EO 005_02_Maintain under control medication inventory
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EO 005.02 Maintaining Undercontrol Medication Inventory (Dari) AFAMS 01/09/2013 Importance of Lesson (Dari) • In the previous lecture you learned that Undercontrol/ Controlled Medications require stringent controls due to the potential for their misuse (e.g. diversion and abuse). • These more stringent controls include increased steps when: – – – – – Insert Dari Storing; Ordering; Receiving; Accounting; and Dispensing. AFAMS Importance of Lesson (Dari) • The purpose of this lecture is to teach the processes for the proper management of these medications. Insert Dari AFAMS Overview EO 005.02 (Dari) • • • • • • Identify the prescription requirements for an under control medication prescription. Process for performing physical counts under Pharmacist’s supervision Maintain and update records Procedure to address under control drug discrepancies Review Scenarios (not graded) Insert Dari AFAMS Under Control Prescriptions • Inpatient: – Require form 58 prescription • Outpatient: – Outpatient prescription written by physician AFAMS Form 58 AFAMS Form 58 Drug Strength Amount of Drug Required for Each Patient Patient Total of Each Drug Required AFAMS Outpatient Prescription Example Dari All prescriptions for Under control medications require a pharmacist to review The date should be within 3-7 days of today’s date An exact quantity should be written. Only dispense if you are aware of the prescriber and recognize their signature. If not, call the prescriber. AFAMS Signs of Counterfeit Prescriptions Dari • Under control medication prescriptions are commonly counterfeited. Look for: – Use of two colours of ink. This may indicate changes made after it was written. – Unknown prescriber. – Incorrect registration number – Drug names misspelled – Quantity does not match direction requirements – Not written on an official prescription form. – No Sig Code – Quantities changed by crossing out • In all these instances the Pharmacist will have to investigate. AFAMS Learning Check • What are some common signs of a counterfeit Under control medication prescription? AFAMS Learning Check • What are some common signs of a counterfeit Under control medication prescription? – Use of two colours of ink. This may indicate changes made after it was written. – Unknown prescriber. – Incorrect registration number – Drug names misspelled – Quantity does not match direction requirements – Not written on an official prescription form. – No Sig Code – Quantities changed by crossing out AFAMS Authority to Order Controlled Drugs Dari OTSG Policy 18 AFAMS Authority to Order Controlled Drugs Dari OTSG Policy 18 AFAMS Authority to Order Controlled Drugs Dari OTSG Policy 18 AFAMS Uncontrolled Access OTSG Policy 18 AFAMS Uncontrolled Access • • • Unaccompanied access to controlled medical substances will be denied until a satisfactory local security check is completed. (Appendix A to OTSG Policy 18) The Medical Commander reviews the security check and determines if the individual meets the requirements to have unaccompanied access to controlled substances. Appendix B to OTSG is completed authorizing unaccompanied access to controlled substances – provided to the employee, the immediate supervisor, and the unit Security Officer. AFAMS Appendix A AFAMS Appendix B AFAMS Uncontrolled Access OTSG Policy 18: AFAMS Uncontrolled Access OTSG Policy 18: AFAMS Uncontrolled Access OTSG Policy 18: AFAMS Physical Count Requirements Dari OTSG Policy 18 AFAMS Physical Count Requirements Dari OTSG Policy 18 AFAMS Physical Count Requirements Dari OTSG Policy 18 Requirement for a perpetual log AFAMS Physical Count Requirements Dari ANA 6-81: AFAMS Physical Count Requirements Dari OTSG Policy 18: AFAMS Pharmacy Depot Requirements Policies and Procedures Dari of Pharmacy Department ANA Stock cards and MoD Form 1 will be discussed in future lectures AFAMS Pharmacy Depot Requirements Dari Policies and Procedures of Pharmacy Department ANA AFAMS Pharmacy Dispensary Requirements Dari Policies and Procedures of Pharmacy Department ANA AFAMS Pharmacy Dispensary Requirements Dari Policies and Procedures of Pharmacy Department ANA AFAMS Pharmacy Dispensary Requirements Dari Policies and Procedures of Pharmacy Department ANA AFAMS Pharmacy Dispensary Requirements Dari Policies and Procedures of Pharmacy Department ANA AFAMS Perpetual Log Dari Documentation: • Each time a controlled substance is administered, record: – day – hour – patient’s name – initial and last name of the prescriber – signature of the individual administering the medication – amount of the substance administered – new balance recorded • Dari AFAMS Perpetual Log Dari • Dari AFAMS Perpetual Log Example Dari AFAMS Perpetual Log Dari • Dari Morphine 10mg tablets 20 Apr 13 0950 Previous page qty Latifa Ahmad ------Mohammad Taj Abdullah Behroz Behnam 28 ---------- 100 72 