Create presentation for nursing education on various pharmacy policies and procedures, including: dispensing from MedSelect (Must use MAR as source - do NOT go by MedSelect profile. If discrepancy between MAR and MedSelect profile - REVIEW PHYSICIAN'S ORDER IN EMR. If still not clear, call pharmacy. DO NOT JUST OVERRIDE. Follow up - don't just ignore discrepancies.); Overriding medications (Seeing LOTS of unnecessary overrides and several errors. Nurses are jumping to override too quickly. Overrides are associated with a HIGH RISK of error and should ONLY be done when necessary and in strict adherence to policy. Overrides during the day when pharmacy is open should be extremely rare. Call pharmacy if a now dose is needed. Required safety steps are routinely being skipped. This puts patients at risk. Process: Physician's order in EMR must be reviewed by the nurse and witness prior to overriding a medication [stress this step - most nurses are skipping this step and putting patients at risk], under the Physician tab in MedSelect, document order verification (if you spoke to a pharmacist, select the pharmacist's name; if the order was previously verified by a pharmacist as indicated by RxV on the MAR, select "previously RxV'd-not on profile"; in rare situations where the delay to call to verify could result in harm to the patient or staff*, select "Emergent-not RxV'd") [*also applies to emergent doses given overnight between nighttime & morning med pass]; Medication administration (Use MAR as source when pulling meds, review gray area on screen for doing info, keep meds in package to double check drug and dose against MAR at time of admin, initial MAR); medication reconciliation (include reviewing each medication with guardian for drug, dose, length of therapy, compliance, etc.), processing admission orders (immediately upon arrival to unit: obtain height & weight, enter in admission order, tag Shelly on order and sign order to transmit to pharmacy. Write unit patient is admitting to, weight, height & allergies at top of preadmission med list and fax to pharmacy with MedHx report), controlled substance accountability, MAR documentation (use standard format: Drug name, dose (in mg, mcg - not volume), route, frequency and indication. Bottom left - date transcribed and initials of nurse transcribing order; Bottom right - consent date and initials of nurse obtaining consent (DO NOT USE "+" TO INDICATE CONSENT); Bottom center (only if you called a pharmacist to verify order)- RxV & initials of pharmacist that verified the order.; nightly chart check, new MAR reconciliation, medication errors, patient transfers & discharges. Nurses must understand all processes. Stress strict compliance with controlled substance documentation, shift-to-shift counts, etc., (include AR law regarding nurse's accountability for controlled substance and examples of violations, repercussions, etc.). Include DEA compliance, audits, repercussions for non-compliance.
Create presentation for nursing education on various pharmacy policies and procedures, including: dispensing from MedSelect (Must use MAR as source - do NOT go by MedSelect profile. If discrepancy between MAR and MedSelect profile - REVIEW PHYSICIAN'S ORDER IN EMR. If still not clear, call pharmacy. DO NOT JUST OVERRIDE. Follow up - don't just ignore discrepancies.); Overriding medications (Seeing LOTS of unnecessary overrides and several errors. Nurses are jumping to override too quickly. Overrides are associated with a HIGH RISK of error and should ONLY be done when necessary and in strict adherence to policy. Overrides during the day when pharmacy is open should be extremely rare. Call pharmacy if a now dose is needed. Required safety steps are routinely being skipped. This puts patients at risk. Process: Physician's order in EMR must be reviewed by the nurse and witness prior to overriding a medication [stress this step - most nurses are skipping this step and putting patients at risk], under the Physician tab in MedSelect, document order verification (if you spoke to a pharmacist, select the pharmacist's name; if the order was previously verified by a pharmacist as indicated by RxV on the MAR, select "previously RxV'd-not on profile"; in rare situations where the delay to call to verify could result in harm to the patient or staff*, select "Emergent-not RxV'd") [*also applies to emergent doses given overnight between nighttime & morning med pass]; Medication administration (Use MAR as source when pulling meds, review gray area on screen for doing info, keep meds in package to double check drug and dose against MAR at time of admin, initial MAR);
medication reconciliation (include reviewing each medication with guardian for drug, dose, length of therapy, compliance, etc.), processing admission orders (immediately upon arrival to unit: obtain height & weight, enter in admission order, tag Shelly on order and sign order to transmit to pharmacy. Write unit patient is admitting to, weight, height & allergies at top of preadmission med list and fax to pharmacy with MedHx report), controlled substance accountability, MAR documentation (use standard format: Drug name, dose (in mg, mcg - not volume), route, frequency and indication. Bottom left - date transcribed and initials of nurse transcribing order; Bottom right - consent date and initials of nurse obtaining consent (DO NOT USE "+" TO INDICATE CONSENT); Bottom center (only if you called a pharmacist to verify order)- RxV & initials of pharmacist that verified the order.; nightly chart check, new MAR reconciliation, medication errors, patient transfers & discharges. Nurses must understand all processes. Stress strict compliance with controlled substance documentation, shift-to-shift counts, etc., (include AR law regarding nurse's accountability for controlled substance and examples of violations, repercussions, etc.). Include DEA compliance, audits, repercussions for non-compliance.
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This presentation delves into the critical aspects of medication management and accountability, emphasizing healthcare compliance with laws and regulations. Highlighted topics include the importance of strict documentation for controlled substances, mandatory shift-to-shift counts, and adherence to AR & federal laws. It also covers the proper use of MedSelect systems, addressing discrepancies, and consulting the pharmacy when issues arise. The session stresses reviewing electronic medical...