buyers taking an active role in patient safety patrick gallagher, cpht pharmacy buyer marian medical...
TRANSCRIPT
Buyers Taking an Active Role in Patient Safety
Patrick Gallagher, CPhT
Pharmacy Buyer
Marian Medical Center
How Buyers can play a Key Role
It’s not just about ordering drugs and processing invoices anymore!
As a Buyer, it is important for us to learn more
How Buyers can play a Key Role
Past expectations of the Pharmacy Buyer How the position has evolved (Buyers are
CPhT , full time person, 340B Accounts) Buyers role in patient safety Future expectations of Pharmacy Buyer
(National Certification)
What is the bottom line?
High-Alert Drugs
Identified by ISMP, Joint Commission, IHI and others High potential for causing errors in the medication
use system– Selection– Storage– Ordering– Dispensing– Administering– Monitoring
High-Alert Core List
Concentrated electrolytes– Potassium chloride– Potassium phosphate– Sodium chloride greater than 0.9%
Insulin Anticoagulants Narcotics and opiates
Heparin 10,000 unit vials
Unsafe Storage: Insulin Jumble
CHW High Alert Medications 2010
Insulins
Concentrated Potassium and Sodium Solutions (KCL, Kphos, NaCl > 0.9%)
Chemotherapy Agents
Therapeutic Heparin
Neuromuscular Blocking Agents
Epidurals & any opiate intrathecal or other analgesic drip administered into the central system
Any Opiate administered by PCA, NCA or IV drip(Morphine, Hydromorphone, Meperidine, Fentanyl)
Oxytocin (Pitocin) drip
Magnesium Infusion > 4 Grams
Neonatal or Pediatric medications in facilities with low volumes of these patients
Additional High-Alert Drugs
Chemotherapy Drugs used in neonates and pediatrics TPN Sterile Water
– Injection larger than 10 mL– Irrigation bags
Others as determined by the hospital
It’s also not about saving money, it’s about saving lives!
Objective 1: Identifying a Problem
Identifying a possible danger to patient safety.
Verifying/ validating a potential problem to patient safety.
Alert the person(s) of authority of the problem ( notify manufacturer, notify ISMP.)
Alert others that may be affected of this potential problem.
Too many LASAs!
If it doesn’t look right, or you don’t feel right about it, it probably isn’t right
Most Pharmacists will thank you if you question it
You should feel good about bringing it to someone’s attention, especially a high alert drug
It takes a series of little things to create one big error
The Swiss Cheese Model
Objective 2: Make Change
Use your own resources. Talk to your co-workers. Consult your colleagues / buyers. Consult other buyers/ wholesalers that you
have met through NPPA.
By speaking up you become a wing man, no…not Batman!
Fentanyl IV PCA
Morphine IV PCA
Dilaudid IV PCA
Epidural
Objective 3: Going Public with Change
Getting the word out for change. Ask for feedback from people that may be
involved in change. Always be willing to listen and expand on
initial idea. Monitor / listen to new ideas.
CADD Cassette
CADD Cassette Epidural
Heparin Bag
Patient take home meds from the ER Department
Any Questions?