectors are having a hard time with the vertical labels - they are too small and get hard to see after a few hours.
I can think of only one way to change this, and that is to go back to the old layout of having two lines of drug tables. I changed away from this because it only allowed two lines of drugs per patient, and there had been complaints about that.


Someone mentioned changing it to two columns with the drugs listed horizontally, but sadly Access doesn't provide for a functionality of pivoting lines into columns in forms (newer versions might ours doesn't).
[[Category:Pharmacy| *]]
 
*Laura emailed: ''...it would be helpful if you could slant the words in the pharmacy list to make them easier to read (like you had them in the original version.  Reading at a right angle is more difficult..."
**I replied: "If we want to keep them on one line I don’t think there is room for slanting, is there? I have not actually looked at this on a collector laptop, my screen is much bigger, but I try to be mindful of fitting the forms on the screen.''- Ttenbergen 12:01, 2012 October 4 (CDT)
***Collectors continue to have a hard time with the current pharmacy entry screen on laptop.  The list of drugs is vertical and makes veiwing and entry difficult.  Hard on neck, have to put laptop on its side to see drug.  Even when drugs list on angle, too many on list and it is hard to line up drug with correct field that the count should go in.  Tina or Fred, is there another way the set up pharm list so that it is more ergonomically better for viewing and entering.--[[User:TOstryzniuk|Trish Ostryzniuk]] 18:40, 2012 October 11 (CDT)
****'''An alternative approach would be to list all the drugs in a series of columns with drug label to the left and data entry field following, e.g., Heparin SQ''': [__________]. '''This approach would take up more space on the form but I think it is doable. I'll mock up a prototype today and send it to you'''. -- [[User:Fschumacher|Fred Schumacher]] 08:43, 2012 October 12 (CDT)
*****Collectors: An email was sent today Oct 12.12 showing a mock up of a change to pharmacy screen for viewing and entry.  Please comment here what you think of new idea. For example of idea go to: [[File:Suggestion for Pharmacy entry screen Oct12.12.pdf]]-[[User:TOstryzniuk|Trish Ostryzniuk]] 11:15, 2012 October 12 (CDT)
******''Having a difficult time trying to imagine this new format when I open it up. I can see it more clearly which is a plus. But why the big empty space to enter the number of days? And can we have yes or no for the drugs we don’t count the days for? Thanks Shirley Not all the drugs are entered so I don’t know if it more user friendly''.-[[User: SKiesman | Shirley Kiesman]]
******* Don't forget that this suggested format is incomplete and is not representative of the final product. In other words, there is no final formatting in this example and I didn't include all the drugs--there is more work to do to get this screen ready for production use. While data entry is displayed differently, you will have the same functionality as the current version. -- [[User:Fschumacher|Fred Schumacher]] 08:48, 2012 October 15 (CDT)
******* ''I like it and so does my neck. Reading things like a book just makes sense, thanks Fred for a good idea''.[[User:GHall|GHall]] 17:04, 2012 October 12 (CDT)
******* Will this new format allow for multiple lines/days of entries that will be subtotaled (as the current Access program does)?[[User:Mlaporte|Mlaporte]] 07:16, 2012 October 15 (CDT)
******** Yes. -- [[User:Fschumacher|Fred Schumacher]] 08:48, 2012 October 15 (CDT)
*********I prefer the format, as long as we still have the "hover" feature and all the drugs are on one page with a differentiation for the ones that only require a yes, then I much prefer this. --[[User:LKolesar|LKolesar]] 08:49, 2012 October 16 (CDT)
****** Marla Penner's suggestion: Could we go back to 2 lines for the drugs please?  Top line could be for the drugs requiring "days numbered" and the lower line for the "yes/no" drugs or reverse this order if the drugs requiring numbers of days would benefit from additional space for more entry days.  This way we could have the drug headings slanted like they were before.  Thanks
*******At first glance, it appears to be more user friendly. I would have to see the entire format and use it before I could really comment. I do not like the format we are currently using due to the difficulty I experience in trying to read sideways--[[User:Lpruden2|Lpruden2]] 08:58, 2012 October 18 (CDT)
 
 
=== alphabetical vs old order of drugs ===
* Could you put in alphabetical order like in the [[Drugs Collected]] article. 
** I asked collectors how they would like this sorted. The request was to have it sorted as before, so that's what I did. It could be sorted otherwise, but let's seek some more input from collectors on that so we don't end up changing it back. Ttenbergen 12:22, 2012 September 26 (CDT)
***it seems logical and easier to find the drug on the list when grouped alphabetically rather than current list in no logical order and hard to find.  It is up to collectors what they want.
**** If any data collectors would like the order changed please comment below with how you would like to see it ordered. I will leave the order as is unless I hear back. '''Please also comment if you would like the order to stay as is''' - otherwise a small minority wanting it changed would be able to launch the change. Ttenbergen 11:36, 2012 October 1 (CDT)
**alphabetical is not helpful because often we are still "looking" for the right category for a particular drug.  It is helpful if all the antimicrobials are together and all the vasoactives are together and I think the way it is now does accomplish that. I suggest leaving them in the order they are now.  --[[User:LKolesar|LKolesar]] 08:56, 2012 October 16 (CDT)
***It is hard to read the vertical lines, Fred's idea seems better but will need to see the actual format to really decide. I do not think alphabetical is a good idea, I prefer it the way it is. lois
****I would prefer categories versus alphabetical--[[User:Lpruden2|Lpruden2]] 08:58, 2012 October 18 (CDT)
*****I do not think the alphabetical listing of drugs is appropriate as there are different names within each category.  I would like to see drugs grouped, e.g. all vasoactive categories lumped, all antibiotic categories together, etc.  Thanks (Marla Penner)
 
== [[TISS]] / Pharm correlation  ==
The following items on your pharmacy form should be confirmed against the corresponding items on the [[:Category:TISS|TISS]]:
 
*vasoactive drugs, heparin, antiarrythmic marked in your history notes and pharmacy form (Tiss items 67, 68& 69 )
*check that TISS # 76 or 77 is marked against the antibiotics on the MAR
*check that Tiss 71 is marked when pt had potassium via central line;
*check #70 is marked if patient is on Vasopressin.
 
=== updating [[:Category: Data Cleaner.mdb | Data cleaner]] ===
[[file:Change pot.svg|right]]<noinclude>
*don't think this is added to [[Data cleaner.mdb general information | Cleaner.mdb]] yet. Trish, let me know the priority of this. [[User:Ttenbergen|Ttenbergen]] 19:22, 2012 September 6 (CDT)
** we don't have this in cleaner. Since we are changing to new [[TISS28]] we should wait since some check will not be able to do.[[User:TOstryzniuk|Trish Ostryzniuk]] 11:09, 2012 September 7 (CDT)
 
== {{Data Integrity Rules}}  ==
* each patient has to have at least one line of no entries (implemented)
 
* maximum count for any drug must be < LOS+2 if calculated using admit date/time & discharge date/(time or 23:59 if unavailable)
** implemented as LOS = CLng(Nz(Form_View.R_DisDate) + nz(Form_View.R_DisTime, 1)) - Nz(Form_View.R_AdmDate, 0))
 
== Dates / Startup / Legacy Info ==
*for patients admitted started after midnight January 1, 2012 and
*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_Flow sheet.
*As of January 1, 2012 @ 0001 hrs, only the new Pharm Flow sheet for pharmacy will be used.
* we used to count a different list of drugs, and all had doses and days counted before Jan 1 2012
 
 
[[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: