Approved Hospital Formulary
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Approved Hospital Formulary
01/05/18 MD -- Remote Order Process for Madison
From: Mary Dang
Sent: 05 January, 2018 12:55 PM
To: Pharmacy
Cc: Christopher Strickland
Subject: Remote Order Process for Madison
Hello,
Effective Monday (1/8/18), we will change the remote order process for Madison. HHM and HHWC will be involved in this process.
On Mondays - Fridays (2230-0630) & Saturdays - Sundays (2000-0800), Madison pharmacy will transfer their phone (5-5037) to HHM (5-8282). All Madison units, except OBGYN and ED, will be evaluated/entered/verified by Main. Madison OBGYN (2E-W, 2W-W, 2NBW) and ED-W will be covered by HHWC.We will follow these unit options for a while and see if adjustments in assignments need to be made. Once stabilized, we will have OBGYN and Madison ED departments call HHWC ext (5-7620) directly instead of having HHM being a clearing house. If the transfer of phones from Madison failed or the Madison pharmacist forgot to transfer the phone lines, HHM can call IT to transfer the phone lines.
***Note - HHM & HHWC will begin with orders time-stamped 2230 in HCS at Mon.-Fri.
HCS Updates - willhave updated HCS to enable HHM and HHWC pharmacists to select/include their designated Madison units.
Hand-offs - will occur prior to Madison closing and when Madison opens. A pharmacist from HHWC and a pharmacist from HHM will receive phone calls from a Madison pharmacist. Items of discussions will be HCS/Order issues and unverified orders (all involved will pull up unverified orders for their areas and discuss any issues).
HCAs and Nurses - will enter all medication orders from blue Patient Keeper sheets and Order Sets. Pharmacists will enter all other medication orders (e.g. handwritten medication orders, HCS Medication Reconciliation Sheets, and meds form any order sets with * Not In iCARE* printed at the bottom of the sheet(s). Please use your clinical judgment and prioritize orders. If you are slammed, HCS Medication Reconciliation Sheets can be addressed last or earlier when a medication is needed before Madison Pharmacy is available.
VT Entries - some orders are designated as "Madison " or "Madison Only" per VT selection. This is done for formulation differences. When entering orders into iCARE, please check in your VT selection if any of the above are options.
Madison ED orders - medication orders will be scanned to pharmacy. The ED will denote what items are needed from pharmacy.
Madison Pharmacy - will scan an IV Items Sheet into HCS. This sheet will list IV/IVPB items that have already been made and sent to the nursing units from Madison pharmacy. This is helpful if the nurse calls and asks for an IV/IVPB item that has to be made.
Madison Surge Alert - when bed capacity is full and there are Madison ED Boarders, these patients will be placed in Madison PACU or Madison Imaging until a floor bed is available. These areas are denoted as Faxback/Scan Back. These temporary patient areas are "Non-Profiled" Pyxis areas. Two scenarios may occur: 1) HCAs from the floors will come to these areas and enter Order Sets and blue Patient Keeper sheets into iCARE. Pharmacists will enter orders into iCARE handwritten medication orders, HCS Medication Reconciliation Sheets, and meds form any order sets with * Not In iCARE* printed at the bottom of the sheet. Or...... 2) Medication orders will be entered into iCARE once the patient is transferred to a nursing floor.
Medication Items in Madison Pyxis Machines - it shall be the responsibility of the nurse to first check availability of ordered medications in their Pyxis and, if not loaded, attempt to locate in another Madison Pyxis location (using Global Find function in Pyxis). Assistance with this can be provided by Charge Nurses and House Supervisors.Global Find is turned on for all nurses and allows RNs to search "like" Pyxis machines. So, if the RN is on a Profile machine, she can search for the med in all Profile machines but not Non-Profile machines (and vice-versa). If, after these attempts, the medication is unavailable then pharmacy will be available to assist or make alternative recommendations.
Courier Items - items not in any of Madison Pyxis machines and can't wait until Madison pharmacy is available, will be procured from either HHWC(for their covering units) or Main (for their covering units). Please note that it can take anywhere from 1 hour to 3 hours for the courier to reach Madison Hospital.
Surgery Sheets (starting 1/8/18, PM) - will be split up between HHWC and HHM. HHWC will verify for HHWC and GMT surgery sheets. These sheets will automatically print at HHWC pharmacy. HHM will verify for Main surgery (not GMT).
Following this email, the following will be e-mailed out to all: list of all Madison Hospital patient care areas with their iCARE names, Pyxis names, phone exts, charge nurse names; printout of all medication items listed in Madison's "After Hours Pyxis" machine and Madison Pxyis ED machines; Global Find instructions; Madison pharmacists' contact information; how to access the Madison Hospital Pharmacists' schedule.
All of these documents and this e-mail will be uploaded in Form Web. Please let me know if you have any questions at all.
Thank you,
Mary
---
Mary Dang, Pharm.D.
