We have been doing this for 9 months, so far no problems, but we set
this up to be extremely easy on pharmacy and radiology, so it may not be
the best way.
 
When a test is ordered by the doctor, nursing enters the test in through
the nursing module. It prints out to radiology and to pharmacy. We have
a designated printer next to the pharmacist. Pharmacy then enters the
drug, we have three drugs, contrast oral, contrast iv, and contrast mri.
We have attached the ingredients only, not generic. We have attached the
drug interactions, Ex: glucophage and the allergies, Ex: iodine.
Pharmacy then enters using an order type of RAD, using sets civ, cor,
cmri. The sets of course, are built as one time entries, and using the
order type or RAD, nursing does not see in their module, so no
confusion. Any interactions or allergies pop up in the system, as the
pharmacy enters the orders. The pharmacist notifies radiology, and
documents who they have talked too, so the doctor can decided or what
they need if there is a problem.
 
Radiology goes into PCI, and views the order that pharmacy has put in.
Basically if it is entered and they see it, they
know to give the contrast. If it is not in PCI, they know there is a
problem. So far, it has worked very well, if they don't see
it they call, which is usually we did not get in fast enough, but is
very rare, We have usually already talked to them, so no
phone call. Radiology is not up on emar, so they can only view in PCI.
Also we made a special category (drug type) in PCI drug history , called
RAD so they can find the drug entry real fast.
 
We have not developed any automatic stopping of drugs. Ex; glucophage
for 48 hr. We have been talking about getting a policy for automatic
stopping, that the pharmacist can write, but for now we called the
radiologist and let them do it.
 
One thing we have noticed, and the reason we have drugs called civ , cor
, cmr ( contrast iv , etc), instead of actually entering all the
different contrasts was, nursing enters the test numerous times, before
getting it right, a lot of times.
We would be entering numerous contrasts, not knowing which one is right,
so we just lumped them with all interactions, and allergies and assume
all tests have. Also the viewing in PCI helps, because we have no clue
when the test will be done and since we enter as once, it drops off any
module viewing in one minute and Radiology has no problem viewing at
any time, "we don't get the phone call, the drug is not on the profile,
", ten hours later.
 
Your other question, we order all contrast for radiology. They keep an
on going log book for readi cat contrast only, when they come to
pharmacy, they sign out 10 or 20 bottles, in their log. As they use it
they sign out to each patient in their log. As they come to get more
contrast from pharmacy, they leave their filled out sheets, which we
keep.  Not sure why, only the oral contrast, can't remember the reason
behind that one, but I think it was because the radiology tech delivers
to the patient on the floor. Sorry.
 
Hope this gives you a few ideas.
thanks,
Becky Maxwell Rph
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

________________________________

From: [email protected] [mailto:[EMAIL PROTECTED] On Behalf
Of Arthur, Jerri
Sent: Monday, January 22, 2007 2:11 PM
To: [EMAIL PROTECTED]; [email protected]
Subject: [MEDITECH-L] Imaging Contrast Oversight by Pharmacy



I'm posting for our Pharmacy Director: 
  
Our pharmacy is working with the imaging department to meet the
standards and intent JC has issued related to pharmacy oversight of
contrast agents used in Medical imaging. We plan on pharmacy screening
inpatients for use of imaging products in advance, and outpatients using
pre-approved protocols. I am interested in learning how other small
hospitals have done their procedures, and if Meditech can help
communications. For instance,

1. are you entering all contrast agents in the Meditech PHA system like
you would any other drug? 
2. does your pharmacy also dispense these agents? 
3. Did you create a new order type for the imaging drug dictionaries to
use? We thought this might be helpful to track only contrast products.

4. Do you use any kind of Meditech automation to alert the pharmacy to
an imaging procedure that needs a contrast agent screened? 

All help or opinions would be appreciated. 

Bill Arrington D.Ph. 
Dir. of Pharmacy 
Stillwater Medical Center 
Stillwater, Oklahoma 
405-742-5687 
[EMAIL PROTECTED] 

Thank You, 
Jerri Arthur, MS
Applications Analyst
Information Technology
Stillwater Medical Center
1323 W 6th, Box 2408
Stillwater, OK 74074
405-742-5269
405-742-5971 fax
405-742-9266 pager
[EMAIL PROTECTED] 
Meditech Client Server, 5.5.2 

MUSE Western US Region Chair Elect 
Education/Scheduling Coordinator 



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