Chapter 17: Hospital Pharmacy
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| show | Require high school diploma or equivalent and a current state pharmacy technician license.
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| show | A work station for medical personnel located on a nursing unit.
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| What are ancillary areas? | show 🗑
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| show | An area of the hospital that may carry supplies not provided by the pharmacy (lotion, mouthwash, pill cutters). They are also be responsible for supplying nursing units with dialysis solutions & some premade IV fluid bags.
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| show | Examines the patients and administers treatment for people suffering from injury or disease. M.D.s write majority of all medication orders.
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| show | Same responsibilities as an M.D. but practices a "whole person" approach to medicine.
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| N.P., Nurse Practitioner | show 🗑
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| R.N., Registered Nurse | show 🗑
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| R.T., Respiratory Therapist | show 🗑
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| show | Coordinates care for patients under the close supervision of a M.D. or D.O.
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| M.S.W., Master's of Social Work | show 🗑
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| show | Additional training and work closely with the medical team.
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| What is inpatient pharmacy ? | show 🗑
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| show | A branch of the inpatient pharmacy responsible for preparing, dispensing, and monitoring medication for specific patient areas.
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| show | Located in the same area as the patient care units they are servicing.
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| show | Providing first doses of new medications ordered, emergency medications, and replacing any missing or lost doses.
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| What is the central pharmacy? | show 🗑
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| What is batching? | show 🗑
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| show | Preparing and delivering of unit dose patient medication carts, batching the medications, and covering service areas not covered by the pharmacy satellites.
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| What is the clean room and where is it usually located? | show 🗑
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| show | A committee that assures hospitals research complies with federal, hospital and ethical standards.
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| show | A pharmacy attached to a hospital that services patients who have left the hospital or who are visiting doctors in a hospital outpatient clinic.
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| show | A review of a nursing unit to ensure compliance with hospital medication policies.
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| What are pediatric satellite pharmacies ? | show 🗑
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| What are operating room (OR) satellite pharmacies? | show 🗑
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| What are oncology satellite pharmacies? | show 🗑
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| What is a hospital formulary? | show 🗑
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| Whose responsibility is it to set up, add, remove, and periodically evaluate medications list on the hospital formulary? | show 🗑
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| What is a closed hospital formulary? | show 🗑
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| What is a non-formulary ? | show 🗑
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| show | A policy approved by the hospital P&T Committee that allows the pharmacist to change a medication order to a therapeutically equivalent formulary medication w/o notifying the doctor.
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| What is a pneumatic tube? | show 🗑
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| What are medical or heath records? | show 🗑
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| What is electronic medical records (EMRs) or electronic health records (EHRs)? | show 🗑
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| What are some different sections in a medical chart? | show 🗑
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| What is a computerized physician order entry (CPOE)? | show 🗑
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| show | Makes orders more efficient and helps eliminate medication errors due to illegible handwriting.
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| show | A standard medical order for patients to receive medication at scheduled intervals.
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| show | An order for medication to be administered only on an as needed basis.
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| show | An order for medication to be administered immediately.
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| show | The initial medications ordered when a patient is administered to the hospital.
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| What is a medication administration record (MAR)? | show 🗑
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| show | Medication name, dose, route, and frequency. The order may also include the duration of therapy.
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| show | Used for a certain class of medications like antibiotics or narcotics. These orders are only active for a limited period of time, after which a new medication order is required to continue.
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| What do automatic stop orders help ensure? | show 🗑
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| show | A device used to remove particulate matter. The filter should be placed at the end point of an IV line just before it enters the patient's vein.
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| show | A program that allows a specially trained pharmacy technician to check medications prepared by another technician. At least nine states currently allow it.
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| show | Med order is written in the patient chart, a copy of the med order is taken, picked up at a nursing station by pharm tech, the order is entered into the computer, pharmacist reviews & verifies order, then filled and checked, &delivered to nursing station.
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| show | Physician or physician agent enters med order in the hospital computer which goes directly to the pharmacy.
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| What are drip rounds? | show 🗑
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| What is the purpose of drip rounds? | show 🗑
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| What is a drug recall? | show 🗑
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| show | The amount of drug product that should be kept on the pharmacy shelf. May also be assigned to drug products in ADCs.
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| show | The pharm techs supervisor.
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| What is a primary area of concern for inventory control? | show 🗑
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| show | Two people.
