Download July 2015 - Brigham and Women`s Faulkner Hospital

July
o Appropriate timing of medications for
treatment of Parkinson’s Disease...p.1
o MAR Reminder...p.1
o New or Updated DAGs...p.2
2015
o Preventing Medication Errors
with Barcode Scanning..p.2
o Update: Ordering TPN...p2
Brigham and Women’s Faulkner
Med Thread
CONNECTING DISCIPLINES THROUGH
MEDICATION INFORMATION
Appropriate timing of medications for treatment of
Parkinson’s Disease
About one-third of patients with
Parkinson’s disease will visit the
Emergency
Room
or
are
hospitalized each year. These
patients often have complex
medication
schedules.
For
example, it is quite normal for
carbidopa/levodopa to be taken
every 1 to 2 hours.
With such complex medication
schedules it is important for
hospitals to allow these patients to
take their medications as they
would at home. This can help
minimize symptoms of the disease
as much as possible during their
stay. Parkinsonian symptoms such
as
tremor,
impaired
balance/posture,
and
muscle
rigidity all greatly increase the risk
of falls. Approximately threequarters of hospitalized patients
with Parkinson’s disease do not
receive their medications on time hospitalization. Medications such
or have doses omitted entirely as haloperidol may be given to a
while hospitalized.
patient with Parkinson’s disease
for the associated dementia and
The dosage of medications used
agitation. Although thought to be
for treatment of Parkinson’s
helpful, these medications may
disease should not be abruptly
cause harm. Haloperidol may
reduced because this may have
exacerbate the patient’s symptoms
the same effect as delaying or
instead of relieving them and has
omitting doses. Changes to the
the additional risk of falls.
administration schedule of these
medications may make these When patients with Parkinson’s
patients
uncomfortable
and disease are admitted to the
potentially put them at an hospital it is important that they
increased risk of injury.
receive their medications as close
to their home schedule as
It is important to understand which
possible. It is also important to
common medications should not
avoid contraindicated medications.
be prescribed to patients with
These steps can reduce the risk of
Parkinson’s disease because they
exacerbating
the
patient’s
could exacerbate their condition.
condition which in turn may lead to
One study found that one-third of
falls and a longer hospital stay.
all Parkinson’s patients had been
prescribed
at
least
one
- Joe Braasch, MCPHS
contraindicated medication during
Pharmacy Student 2015
New or Updated DAGs:
Check out what’s new in the Faulkner DAG library on Faulkner 411
 Adenosine
 Heparin
Preventing Medication Errors with Barcode Scanning
Barcode scanning is a useful mechanism to
prevent medication errors by ensuring that the
correct product is being used for medication
administration. Even with this system in place,
mistakes can happen if one does not use
proper scanning technique.
4. If the manufacturer’s barcode is unavailable,
as in the case of products compounded by the
BWF pharmacy, the barcode on the EPIC
label should be used to document
administration.
Here are some helpful tips to remember to help
prevent unnecessary errors in medication
administration:
1. Look at the medication that is being
administered. Make sure that it matches the
dose and description of the product on the
MAR (tablet, capsule, injection).
2. Always scan the barcode at the time of
administration. This ensures that the
accurate product is administered at the time
of documentation.
3. Scan the manufacturer bar code if available
for products to be administered. The EPIC
labels come with several different barcodes
on the label. These are useful for
medication tracking and dispensing within
the pharmacy, but should not be used
during administration. To help prevent
accidental scanning of the wrong label,
these barcodes will now read “FOR
PHARMACY USE ONLY” to serve as a
reminder not to use this for scanning during
administration.
SCAN these
barcodes
NOT this
barcode
Using these tips can ensure the right patient
receives the right medication and dose.
MAR Reminder:
Look for Pharmacist Verification
As a reminder, medications will appear in the MAR immediately after
they have been entered by the prescriber, even if they have not been
verified by a pharmacist. A stop sign on the right in the MAR indicates a
medication is unverified and should be verified prior to administration.
Editor: Alana Gruszecki, PharmD
NEXT PHARMACY AND
THERAPEUTICS
COMMITTEE MEETING:
August 13, 2015