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Medication Administration with Care Admin and Care Mobile by Karen Biggio Debbie Chapman. Objectives. What is PPID How to maintain NDC numbers stacking vs identifiers Bar Codes 1D vs 2D Pharmacy’s process for adding new NDC numbers in the formulary . Objectives.
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Medication Administrationwith Care Admin and Care Mobileby Karen Biggio Debbie Chapman
Objectives • What is PPID • How to maintain NDC numbers stacking vs identifiers • Bar Codes 1D vs 2D • Pharmacy’s process for adding new NDC numbers in the formulary
Objectives • Choosing between Care Admin and Care Mobile • Scanner Selection Tips • Tweaking the Order Catalog • PPID Reports
Objectives • Implementation Plan • Medication Safety Catches • Questions??
Who we are: 7 hospitals 13,000 staff 1,400 physicians 2,000 volunteers 140+ service sites Who we serve: 3 million people 450,000 health plan members 6,300 employers About Spectrum Health
Largest not-for-profit health care system in West Michigan DeVos Children’s Hospital—Only children’s hospital in West Michigan Largest open heart program in the state Largest regional provider of cancer care Priority Health – Ranked #1 by National Business Coalition on Health Regional Neonatal Center Regional Poison Center Regional Burn Center Regional Level I Trauma Center – most trauma care in Michigan Aero Med regional medical transport service More than 40 national quality awards About Spectrum Health
2001 – 2006 Process PowerChart Firstnet PharmNet Nursing Documentation I-View Meds Integration eMar Task Lists Meds Reconciliation CPOE in Firstnet Auto Verification
2007 PPID The ability to use barcode technology in conjuncture with medication administration. This is accomplished by scanning the patient identification band and then scanning the medication, thus enabling the clinician to check the five rights.
2007 PPID 5 Rights: • Right person • Right medication • Right route • Right dose • Right time
NDC Numbers & Unique IDs Drug products are identified and reported using a unique, ten-digit, three-segment number, called the National Drug Code (NDC), which is a universal product identifier for human drugs. This number identifies the labeler, product, and trade package size. When the barcode is scanned, the scanner is looking for the NDC number.
NDC Numbers In order for the scanner to read and identify the drug, every product’s barcode must be scanned into the the product tool (phadbproductmgr.exe). There are 2 ways to place a NDC number in the product tool: • Stacking the NDC number • Using identifiers
NDC Numbers - stacking Add each manufacturer (each NDC number) to the supply tab in phadbproductmgr. There is no limit as to how many manufacturers you can add here.
NDC Numbers - identifiers Under the identifier tab add each NDC number as Rx Misc1. There is a limit of 5 Rx Misc1 that can be added. We also added the item_id of each product as Rx Misc2. If the cerner label is scanned, the label contains the dispense_id which goes back to the item_id and the medication is identified by that.
Medication Labels Patient specific medications may be sent up from pharmacy with a Cerner label. This label contains: • Patient name and Fin# • Room and bed • Drug name (included is order_id, dispense_id, and item_id)
Bar Codes Different bar and space patterns represent different characters. Patterns grouped together form a “symbology”. Most medication barcodes incorporate the NDC number in the barcode.
Bar Codes – 1D Most scanners can read 1D (linear) barcodes. Code 128 and Code 39 are two common linear barcodes used in healthcare. A linear barcode requires more area than a 2D barcode and they have a limited data storage capacity.
Bar Codes – 2D 2D barcodes have a higher capacity of data storage and require less space on the label. Not all scanners will read 2D barcodes or a scanner may not read all the types of 2D barcodes.
Pharmacy’s Process All medications are scanned into the system in pharmacy receiving area to make sure they are in the system. The PDA device is used to complete this process because of mobility of the device. If a medication is not found this is forwarded to the management team to add prior to dispense.
Care Admin Care Admin is a scanner that is connected to either a stationary computer or a computer on wheels (COW). The user has a full-screen view and is able to use the workstation in conjunction with the bar code scanning device
Care Admin Pros • Use it in conjunction with the computer • You are able to see and chart current due medications, prn medications, continuous infusions and overdue medications • I&O 2G compatible • An option for nursing units that have a computer in every patient room
Care Admin Cons • Can only use for Begin Bag on continuous infusions, cannot Infuse, Change Rate, etc. • Depending on how you customized your frequencies and when your DCP Task Status – Overdue ops job runs, there may be a time period where some overdue medications will not show in the care admin box. • Not only has to be plugged into the computer but also has a second plug for power.
Care Mobile Care Mobile is a hand held device. Users have full medication administration capabilities along with the barcode verification of the 5 rights. Can also document on a simple powerform and place an order for a stat medication (ad hoc order).
Care Mobile - Pros • It’s small, light weight, not connected to a computer • Able to do complete charting on continuous infusions, such as Begin Bag, Rate Change, Infused, etc • Have the ability to chart on simple power forms • An option for nursing units that do not have many computers per patient ratio.
Care Mobile - Pros • Have the ability to add a stat one time order. That order will go to pharmacy med manager, the orders tab and to eMAR • Have the ability to chart titratable drips • User can view most recent laboratory results, radiology results and vitalsigns • Utilizes Multum checking: • Drug-allergy • Drug-drug • Duplicate
Care Mobile - Cons • It has a small viewing screen • Does not have the ability to do more complex power forms • It is not fully integrated with I&O2G yet but that is coming in the near future
Scanner Selection What to look for in a scanner: • Must have the ability to read ALL 2D symbology • How heavy is the scanner • How easy is it to set the scanner back in the cradle • How easy is it to point and scan • How easy is set up of the device
Scanner Selection • How is power delivered to the device • Is the device wireless whether Care Admin or Care Mobile
Tweaking the Order Catalog Scenario 1 Multi strength physician orders Lipitor 30mg po, pharmacy sends 1-20mg and 1-10mg tablet. How will the scanner know? Customization of Order Catalog for multi strength orders: Scope synonyms for multi strength doses at the primary and brand name level
Tweaking the Order Catalog Scenario 2 Multi form same route orders 325mg po tablet. Order is changed to NG, liquid form of drug is now required. How will the scanner know?
Tweaking the Order Catalog Customization of order catalog for same route orders Scope synonyms for same route different form of doses at the Rx Mnemonic level. This allows for the order to be modified from one form to the other such as, oral tablet to oral liquid without creating a complete new order.