Manager of Pharmacy Professional Services Huntsville Hospital, Department of Pharmacy
Sent: 05 January, 2018 12:55 PM
To: Pharmacy
Cc: Christopher Strickland
Subject: Remote Order Process for Madison
Hello,
Effective Monday (1/8/18), we will change the remote order process for Madison. HHM and HHWC will be involved in this process.
On Mondays - Fridays (2230-0630) & Saturdays - Sundays (2000-0800), Madison pharmacy will transfer their phone (5-5037) to HHM (5-8282). All Madison units, except OBGYN and ED, will be evaluated/entered/verified by Main. Madison OBGYN (2E-W, 2W-W, 2NBW) and ED-W will be covered by HHWC.We will follow these unit options for a while and see if adjustments in assignments need to be made. Once stabilized, we will have OBGYN and Madison ED departments call HHWC ext (5-7620) directly instead of having HHM being a clearing house. If the transfer of phones from Madison failed or the Madison pharmacist forgot to transfer the phone lines, HHM can call IT to transfer the phone lines.
***Note - HHM & HHWC will begin with orders time-stamped 2230 in HCS at Mon.-Fri.
HCS Updates - willhave updated HCS to enable HHM and HHWC pharmacists to select/include their designated Madison units.
Hand-offs - will occur prior to Madison closing and when Madison opens. A pharmacist from HHWC and a pharmacist from HHM will receive phone calls from a Madison pharmacist. Items of discussions will be HCS/Order issues and unverified orders (all involved will pull up unverified orders for their areas and discuss any issues).
HCAs and Nurses - will enter all medication orders from blue Patient Keeper sheets and Order Sets. Pharmacists will enter all other medication orders (e.g. handwritten medication orders, HCS Medication Reconciliation Sheets, and meds form any order sets with * Not In iCARE* printed at the bottom of the sheet(s). Please use your clinical judgment and prioritize orders. If you are slammed, HCS Medication Reconciliation Sheets can be addressed last or earlier when a medication is needed before Madison Pharmacy is available.
VT Entries - some orders are designated as "Madison " or "Madison Only" per VT selection. This is done for formulation differences. When entering orders into iCARE, please check in your VT selection if any of the above are options.
Madison ED orders - medication orders will be scanned to pharmacy. The ED will denote what items are needed from pharmacy.
Madison Pharmacy - will scan an IV Items Sheet into HCS. This sheet will list IV/IVPB items that have already been made and sent to the nursing units from Madison pharmacy. This is helpful if the nurse calls and asks for an IV/IVPB item that has to be made.
Madison Surge Alert - when bed capacity is full and there are Madison ED Boarders, these patients will be placed in Madison PACU or Madison Imaging until a floor bed is available. These areas are denoted as Faxback/Scan Back. These temporary patient areas are "Non-Profiled" Pyxis areas. Two scenarios may occur: 1) HCAs from the floors will come to these areas and enter Order Sets and blue Patient Keeper sheets into iCARE. Pharmacists will enter orders into iCARE handwritten medication orders, HCS Medication Reconciliation Sheets, and meds form any order sets with * Not In iCARE* printed at the bottom of the sheet. Or...... 2) Medication orders will be entered into iCARE once the patient is transferred to a nursing floor.
Medication Items in Madison Pyxis Machines - it shall be the responsibility of the nurse to first check availability of ordered medications in their Pyxis and, if not loaded, attempt to locate in another Madison Pyxis location (using Global Find function in Pyxis). Assistance with this can be provided by Charge Nurses and House Supervisors.Global Find is turned on for all nurses and allows RNs to search "like" Pyxis machines. So, if the RN is on a Profile machine, she can search for the med in all Profile machines but not Non-Profile machines (and vice-versa). If, after these attempts, the medication is unavailable then pharmacy will be available to assist or make alternative recommendations.
Courier Items - items not in any of Madison Pyxis machines and can't wait until Madison pharmacy is available, will be procured from either HHWC(for their covering units) or Main (for their covering units). Please note that it can take anywhere from 1 hour to 3 hours for the courier to reach Madison Hospital.
Surgery Sheets (starting 1/8/18, PM) - will be split up between HHWC and HHM. HHWC will verify for HHWC and GMT surgery sheets. These sheets will automatically print at HHWC pharmacy. HHM will verify for Main surgery (not GMT).
Following this email, the following will be e-mailed out to all: list of all Madison Hospital patient care areas with their iCARE names, Pyxis names, phone exts, charge nurse names; printout of all medication items listed in Madison's "After Hours Pyxis" machine and Madison Pxyis ED machines; Global Find instructions; Madison pharmacists' contact information; how to access the Madison Hospital Pharmacists' schedule.
All of these documents and this e-mail will be uploaded in Form Web. Please let me know if you have any questions at all.
Thank you,
Mary
---
Mary Dang, Pharm.D.
Manager of Pharmacy Professional Services Huntsville Hospital, Department of Pharmacy