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Ch. 9
Institutional Pharmacy Practices + Tables & Boxes
| Term | Definition |
|---|---|
| ASAP Order | As soon as possible but not an emergency |
| Aseptic technique | Procedures used in the sterile compounding of hazardous and nonhazardous materials to minimize the introduction of microbes or unwanted debris that could contaminate the preparation |
| Automated dispensing system (ADS) | Computerized cabinets and integrated systems that control inventory on nursing floors, in emergency departments, and in surgical suites and other patient care areas |
| Computerized physician order entry (CPOE) | Computerized order entry |
| Crash carts | Moveable carts containing trays of medications, administration sets, oxygen, and other materials used in life-threatening situation such as cardiac arrest; also known as code carts |
| Electronic medication administration record (E-MAR) | A computer program that automatically documents the administration of medication into certified electronic health record (EHR) systems; the report serves as a legal record. |
| Floor stock | Drugs not labeled for a specific patient and maintained at a nursing station or other department of the institution (excluding the pharmacy) for the purpose of administration to a patient of the facility |
| Formulary | A list of drugs approved for use in hospitals in which patients recieve care on site; institutional pharmacies are also found in government-supported hospitals run by departments. |
| Institutional pharmacy | A pharmacy in facilities in which patients receive care on site; institutional pharmacies are also found in government-supported hospitals run by the Department of Veterans Affairs, Indian Health Service, and Bureau of Prisons |
| Investigational drug | A drug that has not been approved by the US Food and Drug Administration (FDA) for marketing but is in clinical trials; also, an FDA-approved drug seeking a new indication for use |
| Medication order | A prescription written for administration in a hospital or institution |
| NKA | No known allergy |
| NKDA | No known drug allergy |
| Nonformulary medications | Drugs that are not approved for use within an institution unless specific exceptions are filed and accepted by institutional protocols |
| Parenteral medication | Medication that bypasses the digestive system but is intended for systemic action; the term parenteral most commonly describes medications given by injection such as intravenously or intramuscularly |
| Periodic automatic replenishment (PAR) | A set level of certain medications kept on hospital floors |
| prn | From the Latin term pro re nata, meaning "as needed" |
| Protocol | A set of standards and guidelines by which a facility operates |
| Pyxis | An automated dispensing system often used in hospitals |
| Satellite pharmacy | A specialty pharmacy located away from the central pharmacy, such as an operating room (OR), emergency department (ED), or a neonatal pharmacy; satellite pharmacies typically are staffed by a pharmacist and a pharmacy technician |
| Standing order | Written procedure for drug or treatment that is to be used in a specific situation |
| Stat order | A medication order that must be filled immediately, as quickly as is safely possible to prepare the dose, usually within 10 to 15 minutes |
| SureMed | An automated dispensing system often used in hospitals |
| The Joint Commission | An independent, nonprofit organization that accredits hospitals and other health care facilities in the United States; the facility must be accredited to receive Medicare and Medicaid payment |
| Unit dose (UD) | Individualized packaged doses used in institutional practice settings |
| United States Pharmacopeia (USP) | A compendium of drug information, published annually, comprising enforceable guidelines for the safe preparation of sterile products |
| Small hospitals | Bed capacity: 25-50 Limited care, minor surgeries, temporary |
| Medium hospitals | Bed capacity: 50-100 Most surgeries, coronary care unit, ICU |
| Large hospitals | Bed capacity: 100 Has a central and satellite pharmacy Independent pharmacy treats most conditions, physical therapy, ICU, specialty units |
| Teaching hospitals | Bed capacity: 100 Has a central and satellite pharmacy Independent pharmacy Covers all conditions & has specialty areas for teaching purposes, trains all health care providers |
| Institutional | Bed capacity: 10-100 Independent pharmacy Care ranges from treating severe emergencies, may include triage to a larger facility that specializes in a particular areas (Ex: prisons & mental health institutes) |
| Convalescent/Long term care | Bed capacity: 100 Level of care varies; some patients sent to hospital for surgery & recover & then sent to their homes |
| Chemotherapy | Prepares cytotoxic agents |
| Controlled substances | Gathers all controlled substance inventory sheets from all areas of the hospital; technician also may fill and deliver all controlled substances; pharmacist is required to verify pharmacy inventory daily |
| Discharge pharmacy | Fills prescription orders as patients are discharged from the hospital; medications are sent to the floor for patients, or patients may come to the pharmacy window to pick up medications |
| Filling requisitions | Fills all requisitions sent to pharmacy; stocks inventory; orders pharmacy stock; controls opioids inventory and audits opioids if required; transports medications throughout hospital facility |
| Inventory | Orders all medications and supplies for the pharmacy; also may order specialty items for other areas of the hospital; handles all returns and recalled items that must be sent back to the manufacturer, etc. |
| IV room | Prepares all parenteral IV preparations, including large-volume drips and parenteral nutrition; prepares drugs that are under investigational trial and logs these special medications in appropriate manner as required by law |
