I need your input please!!

[metermaiden1969]

Are there any other ED's that are having their medication orders reviewed by pharmacy? My quality department has implemented an interim action plan to have ED med orders/administration reviewed by the pharmacist within 48 hours. The pharmacy and ED are having difficulty in making this work smoothly. Any ideas?? I am desparately seeking feedback for resolution. Thanks

[S.T.A.C.E.Y, LPN]

Just for admitted patients or for patients who are in & out of emerg as well?

[metermaiden1969]

all patients that are seen in the ED.

[errneducator]

Unfortunately, JCAHO and other accrediting agencies don't work in the ER. They are the ones wanting the meds looked at by the pharmacists. Currently, our hospital is not doing the evaluation, but I am sure it will come down the pike eventually.

[Altra, BSN, RN]

Are there any other ED's that are having their medication orders reviewed by pharmacy? My quality department has implemented an interim action plan to have ED med orders/administration reviewed by the pharmacist within 48 hours. The pharmacy and ED are having difficulty in making this work smoothly. Any ideas?? I am desparately seeking feedback for resolution. Thanks

Are you saying that the charts need to be reviewed within 48 hours for compliance to policies/standards ... i.e., pneumonia pts. being given abx within 4 hours of arrival to the ED ... that sort of thing?

Is it a problem making the charts available to pharmacy? Or is it that pharmacy does not have the staff available to complete these reviews promptly?

Just trying to understand ...

[metermaiden1969]

This is a JCAHO standard. It is not for quality/core measure review. This is a must do thing for our ED as well as our clinics. The process that we have now for the ED is for pharmacy to pull the scanned record off of the computer. They have complained that this is difficult and very time consuming. What JCAHO is wanting is to avoid medication administration errors...inappropriate dosing, inappropriate medications, etc. To do this properly, we should be faxing every med order or prescription down for review prior to the med or Rx being dispensed. We are able to do a "work around" because of the 48 hour leway we have in the standard. This was added to the standard because some hopitals function without a pharmacist on the weekends. I would like to do it right...meaning faxing orders immediately...but this seems unreasonable in the ED. The pace is just too fast for yet one more delay. Since we are having the pharmacist review "after the fact", I am wanting to make it as easy on our pharmacist as possible. So, with all of that...I would love feedback. Thanks

[Altra, BSN, RN]

This is a JCAHO standard. It is not for quality/core measure review. This is a must do thing for our ED as well as our clinics. The process that we have now for the ED is for pharmacy to pull the scanned record off of the computer. They have complained that this is difficult and very time consuming. What JCAHO is wanting is to avoid medication administration errors...inappropriate dosing, inappropriate medications, etc. To do this properly, we should be faxing every med order or prescription down for review prior to the med or Rx being dispensed. We are able to do a "work around" because of the 48 hour leway we have in the standard. This was added to the standard because some hopitals function without a pharmacist on the weekends. I would like to do it right...meaning faxing orders immediately...but this seems unreasonable in the ED. The pace is just too fast for yet one more delay. Since we are having the pharmacist review "after the fact", I am wanting to make it as easy on our pharmacist as possible. So, with all of that...I would love feedback. Thanks

I'm sorry, I'm still not quite understanding.

If this is a JCAHO mandate "to avoid medication administration errors" then what is the point of reviewing orders 48 hrs. later?

If for whatever reason it is cumbersome for Pharmacy to have access to patient charts/order sheets after the fact ... this sounds like an IT issue. The last thing you want to do is to create some process where yet another paper copy of things is generated ...

As I'm sure is apparent ... our Level I ER is not doing this. All charts are reviewed, including med orders, for quality.

[phiposurde]

That sound like a pretty bad idea. If they really want to implement such hard condition, maybe they should consider having the computarize machine that distribute medication. In the ICU i work, we have a pharmacist assign only to our department. Maybe that could be the middle ground!