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| If a narcotic medication is damaged for any reason, what needs to happen? | show 🗑
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| What is a floor stock? | show 🗑
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| show | The inventory technician may have to go outside of their usual distributor.
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| What is emergency drug procurement? | show 🗑
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| show | 2 to 8 degrees Celsius (36 to 46 F)
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| show | -20 to -10 degrees celsius (-4 to 14 F)
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| What are extemporaneous compounds? | show 🗑
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| What is a bulk compounding log? | show 🗑
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| What is reconstitute? | show 🗑
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| What is a unit dose? | show 🗑
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| Which medications cannot be divided into unit dose increments? | show 🗑
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| show | A system in which medications are dispensed from an automated cabinet at the point of use.
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| show | In medication carts containing a 24 hour supply of drugs for each patient.
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| How are oral syringes different from IV syringes? | show 🗑
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| The documentation logs for prepacked medications have what? | show 🗑
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| show | A small volume parenteral that will be added into or "piggybacked" into large volume parenteral (LVP).
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| show | Protein, carbohydrates and essential nutrients to be given to the patient through an IV line.
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| What is an epidural? | show 🗑
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| What is short stability? | show 🗑
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| show | Single dose are preservative free while multi dose contains preservatives.
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| What are nosocomial infections? | show 🗑
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| show | A broad term that pertains to proper handwashing or use of antiseptic hand gel/rub.
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| What is the Infection Control Committee? | show 🗑
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| show | An infection control practice where healthcare providers avoid direct contact with blood, mucous membranes, body fluids, and non-intact skin by use of barriers like gloves, goggles, gowns, and face shields.
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| show | Medications for healthcare providers being exposed to HIV infected blood or needles in order to help reduce the chance of contracting HIV.
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| show | A injury or harm due to medication use that may be preventable in some cases but may be unpredictable and unavoidable in other cases.
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| What is medication error? | show 🗑
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| show | Range from allergic reaction to kidney failure to death.
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| What is a common cause of ADEs? | show 🗑
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| show | Elderly because they are often on multiple medications and have multiple medical problems.
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| show | Administration error, allergy, compounding error, duplicate therapy, expired product, extra dose, incorrect dosage form, missed dose, omission error, prescribing error, and wrong patient.
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| show | A statement of facts surrounding medical error or incident.
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| show | A medication safety event that had the potential to cause harm but did not reach the patient.
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| What is a sentinel event? | show 🗑
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| show | A process that evaluates all actions leading to the medical error.
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| show | Safety Data Sheets
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| What are red bags used for? | show 🗑
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| show | Red sharps containers
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| show | Black hazardous waste bins.
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| Items with trace amounts of chemotherapy or cytotoxic medications are disposed in what? | show 🗑
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| show | Color-based emergency codes systems are used at many hospitals to alert staff to various emergency/safety situations.
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| What is code blue ? | show 🗑
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| What is code pink? | show 🗑
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| show | fire
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| show | Bomb threat
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| What is code orange? | show 🗑
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| show | hostage situation
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| show | Disaster plan activation
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| show | need for security
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| What does the TJC publish (The Joint Commission)? | show 🗑
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| Which chapter of the USP-NF talks about hazardous drugs defined by the NIOSH? | show 🗑
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| What is a code cart? | show 🗑
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| show | Pharmacy technicians
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| show | Cardiac Care Unit
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| show | Emergency Department
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| ER | show 🗑
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| show | Intensive Care Unit
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| CT ICU | show 🗑
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| show | Neonatal ICU
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| PICU | show 🗑
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| show | Surgical ICU
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| show | Obstetrics
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| OR | show 🗑
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| Who can prescribe medications? | show 🗑
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| Who can administer medications? | show 🗑
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| show | Pharmacists, social workers, patient care techs, pharmacy techs
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| What is voluntary formulary permitted? | show 🗑
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| What does the Orange Book two letter evaluation code provide? | show 🗑
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| What does the first letter say in the code? | show 🗑
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| show | Provide additional info on the basis of FDA evaluations such as info about the dosage form.
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| If they are A products what does that mean? | show 🗑
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| show | They are not bioequivalent. Known issue could dosage form, etc.
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| show | Products not presenting bioequivalence problems.
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| If it is labeled AB? | show 🗑
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| show | Ordered when other options have failed and it is used for cystic acne. Cannot use if preg or become preg (major birth defects).
