Full Time and Part Time Consultant Pharmacist – Massachusetts (North Shore), New Hampshire (Southern), Florida (Southern), Pennsylvania (North East)
Managing High-Alert/Hazardous and Look-Alike-Sound-Alike Medications in Ambulatory Care Settings
In this week's post we discuss managing High Alert and Look-Alike-Sound-Alike medications. These medications require special attention because they can cause significant patient harm when used in error.
Storage Guidelines and Shortened Expiration Dates
This week we talk about medication storage, shortened expiration dating and the big impact it can have on your survey results. Are you prepared?
Compounded Drugs
Does your facility use compounded drugs? Do you get them from an FDA registered 503B outsourcing facility? According to a recent report from the U.S. Department of Health and Human Services Office of Inspector General, about 11% of hospitals get compounded drugs from sources that are not registered with the FDA.
Medication Safety Quiz
In our most recent newsletter issue and during our customer visits, we have shared our updated "Med Safety Quiz". The quiz is designed to actually "teach rather than trick". If you’d like to try these questions and then check your answers, please reach out to us for more details.
Medication Storage Guidance
One of the key components for meeting the CMS requirements for the proper provision of pharmaceutical services is the requirement to properly store medications. First, we address the general requirements of medication storage. Second, we address the specific requirements for medication rooms and refrigerators. According to F-Tag 761, facilities must store all drugs and biologicals in locked compartments under proper temperature controls and permit only authorized personnel to have access to the keys. A facility, in coordination with a licensed pharmacist, which is generally its consultant pharmacist, must provide safe and secure storage, limited access, and mechanisms to minimize loss...
Medication Rooms and Refrigerators
Ensuring a medication room is always ready for survey requires minimal effort but requires constant vigilance. Starting with security, medication storage areas must be locked when not being accessed by an authorized person. Schedule II-controlled substances must be maintained within a separately locked permanently affixed compartment (double lock requirement). Proper labeling is also required for proper storage. Facilities must ensure medications and biologicals are properly labeled in accordance with currently accepted professional principles, including expiration dates. During the survey process, surveyors focus not only on security and the general cleanliness and organization of medication rooms and refrigerators, but also on...
Unnecessary Drugs
One of the areas often cited under Pharmaceutical Services during survey is Unnecessary Drugs, which now falls under F757 in the updated State Operations Manual (SOM). The F-Tag states that “Each resident’s drug regimen must be free from unnecessary drugs”. The term Unnecessary Drug is often misunderstood, incorrectly used and poorly applied. Upon hearing it for the first time, most assume that it refers to using a medication without an appropriate diagnosis. Although using a medication without an appropriate diagnosis would be considered unnecessary, a diagnosis alone does not justify the use of any medication or keep it from being...
Practical examples of Unnecessary Drugs
The most obvious example of a situation that could include an Unnecessary Drug is when a patient is admitted or a new medication is started and a proper diagnosis is not noted in the medical record. We encourage you to add all diagnoses to one central list, even if the diagnosis can be found in other parts of the medical record. Excessive dose happens more frequently than we realize. Although medication references list maximum daily dosages, those maximums are often different for the geriatric population and sometimes also differ based on the condition being treated. It is important to ensure...
New Clostridium Difficile Guidelines
A lot has changed in the diagnosis and treatment of Clostridium Difficile Infection (CDI) since the Infectious Disease Society of America (IDSA) and the Society for Healthcare Epidemiology of America (SHEA) last published guidelines in 2010. The new guidelines recommend the development of an antibiotic stewardship program, which should focus on reducing the frequency and duration of the use of high-risk antibiotics. Specifically, restriction of fluoroquinolones, clindamycin, and cephalosporins (except for surgical antibiotic prophylaxis) should be considered. Although probiotics are commonly seen during the treatment of CDI, the current guidelines state that there is insufficient data to support this practice...