News Briefs

Pharmacy groups create pandemic flu guide

The American Pharmacists Association, American Society of Health-System Pharmacists, and National Association of Chain Drug Stores Foundation have collaborated to produce a guide to help pharmacists respond to pandemic influenza. The document covers how pharmacies can help raise awareness and educate the public in the fight against a pandemic and how planning by pharmacists and others can significantly reduce the disease's impact.

Pharmacists are advised to learn about government preparedness and response plans, understand resources available in their health systems, corporations, communities, and actively participate in planning meetings dealing with pandemics. They also are encouraged to take part in immunization treating opportunities and establish a plan to maintain a week's supply of resources such as prescription drugs and consumable supplies.

The guide features a pandemic flu pharmacy checklist listing supplies for immunizations such as alcohol swabs and latex gloves; consumables such as bottled water and electrolyte solution; and drugs such as anti-nausea medications and opioids. It also lists the top medications dispensed during Hurricane Katrina, including hydrochlorlothiazide and albuterol, as reported by a major pharmacy chain, as examples of non-flu drugs that might be needed to meet patients' needs. The guide will be distributed through the three organizations' web sites.

Medication database may help in disasters

In the event of a disaster, a new online resource can provide licensed prescribers and pharmacists caring for disaster victims secure access to patients' medication history. As of June 4, 2007, licensed physicians have been able to register at http://www.ICERx.org (In Case of Emergency Prescription Database), which was created by the American Medical Association, Informed Decisions, the National Association of Chain Drug Stores, the National Community Pharmacists Association, RxHub, SureScripts, and other public and private organizations.

"The ICERx online service provides authorized pharmacists and doctors the ability to obtain records of medications victims were using prior to the disaster, including specific dosages," says RxHub marketing and communications director Chris van Horrick. "With this information clinicians are able to understand a patient's prescription history, renew prescriptions for victims, and effectively assist in the coordination of care while avoiding harmful prescription errors in real time."

ICERx also will give registered users drug reference information and clinical decision-support tools such as therapeutic duplication, interaction alerts, and a drug identifier. Prescription history information for evacuees would include drug name, dosage, quantity, day supply, the name of the provider who wrote the prescription, and the pharmacy that filled the prescription.

Data sources wishing to connect to ICERx.org to provide critical information in times of emergency should contact Informed Decisions at (800) 375-0943. The AMA will process the authentication and registration for licensed physicians wanting to access ICERx.org.

German hospital tests RFID drug tracking

Jena University Hospital in Germany is pilot testing use of high-frequency RFID (radio frequency identification) tags to track antibiotics from the point of dispensing in the hospital pharmacy to patient administration. The trial expects to use 125 tags per day for medication for 25 patients. Hospitals officials told RFID Journal they are testing the tracking system to improve treatment process efficiency and enhance drug handling safety. The hospital is using handheld and fixed RFID interrogators and is relying on robots that move supplies around the hospital in trolleys to transport drugs from the pharmacy to the intensive care unit.

Jena's doctors submit prescriptions into an electronic system implemented nine years ago to reduce medication errors. In-house pharmacists access the prescriptions on computers and prepare each patient's correct dosage. Under the pilot, pharmacists will affix RFID encoded tags to each sealed packet of an individual dose of medication or bottle of medicine. The packets and bottles are then put into plastic containers, which are also tagged.

Once a container is full, all the tags are read by a fixed interrogator. The reader documents the prescription, exact pill counts, intended patients, and other details in a patient information database. The containers are loaded onto a trolley, which also is tagged, and a pharmaceutical assistant uses a handheld interrogator to read the tags on the containers and on the trolley. The patient information database is then updated with the departure time for all medications.

When the antibiotics arrive in the ICU, nurses use handheld readers to scan the trolleys, documenting the medication's arrival. They then unload the containers and bring the appropriate medications to patients' beds. At the bedside, nurses use the handheld scanners to read the RFID tags on their employee ID badges and the tag on each medication dose and on patients' wristbands. All the tags' unique identification numbers are cross-checked in the hospital's patient information system to ensure that nurses administer the right medicine to the right patient at the right time. The system is then updated to show the antibiotics have been administered.

Pharmacists gain input into Joint Commission revision

Medication management standard on the table

The American Society of Health-System Pharmacists (ASHP) has accepted a Joint Commission invitation to serve on a new interdisciplinary task force revising Medication Management standard 4.10, which states, "All prescriptions or medication orders are reviewed for appropriateness."

The Joint Commission said at the beginning of this year that hospitals have been "consistently out of compliance" when it came to having a pharmacist review prescriptions and medication orders before emergency department (ED) personnel dispensed and administered the doses. The Joint Commission responded by requiring pharmacists to retrospectively review all ED orders.

In April, the Joint Commission reverted to its original requirement in the ED for pharmacist prospective review of all medication orders except those for urgent situations or when a licensed independent practitioner oversees dose dispensing and administration, and that led to renewed complaints from ED doctors. Joint Commissioner surveyor Darryl Rich told the ASHP summer meeting in San Francisco that the Joint Commission decided to let each hospital choose how to deal with the issue of ED medication order review. He said MM.4.10 is not being scored in the ED until it gets resolved and a final outcome comes out in 2008. ASHP director of patient safety Kasey Thompson said the society is "not going to wait for the Joint Commission to tell us what they think needs to be done. "We're going to provide a model that we think will work for everybody and meet the needs of patients," he said.