Pharmacy collection

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 Pharm_Flow tab.

For the drugs listed in black, enter the number of days for which a 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.

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).

Sending

The Pharmacy items SENT in for each patient does not show up in your EXCEL sheet that opens when sending patients. You do not need to check that this data is being sent.

Pharmacy Format on CCMDB.mdb

this discussion is linked in from Requested_CCMDB_changes_for_the_next_version#Drugs_Collected Requested_CCMDB_changes; please comment here.

Template:Discussion Any comments on the new format? I changed it to be all on one line to allow people to scroll between lines. Let me know what you think. Specifically, let me know what it could be changed _to_, not just if it's not working. --Ttenbergen 10:58, 2012 September 26 (CDT)

• 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.

• Some collectors have commented that the are really having difficulty with drug list being vertical on the screen. Could there not be 2 columns and drugs list horizontal for easier reading? Thanks!
  • I can't change it to columns unless we are willing to give up the ability to enter daily - Access has no functionality to display records that way. We could go back to two horizontal boxes as before. I wonder if there is any alternative to (how it's done now, how suggested above) that would be better. Can't think of one for the moment. Ttenbergen 12:22, 2012 September 26 (CDT)

• • I am finding it difficult to read the drugs in the vertical columns--really have to crank my neck to read, or have to turn the laptop. I have a couple of long of long stay pts and was unable to add a line to the pharm collection (the field had approx. 8 rows showing). There is no visible scroll bar or is there a trick to creating the next line?Mlaporte 15:00, 2012 September 26 (CDT)

TISS / Pharm correlation

The following items on your pharmacy form should be confirmed against the corresponding items on the 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 cleaner.mdb

• don't think this is added to Cleaner.mdb yet. Trish, let me know the priority of this. Ttenbergen 19:22, 2012 September 6 (CDT)
  • we don't have this in cleaner. Since we are changing to new TISS we should wait since some check will not be able to do.Trish Ostryzniuk 11:09, 2012 September 7 (CDT)

Template: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