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(2011-11-24 01:43:47)
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Related article: The Clinical Pharmacist will participate with P.I. as designated by the Director of Pharmacy. F) Laboratory Values The Clinical Pharmacist will review appropriate lab values, including culture and sensitivities, as a routine part of their clinical duties. Any lab values that the Clinical Pharmacist deems significant will be communicated to the physician for review. G) Drug/Food Interactions The Clinical Pharmacist will coordinate Drug/Food Interactions issues with the Clinical Dietitian. They will review all potential food drug interactions and assist the Clinical Dietitians as appropriate. See Food/Drug procedure in this manual. H) Medication Room Inspection The Clinical Pharmacist, or pharmacy designee, will inspect all areas outside the Pharmacy where drugs are stored. The findings of this inspection will be reported on a Monthly Inspection Report. This form will be reviewed by each Nurse Manager or their designee. Any serious irregularities must be reported immediately to the Director of Pharmacy. IV-3 PHARMACY DRUG REGIMEN REVIEW PROCEDURE A. Applicable Standards and Requirements Clinical Pharmacists at ECRH are required to review the record of each client receiving medication(s) monthly. Notation, as appropriate, is made in the client�s record, and observations of response to drug therapy, adverse reactions, and over/under utilization of drugs are communicated to the Unit Physician. B. Requirements The Unit Pharmacist reviews each client�s medication regimen at least monthly. In addition to drug reviews, the pharmacist will complete an Annual Pharmacist Assessment. This assessment should be available to the Living Area staff (on shared drive) at least 2 weeks prior to the Annual Conference (Staffing). C. Procedure 1. The Pharmacy Medication Lorazepam Without Prescription Visa Review (CLN Form 681), ECRH Form DD683 and Indicator Comment sheets are used to document reviews. 2. Pharmacy reviews are dated and may include: * Client response to drug therapy * Drug allergies * Adverse drug reactions and/or significant drug interactions * Observations of over/under drug utilization * Follow-up of clients receiving behavior modifying medications. * Follow-up of clients receiving anticonvulsive medications * Potential drug therapy indicators (list may be found in the Department of Pharmacy) 3. Completion of Forms * Pharmacy Medication Review (CLN Form 681) and Consultant Pharmacist�s Drug Regimen Review Comments (DD 683) are identified using the client identification label. Each client receiving medications has these forms in their record in the direct medical care section. This form contains documentation of drug reviews with applicable comments/recommendations for quick reference. * The front of the Pharmacy Medication Review, CLN Form 681, lists medications. PRN medications are listed in the bottom spaces of the form. Review dates are entered at the top of the form. An arrow Lorazepam Without Prescription Visa drawn in a block between review dates indicates medication continuation. Diagonal lines indicate discontinued drugs. * Special medications, i.e., those prescribed for a limited time for an acute condition, are not listed unless in the opinion of the pharmacist, comment is needed regarding usage. * The reverse side of the Pharmacy Medication Review, CLN Form 681, lists known drug allergies. The blocks for the pharmacist�s signature and date are completed at each review. All applicable monitoring parameters, including required laboratory data, are completed also. After the review, the medications block is checked as �appropriate� or �see form DD 683 for comments� * Comments are sent in memorandum form to the Unit Physician on an Lorazepam Without Prescription Visa Indicator Comments sheet, accompanied by a Checklist for Drug Reviews. Copies are distributed to the Pharmacy Director, Assistant Pharmacy Director, Clinical Director, and Nursing Manager. The Pharmacist goes no further than identification of possible irregularities and notification of the Unit Physician. It is not necessary for the Pharmacist to ascertain the outcome of the recommendation. The Pharmacist need not repeat the documentation each review if the apparent irregularity continues provided: a) It has been deemed insignificant by the Pharmacist. b) It has been deemed significant by the Pharmacist, but the identification of possible irregularity has been rejected by the individual having authority to correct it. Under these circumstances, the Pharmacist may document that he/she identified an apparent irregularity and notified a person having authority to correct the potential problem. Notification is required on an annual basis. IV-4 PHARMACIST ANNUAL ASSESSMENT PURPOSE: To provide written documentation of medication usage relative to disease state and efficacy to members of the client�s Interdisciplinary Team. POLICY: The Clinical Pharmacy Department shall perform an annual pharmaceutical assessment on all clients. Drug therapy, which has the maximum potential to develop side effects or be contra-indicated in various clinical disease states, should be emphasized. These assessments must be prepared and submitted by the Clinical Pharmacist to meet the Hospital�s predetermined deadline. PROCEDURE: 1. The following information can be derived from each client�s record for inclusion in annual assessment or from pharmacy resources: a) Pertinent data base includes age, weight, diagnosis, diet, ideal weight range and allergy information. b) Current Lorazepam Without Prescription Visa medication therapy (include drug, dosage, and initiation date if applicable). c) Analysis, description of seizures and/or inappropriate behaviors. Parameters to monitor secondary to current drug therapy (include
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