question

Describe how hospitals are classified.

answer

Length of stay; Type of service provided; Ownership; Community/Non-Community; Teaching/Non-Teaching; Number of beds; Multi-hospital chains; Florida Hospital Association Hospital Directory

question

Describe the difference between the length of stay in acute care hospitals and long-term hospitals.

answer

-Acute care hospitals have an average length of stay fewer than 30 days -Long-term hospitals have an average length of stay longer than 30 days

question

What are the different type of service a hospital provide?

answer

-General medical and surgical services -Specialty hospitals, i.e. mental health, cancer -Population-based, i.e. Children's hospitals or VA hospital

question

Who has the ownership of the hospital?

answer

-Federal government (public hospital) (e.g. veteran, military, and native American) -Non-federal government (public hospital) (e.g. cities, counties, state govt) -Nongovernment •Not-for-profit •Investor owned, for-profit

question

Describe the difference between nongovernment hospital "not-for-profit VS investor owned, for-profit".

answer

BOTH are making profit. Not-for-profit reinvest the hospital; Investor owned, for-profit, share the profit with investor.

question

Describe the characteristics of community or Noncommunity Hospitals.

answer

noncommunity: NOT opened to general public, e.g. VA; community: Nonfederal, short-term general, and specialty hospitals available to the public

question

Describe the characteristics of Teaching or Non-Teaching Hospital.

answer

Clinical training site for physicians

question

T/F Most hospital in the US has <200 beds.

answer

TRUE. it also depends on larger/smaller hospital in urban/rural.

question

Describe the characteristics of Multihospital Chains.

answer

Usually found in one or more geographic region.

question

Summarize the role of the pharmacy services department in patient care in a hospital setting.

answer

Clinical Services; Medication Procurement; Medication Preparation; Medication Distribution; Drug Information to pts, physician, and nurses; Medication Safety; Drug Policies; Education & Training

question

Describe the Buyer's responsibilities in the hospital pharmacy.

answer

-Purchasing -Determining stock levels -Inventory turns -Contract compliance -Annual Inventory

question

Which organization negotiates to get the best price possible for the hospital pharmacy?

answer

GPO: Group Purchasing Organization

question

Give some examples of inventory medication.

answer

- machines (e.g. automated dispensing cabinet) - medications storing area in the nursing room (another Patient care area) - Different medication freezer - IV room - pharmacy room - control substances area

question

What is the differences between the packaging of the dose in community and hospital?

answer

Bulk package- community Unit Dose Packaging- hospital (All have barcode for bedside medication administration)

question

What are the different storage locations?

answer

- Medication cart (nursing unit; medication stored until it's due; patient SPECIFIC) - Medication (storage room; e.g. IV bag) - Fill station in pharmacy department - Automatic dispensing cabinet (order by pharmacist, have pockets of different type of medication: NONPATIENT SPECIFIC) - Medication carousel (rotating carousel; in rows; everything is carried in an electronic manner with accurate count) - Barcode suction

question

Describe the purchasing process.

answer

- telephone order - computerized physician order - pharmacist review it, verify/deny it

question

Identify the components of the medication use system in a hospital setting.

answer

Procurement> Preparation> Distribution

question

How to make a medication order review clear?

answer

Decimal points (no trailing zero, 25.0 mcg; always use leading zero, i.e. 0.25 mcg); No abbreviations; No chemical or investigational names; Avoid vague directions, i.e. "as directed"; Look-alike, Sound-alike medications; Proper spacing, i.e. Metoprolol 120 mg; Include suffixes, i.e. XL; Dose should not be ordered using volume, i.e. 10 ml vs 5 mg; Medication name, dosage form, route, frequency, duration of therapy if appropriate; PRN must include frequency and reason; Range Orders (Dosage range; Frequency range); Continuous infusions (Initial dose; Rate and measurable parameters to increase, decrease or discontinue); Titration and HOLD orders

question

T/F Nurses are allowed to interpret orders.

answer

False. Nurses are not allowed interpret orders- BE CLEAR WITH DIRECTIONS.

question

How does American Society of Health-System Pharmacist (ASHP) define formulary?

answer

a continually updated list of medications and related information, representing the clinical judgment of physicians, pharmacists, and other experts

question

How does American Society of Health-System Pharmacist (ASHP) define formulary system?

answer

The ongoing process through which a health care organization establishes policies regarding the use of drugs, therapies, and drug-related products and identifies those most medically appropriate and cost-effective to best serve the patients.

question

P & T stands for?

answer

Pharmacy and Therpeutics Committee

question

What is the responsibility of Pharmacy and Therpeutics Committee?