AFAMS Ward Requirements Dari Policies and Procedures of Pharmacy Department ANA AFAMS Ward Requirements Dari Policies and Procedures of Pharmacy Department ANA AFAMS Ward Transfers/ Dari AFAMS Updating the Perpetual Log Dari AFAMS Return from a Ward Dari AFAMS Perpetual Log Dari • Dari Morphine 10mg tablets 20 Apr 13 0950 20 Apr 13 1230 Previous page qty Latifa Ahmad Pharmacy ------Mohammad Taj Abdullah Behroz Behnam Behroz Behnam 28 ------ 100 ----15 72 87 AFAMS Error in Recording Dari AFAMS Perpetual Log Dari • Dari Morphine 10mg tablets 20 Apr 13 0950 20 Apr 13 1230 20 Apr 13 1430 20 Apr 13 1430 Previous page qty Latifa Ahmad ------Mohammad Taj Abdullah Pharmacy Behroz Behnam Rm 5430 Mohammad Taj Abdullah Behroz Behnam Behroz Behnam Rm 5415 Mohammad Taj Abdullah Behroz Behnam 28 ------ 15 ----15 ------ 15 ------ 100 72 87 102 signature 102 AFAMS Recording Accidental Destruction (Broken, Unserviceable) Dari AFAMS OTSG Policy 18 AFAMS Perpetual Log Dari • Dari Morphine 10mg tablets 20 Apr 13 0950 20 Apr 13 1230 20 Apr 13 1430 20 Apr 13 21 Apr 13 1430 1030 Previous page qty Latifa Ahmad ------Mohammad Taj Abdullah Pharmacy Rm 5430 Mohammad Taj Abdullah Rm 5415 Pharmacy Mohammad Taj Abdullah Destroyed Behroz Behnam Behroz Behnam Behroz Behnam Behroz Behnam Behroz Behnam 28 ------ 15 ----15 ------ 15 15 Destroyed ----------- 100 72 87 102 signature 102 87 AFAMS Returning Expired to QM Dari AFAMS Perpetual Log Dari • Dari Morphine 10mg tablets 20 Apr 13 0950 20 Apr 13 1230 20 Apr 13 1430 20 Apr 13 1430 1030 21 Apr 13 1130 23 Apr 13 Previous page qty Latifa Ahmad ------Mohammad Taj Abdullah Pharmacy Rm 5430 Mohammad Taj Abdullah Rm 5415 Pharmacy Quartermaster Mohammad Taj Abdullah Destroyed Expired Behroz Behnam Behroz Behnam Behroz Behnam Behroz Behnam Behroz Behnam Behroz Behnam ------ 100 72 15 ----15 ------ 15 15 Destroyed 10 ---------------- 102 87 77 28 87 102 signature 2x signature AFAMS Pharmacy Depot Requirements Policies and Procedures Dari of Pharmacy Department ANA MoD Form 1 and Stock Card indicate destruction in QM Stock cards and MoD Form 1 will be discussed in future lectures AFAMS Under Control/ Controlled Medication Discrepancies Dari AFAMS Reporting Discrepancies OTSG Policy 18: On Ward: AFAMS Dispensary Responsibility Policies and Procedures of Pharmacy Department ANA AFAMS Dispensary Responsibility OTSG Policy 18: AFAMS Questions? AFAMS Review Above Slides (Dari) AFAMS Scenario (Assessment) Dari Formative Assessment: • Not marked • Used to assess the students understanding of lectures material. • Instructors will provide a Scenario involving the updating of the Under Control/ Controlled Medications Perpetual Log. • Instructor to provide students with blank Perpetual Log sheet. • Instructor will provide a debrief at the end of the Scenario. • Time estimate (including debrief): 20-30 mins Insert Dari AFAMS Scenario AFAMS Scenario You are working in the Dispensary and have just received an order (next slide) from the Quartermaster. The Pharmacist (Dr Behroz) has asked you to record the order in the perpetual log. • Instructor to hand out two blank perpetual log sheets to each student. AFAMS Scenario Date: 10 September 2013 Time: 1425 The received order is as follows: • tramadol 100mg tablets – 100 tablets – Previous on hand quantity: 75 tablets • morphine 10mg tablets – 100 tablets – Previous on hand quantity: 150 tablets AFAMS Answer: Perpetual Log Dari • Dari Tramadol 100mg tablets 10 Sept 13 1425 Previous page qty Pharmacy Quartermaster Behroz Behnam ------- ------ ------ 100 75 175 When starting a new page always transfer the quantity on hand to the new page. AFAMS Answer: Perpetual Log Dari • Dari Morphine 10mg tablets 10 Sept 13 1425 Previous page qty Pharmacy Quartermaster Behroz Behnam ------- ------ 150 ------- 100 250 When starting a new page always transfer the quantity on hand to the new page. AFAMS Scenario Date: 10 September 2013 Time: 1545 • You receive an outpatient prescription. • You show the pharmacist (Dr Behroz) who tells you to record it in the perpetual log and to dispense the medication. AFAMS Answer: Perpetual Log Dari • Dari Tramadol 100mg tablets 10 Sept 13 1425 10 Sept 13 1545 Previous page qty Pharmacy Latifa Ahmad Quartermaster Dr Abdullah Behroz Behnam Behroz Behnam ------- ------ ------- 100 14 ----- 75 175 161 AFAMS Scenario Date: 10 September 2013 Time: 1545 • You receive an inpatient prescription. • Signed by: Dr Hussein • You show the pharmacist (Dr Behroz) who tells you to record it in the perpetual log and to dispense the medication. AFAMS Form 58 Tablets Patient Total of Each Drug Required AFAMS Answer: Perpetual Log Dari • Dari Morphine 10mg tablets 10 Sept 13 1425 10 Sept 13 1545 Previous page qty Pharmacy Quartermaster Behroz Behnam ------------- 5845 Dr Hussein Behroz Behnam 10 Sept 13 1545 5846 Dr Hussein Behroz Behnam ------ 150 250 30 100 ------ 220 10 ------ 210 AFAMS Questions? AFAMS End of Lecture Dari AFAMS