| Medication reconciliation | Reviews and documents patient's arrival medication, ensuring appropriate dose, route, frequency, and duration of therapy; may review records for drug-drug interactions, duplication, and drug-allergy interactions, etc |
| Miscellaneous duties | Able to work in all areas of the pharmacy as needed; answers phones, trains new technicians and pharmacist interns; works on a team with other technicians, clerks, and pharmacists |
| Patient medication | Fills medication drawers on a pharmacy cart that will deliver filled medications to all hospital patients; also may deliver carts to all patient areas and restock any floor stock medications, etc |
| Preparation of medication | Fills unit dosing bulk medications; compounds drugs for ointments, creams, and solutions |
| Satellite pharmacy | May be responsible for all tasks related to a small, isolated pharmacy, such as answering phones, ordering and putting away stock, etc |
| Pyxis Stations | by Cardinal Health |
| KbPort, | Simplicity Solutions |
| MedSelect Flex, SupplySelect, CenTrak | by AmerisourceBergen |
| OmniRX, SinglePointe | by Omnicell |
| Compact Robotic System (CRS), SP200, SP Unit Dispenser (SPUD), SP Automation Center (SPace) | by ScriptPro |
| MedRover, MedTower, ATP system, PillPick, BoxPicker, UniPick 2 | by Swisslog Inspired Solutions |
| CCU | Coronary care unit |
| Clinics | Patients may visit a clinic to be seen by a physician, physician's assistant, or nurse practitioner |
| ED or ER | Emergency department; area of hospital where patients can receive emergency care; physicians and nurses are on staff 24 hours a day |
| ICU | Intensive care unit |
| L&D | Labor and delivery; unit where a woman goes through labor and delivers a baby |
| MED-SURG | Medical unit for patients who have undergone surgery or who may be under observation |
| NICU | Neonatal intensive care unit; can also stand for neurological intensive care unit |
| NSY, NUR | Nursery; unit where babies are taken for care and observation by nurses |
| OB/GYN | Obstetrics gynecology; unit that takes care of expectant mothers or those who have just given birth |
| ONCOLOGY | Unit that takes care of patients with cancer |
| OR | Operating room |
| ORTHO | Orthopedics unit; takes care of patients who may need treatment or surgery on bones or joints |
| PACU | Postanesthesia care unit |
| PED | Pediatrics; unit for children younger than age 14 years |
| POSTOP | Unit where patient is kept after an operation or procedure |
| PREOP | Unit where patient is kept before an operation or procedure |
| UROLOGY | Unit that takes care of patients who may need treatment, surgery, or procedures on the urinary system |
| Adenosine | Antiarrhythmic |
| Amiodarone | Antiarrhythmic |
| Atropine sulfate | Anticholinergic |
| Calcium chloride | electrolyte |
| Dextrose | Carbohydrate |
| Dextrose 50% | Carbohydrate |
| Digoxin | Cardiac Glycoside |
| Dobutamine | Vasopressor |
| Dopamine | Vasopressor |
| Enalapril | ACE Inhibitor |
| Epinephrine | Vasopressor |
| Furosemide | Loop Diuretic |
| Glucagon | Glucose-elevating agent |
| Heparin | anticoagulant |
| Lidocaine | antiarrhythmic |
| Magnesium sulfate | electrolyte |
| Mannitol | Osmotic diuretic |
| Metoprolol | beta blocker |
| Naloxone | Narcotic antagonist |
| Nitroglycerin | antianginal |
| Nitroprusside | antihypertensive |
| Norepinephrine | Vasopressor |
| Procainamide | antiarrhythmic |
| Propranolol | beta blocker |
| Sodium bicarbonate | Alkalinizing agent |
| Sodium chloride | electrolyte |
| Vasopressin | Vasopressor |
| Verapamil | Calcium channel blocker |
| Code red | Fire |
| Code blue | Medical emergency-adult |
| Code white | Medical emergency— pediatric |
| Code pink | Infant abduction |
| Code purple | Child abduction |
| Code yellow | Bomb threat |
| Code gray | Combative person |
| Code silver | Person with a weapon and/or hostage situation |
| Code orange | Hazardous material spill/release |
| Code triage internal | An internal disaster |
| Code triage external | An external disaster |
| Anesthesia | Physicians or nurse anesthesiologists administer medications used before and throughout surgery |
| Injection clinic | Nurses administer adult and pediatric immunizations and may also perform allergy skin tests |
| Radiology or imaging department | Technicians and physicians may administer dyes for imaging and may need to use a medication cart (known as a crash cart) for adverse reactions or incidents |
| Respiratory | Therapists administer breathing treatments to hospitalized or clinic patients |
| CMS (HCFA) | Centers for Medicare & Medicaid Services regulates & administers Medicare, Medicaid, CHIP, HIPAA standards, & other health-related programs. Inspects facilities & gives approval for hospitals to provide care & receive reimbursements. |
| HHS | Department of Health and Human Services that protects the health of the American people provides essential human services. |
| DPH | Department of Public Health inspects hospitals and hospital pharmacies to ensure that they are in compliance with these regulations. |
| BOP | Boards of Pharmacy develops, implements, and enforces pharm practice standards that state for the purpose of protecting the public. |
| POE | Point of Entry systems provide electronic access to medical info & drug info data and allow physicians, nurses, and pharmacists to communicate directly with one another. |
| CADM | Computerized Adverse Drug Monitoring (part of POE) Detect and monitor adverse drug events |
| BPOE | Barcode Point-of-Entry Every UD med is barcoded, which can be scanned with a handheld device to gain access to them. Paired along with the E-MAR systems. |
| COW | Computer on Wheels previous system used before POE came along Mainly used in specialty units such as ICU's. |
| EHR | Electronic Health Record system Allows healthcare providers to share this info across facilities. |
Created by:
Yari06
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