answer

•managing the formulary system •Addition and removal of medications from the formulary •Development and monitoring of medication use guidelines •Process for using nonformulary medications •Development and approval of all medication related policies to ensure the safe and effective use of medications

question

Who are the members in P&T Committee?

answer

physicians, pharmacists, nurses, administrators, quality improvement managers and other healthcare professionals and staff

question

What does P&T Committee serves in?

answer

Serves in an advisory capacity to the medical staff on all matters pertaining to these medications

question

How does the formulary make decisions?

answer

Evidence-based practice; Ethical considerations; Legal considerations; Social considerations; Philosophical considerations; Quality of life; Medication safety; Economic factors

question

What is the role of hospital pharmacist?

answer

•Drug therapy monitoring •Staff and patient education •Medication utilization evaluation •Adverse drug reaction monitoring •Transitions of care including medication histories and medication reconciliation •Specialized clinical pharmacy services

question

Identify four non-distributive pharmacy services provided by hospital pharmacist

answer

- PK monitoring TPN total parental nutrition - drugs that needs renal dose adjustment - anticoagulation management - pain management - antibiotics

question

T/F The Pharmacy and Therapeutics Committee determines which policy will be available in the hospital taking into consideration a multiple of variables.

answer

FALSE. The Pharmacy and Therapeutics Committee determines which MEDICATION will be available in the hospital taking into consideration a multiple of variables.

question

List a bunch of pharmacist role.

answer

Leadership; Distributive/General Practice; Ambulatory Care; Anticoagulation; Cardiology; Critical Care; Emergency Department; Geriatrics; Hematology/Oncology; Hospice/Palliative Care; Infectious Diseases; Informatics; IV Room; Medication Safety; Neonatal; Operating Room; Pediatrics; Psychiatry

question

What is residency

answer

Organized, directed, postgraduate training program in a defined area of pharmacy practice

question

In what setting can residency occur in?

answer

-Hospitals -community pharmacies -home care -long-term care facilities -ambulatory care settings

question

Describe the difference between PGY1 and PGY2.

answer

•PGY1 -Postgraduate year one (generalized pharmacist, clinical guidance, individual practitioner, independent pharmacist) •PGY2 -Postgraduate year two (more specialized, deal with complex cases and experts in some areas)

question

Which PGY2 Specialties has Board Certification available?

answer

Ambulatory care; Critical care; Nuclear; Nutrition support; Oncology; Pediatrics; Pharmacotherapy; Psychiatry

question

Which of the following is NOT PGY2 Specialties that needs Board Certification? A. Ambulatory care B. Managed care C. Oncology D. Pediatrics

answer

B. Managed care

question

Describe the drug distribution systems in a hospital setting: Floor-Stock

answer

- usually little risk meds, e.g. IV fluid - Supply of medications in storage bins available for any patient - Safety concern

question

Describe the drug distribution systems in a hospital setting: Unit-Dose Distribution

answer

-Pharmacist reviews all orders before medications are dispensed (Safety Advantage) -Medications dispensed in unit dose packaging and a ready to administer form

question

Describe the drug distribution systems in a hospital setting: centralized and decentralized.

answer

•Centralized -medications dispensed from one centralized location •Decentralized -medications dispensed from two or more satellite locations •Some hospitals have a combination of both types of services

question

Describe the drug distribution systems in a hospital setting: Automated Dispensing Cabinets

answer

•Drug storage device •Interfaces with the pharmacy computer system •Order crosses the interface to the ADC after the pharmacist has verified the order •Nurses can only access those medications which have been verified by the pharmacist except for a few emergency medications

question

Describe the drug distribution systems in a hospital setting: Pyxis Drawer Types: CUBIE pocket

answer

- only allows one pocket to open per time - limit max - error pops out

question

Describe the drug distribution systems in a hospital setting: Pyxis Drawer Types: Carousel drawer

answer

- pockets rotate as needed - same concept with CUBIE pocket

question

Describe the drug distribution systems in a hospital setting: Pyxis Drawer Types: Matrix drawer with optional return bin

answer

- not the safest - large bulky things - try to make sure they look different - nurses can open the pocket at the same time

question

How does the pyxis order work and benefit the system?

answer

- once the order is verified from the pyxis order - nurses can ONLY see the approved meds - also feeds the pharmacy so they can know what's being dispense and CATCH ERROR

question

T/F There is an increase in the use in robot due to it's accuracy.

answer

FALSE. The use of robot decreases because it's expensive.