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| show | Once they have written the prescription, a pharmacy needs has 7 days to fill the prescription.
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| show | Computer program risk management for prescribing and dispensing.
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| Who must be registered in the program? | show 🗑
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| How do the methods of BC work? | show 🗑
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| Do you need preg tests? | show 🗑
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| show | Adenosine, atropine, and epinephrine (high alert).
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| What are intravenous electrolytes? | show 🗑
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| Who gives a list of high alert medications in most settings? | show 🗑
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| What does it mean for something to be a high alert medication ? | show 🗑
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| What are critical care medications? | show 🗑
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| show | Coagulation tests that see how long to take for the blood to clot to see if the patient is on a blood thinner.
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| show | Acyclovir, Fluconazole-Diflucan, Vancomycin (Vancocin)-small windows of therapeutic indexes
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| show | protected health information
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| What was the first part of HIPAA? | show 🗑
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| What are questions that should be asked when the nursing unit calls saying the drug isn't there? | show 🗑
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| show | Like a grocery list that the manufacturer will check if they have it and will send you the things you need. You only get charged when you receive the items.
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| What is Class 1? | show 🗑
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| show | Temporary but reversible adverse effects or little likelihood of serious adverse effects.
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| What is Class 3? | show 🗑
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| show | Application for registration of your site to carry controlled substances.
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| show | used to order schedule 2 drugs
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| show | Used to report theft/loss of controlled substances
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| DEA form 41 | show 🗑
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| show | Short stability (usually expire in 10-14 refrigerator).
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| show | Hyperalimentation
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| show | It is a line near the subclavian vein where the TPN needs to go in through because the solutes can be harsh on those veins.
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| show | label multidose vials with new expiration date 28 days from date of opening unless manufacturer date is sooner.
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| What is a common problem with fentanyl ? | show 🗑
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| show | Chemotherapy agents, fentanyl, heparin, insulin U-500, potassium chloride, sodium chloride 3%, vecuronium
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| show | Prone to peptic ulcers and bleeding
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| show | Post-Anesthesia Care Unit
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| show | Pediatrics
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| show | Doctors, nurses, and pharmacists that must meet on a routine basis to make decision on safe and effective use of meds and make decisions on formulary. Also looks at adverse drug reactions.
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| What are restricted medications? | show 🗑
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| show | Do not exceed 8 C (46 F)
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| What is temp for cool ? | show 🗑
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| What is room temp? | show 🗑
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| What is warm temp? | show 🗑
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| show | Informs manufacturers of errors with packaging and labeling.
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| What is FDA Adverse Effect Reporting System (FAERS)? | show 🗑
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| What is Med Watch? | show 🗑
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| What is Vaccine Adverse Effects Reporting System (VAERS)? | show 🗑
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| show | Reported to ISMP by HC provider.
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| What is MedMarx? | show 🗑
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| show | Alphabetical order using generic name.
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| show | Epoetin, Filgrastim, Fosphenytoin, Most vaccines like Hep B, Pneumococcal Influenza/MMR, chickenpox, and shingles in freezer.
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| show | No longer than 6 months or the earliest expiration date, in controlled room temp.
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| show | No longer than 14 days or the earliest date at controlled cold temp.
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| show | No longer than 30 days or the earliest date at controlled room temp.
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| show | 6 months
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| When should you monitor temperature? | show 🗑
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| show | every 6 months
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| show | Every 6 months
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| show | every 6 months
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| How long should you keep the laminar flow hood before use? | show 🗑
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| show | 6 months
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| show | Beginning of shift, before each batch, after spills or contamination
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| show | Monthly
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| show | Negative pressure room with at least 12 air changes per hour (how many times the air in the room is replaced each hour)
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| Where should antineoplastics go (chemotherapy)? | show 🗑
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| What is compliance error? | show 🗑
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| show | Failure to review a prescribed regimen or problems/failures of using appropriate clinical or lab data assessment of pt response to drug therapy.
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| What is error class A? | show 🗑
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| show | Error but no harm for patient
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| show | Error occurred that had temporary harm but no intervention
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| What is error class I? | show 🗑
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| show | Educates the healthcare community and consumers about safe medication practices. Oversees VERP, MEDMARX, and MERP.
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| What is a black box warning? | show 🗑
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| show | Daily
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| What is the list of do not crush? | show 🗑
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