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.
Category: Advice
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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?
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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...
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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...
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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...
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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...
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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...
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Antibiotic Stewardship
There were two important changes that took place when Phase Two of the CMS “Mega Rule” became effective on November 28, 2017: 1) limiting PRN psychotropic medication orders to 14 days and 2) implementing an Infection Prevention and Control Program (IPCP) that includes an Antibiotic Stewardship Program. Last month we discussed specific limits on PRN...
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The “Mega Rule”
At this point everyone has heard of the so-called CMS “Mega Rule” or the nursing home Requirements for Participation, and the resulting changes. On September 28, 2016, CMS issued the Mega Rule with a three-phase implementation. Phase 1 became effective on November 28, 2016. Phase 2 became effective on November 28, 2017, and Phase 3...
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The OctariusRx Story
Octarius: A pint in the apothecaries’ system.
OctariusRx: The standard by which all other consultant pharmacists are measured.
My life goal has always been to help people. I didn’t always know how, but I always knew the goal: to help others.