question

T/F 97% of the hospital uses automated dispensing cabinet.

answer

TRUE

question

USP 797

answer

a scientific nonprofit organization that sets standards for the identity, strength, quality, and purity of medicines

question

USP's drug standards are enforceable in the United States by?

answer

the Food and Drug Administration, The Joint Commission and many Boards of Pharmacy

question

Hospital making sterile products must adhere to?

answer

USP standards

question

What is the objective of USP 797?

answer

Describe conditions and practices to prevent harm, including death, to patients that could result from: (1) microbial contamination (nonsterility), (2) excessive bacterial endotoxins (3) variability in the intended strength of correct ingredients (4) unintended chemical and physical contaminants (5) ingredients of inappropriate quality in compounded sterile preparations (CSPs)."

question

Medication Administration Record (MAR)

answer

- Nurses have to document everything given to the pt - know: changes of regimen, doses, responses of pts *see if it's accurate

question

Barcode Administration (BCMA)

answer

- allow access of EHR (arm band) - scan meds - if sth goes wrong (WARNING)! *SAFETY - smart warning as well (e.g. allows to enter pain rating) - beneficial for therapeutics

question

What are the Medication Safety Technologies?

answer

•Electronic health records •CPOE -Computerized Physician Order Entry •CDSS -Clinical Decision Support Systems •ADC -Automated Dispensing Cabinets •BCMA -Barcode Medication Administration •Robot and Carousel •IV Workflow software and robotics

question

CPOE

answer

Computerized Physician Order Entry

question

CDSS

answer

Clinical Decision Support Systems

question

ADC

answer

Automated Dispensing Cabinets

question

BCMA

answer

Barcode Medication Administration

question

Which of the following usually work together? •CPOE •CDSS •ADC •BCMA •Robot and Carousel

answer

•CPOE -Computerized Physician Order Entry •CDSS -Clinical Decision Support Systems

question

Pharmacokinetics, total parenteral nutrition (TPN), renal dose adjustments, and anticoagulation services are examples of ________________. a. Adverse drug reaction monitoring b. Drug therapy monitoring c. Transitions of care d. Staff and patient education

answer

b. Drug therapy monitoring

question

T/F Tablets individually packaged is referred to as unit-dosed tablets.

answer

TRUE

question

Which of the following is NOT a feature of Aesynt's i.v.STATIONTM? a. Equipped with class H-14 HEPA filtering and ISO class 5 air control environment b. Provides a complete audit trail for each IV dose c. Can verify and dispense sterile products unattended, allowing staff to multitask and do other duties d. Uses gravimetric control to provide exceptional drug quantity accuracy e. All of the above are features of Aesynt's i.v.STATION™

answer

c. Can verify and dispense sterile products unattended, allowing staff to multitask and do other duties While the i.v.STATION can prepare compounded sterile preparations (CSPs) independent of a pharmacist, the tool still requires remote pharmacist verification in order to verify and dispense the product to the ultimate patient. While the streamlined remote verification feature of the i.v.STATION optimizes the pharmacist's time, it cannot run the functions independently of the pharmacist, making choice C the only appropriate answer choice that is not a feature of the i.v.STATION.

question

Describe i.v.STATION™.

answer

- Gravimetric controls provide exceptional accuracy - In-process barcode scanning and image recognition verifies correct ingredients - Automated final product labeling reduces occurrence of error - Tamper-evident syringe caps ensure product integrity - Robotic technology and ISO Class 5 environment promote sterility and support extended beyond-use dating - Streamlined remote verification optimizes pharmacist's time

question

As the pharmacist in a hospital setting, which of the following medication orders would you deem acceptable during the medication order review? a. Acetaminophen 650 mg tab PO Q4H PRN b. Warfarin 5.0 mg PO Daily c. Temazepam 15 mg tab PO nightly at bedtime d. Benadryl50 mg tab

answer

c. Temazepam 15 mg tab PO nightly at bedtime Medication orders with 'PRN' must include frequency and reason, meaning choice A is missing the reason (e.g. 'prn pain') making it unacceptable. In this example, Acetaminophen (Tylenol) has multiple indications, fever or pain, so the PRN indication is necessary.

question

Which of the following PGY2 residency specialties DOES NOT have a board certification available? a. Nuclear b. Psychiatry c. Cardiology d. Critical Care e. All of the above PGY2 Specialties have board certification available

answer

c. Cardiology

question

Which Aesynt product has been described as "the most flexible and easy-to-learn cabinet on the market" by the manufacturer? a. Aesynt's ROBOT-Rx® b. Aesynt's AcuDose-Rx® c. Aesynt's MedCarousel® d. Aesynt's i.v.STATIONTM e. None of the above

answer

b. Aesynt's AcuDose-Rx®

question

What are the key benefits of Aesynt's AcuDose-Rx?

