Medication reconciliation remains one of The Joint Commission’s 2009 National Patient Safety Goals, but the elements of performance that will apply beginning in 2009 were revised to reflect some of the challenges that ASCs and other small entities encountered in complying with the goal. After ASC Association Treasurer Jerry Henderson, CASC, of Lifebridge shared the concerns of ASCs with this National Patient Safety Goal with The Joint Commission at a summit it held last year, The Joint Commission reconsidered its performance criteria. The goal—to accurately and completely reconcile medications across the continuum of care—remains the same. To address situations “where medications are used minimally, or prescribed for a short duration,” however, The Joint Commission created a modified reconciliation process that ASCs and others can use. The modified process still requires that the organization obtain an accurate list of the patient’s current medications and known allergies so that any prescriptions written during the visit are appropriate. But in situations where only short-term medications are used, the patient needs to be provided only the list of the short-term medications that he or she needs to take after leaving the facility. In such situations, the original list does not need to be provided to the patient. If the patient is confused or unable to comprehend adequately, however, the patient’s family needs to be provided with the original medication list as well as the short-term medication list. This new process can not be used if any new long-term medications are prescribed, if there is a change in any current long-term medications or if the patient is admitted to a facility for ongoing care. Pages 44–49 of the January/February 2008 issue of ASC Focus contain an article on ASC compliance with medication reconciliation. The article is also available at www.ascassociation.org/medrecarticle.pdf. Microsoft Word® versions of the forms featured in the article, which users can download and complete electronically, are available at www.ascassociation.org/medrec.doc.
Please click on the links below to access FDA info on the Fluoroquinolone Antimicrobial Drugs.
http://www.fda.gov/bbs/topics/NEWS/2008/NEW01858.html
http://www.fda.gov/cder/drug/InfoSheets/HCP/fluoroquinolonesHCP.htm
http://www.fda.gov/cder/drug/infopage/fluoroquinolones/default.htm
Contact JDJ Consulting for additional information.
“Dynamic Pharmacist Consulting for Improved Patient Safety and Drug Security”
by John Karwoski, RPh, MBA
President and Founder
JDJ Consulting, LLC
Dynamic Pharmacist Consulting for Improved Patient Safety Presentation
Research shows that the incidence of errors with injectable medications is higher than with other forms of medications. Studies also suggest that half of all harmful medication errors originate during the drug administration phase; of those errors, about two-thirds involve injectable medications. (click on web site for complete article and contact JDJ Consulting if you have any questions.)
Web site:
http://www.ismp.org/newsletters/acutecare/articles/20071115.asp?ptr=y
Please refer to the website below for information on generic Dantrolene. Contact JDJ Consulting if you have any qustions.
Site:
The FDA has the website below which tracks all drug shortages. Please feel free to contact JDJ Consulting if you have any questions or need assistance with substitutions.
Site:
Federal guidelines for the proper disposal of expired drugs can be found at the web site listed below. Please remember that DEA form 41 must be completed prior to destruction of controlled drug substances. Please contact JDJ Consulting if you have any questions or concerns.
Web Site:
http://www.whitehousedrugpolicy.gov/publications/pdf/prescrip_disposal.pdf
Federal regulations related to IV drug preparation have been implemented across the country. Important changes are:
1. All single dose vials are one time use. (controlled drugs must be wasted if not completely used for patient.)
2. All multi-dose vials must be dated when opened and discarded in 28 days. ( an easy reminder is 4 weeks from the day opened.)
Xylocaine dental cartridges continue to be on backorder. No release date.
IC Green is on backorder. Possible release early April. Vision Blue is an alternative.