ACTT nurse input needed

[juschillin, MSN, RN, NP]

I've recently started working on an ACT team (assertive community treatment team) that was recently formed and I'd like to hear how other nurses on ACT teams are organizing themselves. We have 2 full time RNs and close to 60 clients, supposed to have another RN, part-time, once at 60. Some issues I'm trying to work on: How to keep up with Rx refills and picking up meds from various pharmacies; coordinating care with PCP and specialists, and keeping up with what meds they are prescribing; monitoring controlled/scheduled medications use and/or misuse; handling medical emergencies in the field, e.g., diabetic (those situations that can quickly become psych emergencies). Are any of you using any particular apps for smart phones that are free/cheap that have been useful? We aren't using full EMR yet and that limits availability of client info out in the field. Would love to hear your ideas! Thanks.

[TerpGal02, ASN]

I spent close to a year in ACT. We were supposed to have 2 FT RNs and 1 PT RN but for whatever reason the PT RNs we hired just didn't work out. We had 80 clients when I left. It is totally challenging. I didn't use any apps. Buy a planner and use it. It will become your bible. You could use an Outlook Calendar but your schedule will sometimes change in an instant and its not really practical to use a digital calendar. Do you have specific days you pour meds? If not I suggest you do. We did pours on Monday and Thursday. Each one of us took a day. Then there are all the IMs to give. As far as managing scripts, we had a list of people we needed refills on and called refills in when needed (just like you'd call in your own refill) and the case manager was responsible to get it picked up. You have to stay on top of that. Several of our clients were on SafeDose, which is a pharmacy that mails out the client daily meds in unit dosing and have the name, date, and time the med should be taken. They handled all the refill requests not prescribed by our doc. For basic somatic follow up, the case managers handled and reported back to us, usually during treatment team. Do you have your own caseload too? We had a smaller caseload than the other case managers but it was still a lot with all the nursing stuff. I loved ACT and sometimes miss it. Of there's something I haven't covered let me know!

[juschillin, MSN, RN, NP]

Thank you so much for this info. I'm in a rush this morning and don't have time to properly reply, but I'll be back later to do so, with f/u questions. SafeDose -- I'm going to check them out. I wonder if other ACT teams use similar services? You're help is enormously appreciated.