answer

- Supports increased accuracy and medication safety - Reduces costly medication stockouts and diversion - Optimizes medication inventory - Allows pharmacy labor to be redeployed to clinical activities - Features all-new design based on input from nursing/pharmacy staff

question

Which of the following best describes the Pharmacy & Therapeutics (P&T) Committee? a. Responsible for overseeing policies relating to medication use within the hospital b. Members include physicians, pharmacists, nurses, and other healthcare team members c. Develops recommendations for additions and deletions of medications from the formulary d. All of the above

answer

d. All of the above

question

Which of the following BEST describes a PGY1 residency? a. Usually has the resident focusing practicing in one particular area b. Involves specializing in areas such as critical care, oncology, pediatrics, etc. c. Limited to only hospital pharmacies d. Focuses on development of clinical judgment through supervised practice

answer

d. Focuses on development of clinical judgment through supervised practice

question

Which of the following is used to help the pharmacy buyer with managing inventory in different pharmacy locations? a. Automated Dispensing Cabinets b. Medication Robots c. Medication Carousel d. All of the above

answer

d. All of the above

question

Which of the followings is/are responsibilities of all hospital pharmacy services departments? a. Oversight of Barcode Medication Administration (BCMA) b. Development of policies and procedures relating to medication use c. Oversight of ordering, transcribing, dispensing, administering, and monitoring medications in the hospital setting

answer

B and C

question

What are the key benefits of MedCarousel?

answer

- Reduces picking and restocking errors by 96% - Shrinks unit-based cabinet restocking time by 82% - Reduces technician training time by 85% - Increases inventory turns by up to 65% - Improves space efficiency up to 60% - Reduces pharmacist checking time though the use of a barcode verification process - Provides device-level optimization to support medication availability

question

What are the key benefits of ROBOT-Rx?

answer

- Lowers risk of error, with up to 99.9% accuracy - Reduces pharmacist verification and technician labor - Drives cost down by reducing inventory - Minimizes dispensing time, enabling multiple fills per day and multi-site filling - Supports efficient cabinet restocking - Reduces missing, expired and returned medications - Communicates with third party systems

question

Procurement

answer

P&T Committee GPOs Contract Compliance Inventory Control Max/Min Inventory turns Shortages

question

Prescribing/Ordering

answer

Medication Reconciliation CPOE/CDSS Verbal/Telephone Orders Paper Orders Order Sets TJC Order Writing Standards

question

Order Processing

answer

Patient 5 Rights (Drug, Patient, Dose, Route, Time) Drug Therapy Monitoring Adverse Drug Reaction Monitoring

question

Dispensing

answer

Preparation; Barcoding; Unit Dosing; First Doses; Batches; Final Product Verification; Inventory Locations; Automation and Technology

question

What do hospital use for Medication Administration?

answer

Medication Administration Record BCMA Smart Pumps

question

Are the following ready to be stocked? Batches/Unit Dosing - IV Sterile Compounds - Non-Sterile Compounds - Controlled Substances Barcoding Crash Cart Trays Emergency Medication Kits Non-Emergency Medication Kits

answer

NOOOOOOOOOOOOOOO Preparation needed!

question

Are the following ready to be stocked? Pharmacy Stock Replenishment - Robot - Carousel - Refrigerators/Freezers - IV Room - Satellites Nursing Unit and Ancillary Department Replenishment - Floor stock - Automated Dispensing Cabinet - Refrigerators

answer

OF COURSE

question

What are the Non-Patient Specific (standardized doses) batches?

answer

Automated dispensing cabinets - pulling the medications for restocking the machines IV sterile compounds - preparing standardized doses, i.e. Vancomycin 1 g bags Nonsterile compounds - preparing standardized doses, i.e. Amoxicillin oral syringes Controlled substances - restocking the automated dispensing cabinets or preparing standardized doses, i.e. Morphine PCA syringes

question

What are the Patient Specific (non-standardized doses) batches?

answer

IV Sterile Compounds Non-Sterile Compounds Controlled Substances

question

4 factors that influenced the role & function of the modern hospitals

answer

1. system based on scientific method (from medical skls) 2. health insurance (financially stability) 3. hospital survey and constrcution act 1956 (Hill-Burton Act) - federal funding (increase beds and techs) 4. change in types of disease that are prevalent--> preventive measures

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