Download SEAMLESS CARE ENTRY PROCEDURE Aug 03

SEAMLESS CARE DISCHARGE PROCESS
MEDICATION ENTRY PROCEDURE
Step 1: Print the Admissions Reports (7am).
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In Meditech (Pharmacy Live), click on the Admissions Report Menu icon
Click on the Admission Register icon
Sort By Name
In the For Date block, type “T-1”
In the For Time block, type “0000”
The report should be the “short” form
Also run the report “By name” with “T” in the For Date block and “0000” in the For Time block.
Highlight any new patients so that their Home Meds may be checked by the pharmacist.
Step 2: Print the Transfer Report (7am).
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In Meditech (Pharmacy Live), click on the Admissions Report Menu icon
Click on Transfer Register icon
Sort By Name
In the For Date block, type “T-1”
In the For Time block, type” 0000”
Also run the report “By Name” with “T” in the For Date block and “0000” in the For Time block.
Highlight patients that have been either transferred to or from 3600 or 4600.
Step 3: Print a MAR
Print a MAR for the patient being discharged.
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In Meditech (Pharmacy Live), click on the Process Orders button
In capital letters, enter the patients name (last name first) into the Patient block and press “F9”
Choose the appropriate patient from the pop-up screen.
Press “P” (Print)
Press “A” or click “Print MAR” with the cursor.
Leave the MAR Format as “SD.SEH”.
Change the Start Date to “T”
Leave the Start Shift as “1”.
Change the Printer to the local printer’s code.
Step 4: Open the Seamless Care Software
To get to the Seamless Care software, you must have IS granted access to the software and
you must be logged into the computer under your account (not meduser-1).
For Microsoft Access XP:
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Go to the START button
Go to PROGRAMS
Go to Microsoft Access XP (Red key in box)
Go to Open Folder
Look in: Interdepartmental (I:) drive
Go to “pha_Seamless”
Click on “Medcard 2001.mdb”
For Microsoft Access:
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OR
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Go to the START button
Go to PROGRAMS
Go to Microsoft Access (Red key in box)
Click on “Medcard 2001.mdb”
Click on My Computer
Go to Interdepartmental Drive (I:)
Click on pha_seamless
Click on “Medcard 2001.mdb”
A copyright statement pops up. Click “ok”.
The Seamless medcard screen is made up of THREE parts:
Upper Card – patient information
Middle Section – current medication regime
Lower Card – medication history, drug related problems and free-text info.
Step 5: Check for Patient
Make sure that the patient is not already in the Seamless Care program.
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Place the cursor in the PHIN # block
Click on the Binoculars (Find) on the tool bar and a new box will appear.
Type in the patient’s MRN# (ie. just ‘12345’, NOT ‘M0012345’)
Click on Find Next –
o If the patient appears, you may update this previous file. The software is used as a tool, not
for record keeping. DO NOT MAKE DUPLICATE FILES.
o If a patient does not appear, click to a new record using the button at the bottom of the lower
card that looks like this: ►‫٭‬
Step 6: Upper Card
This information can come form the MAR or the actual patient chart. *If the patient is
already in the system, simply review and update this information.
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Place cursor in the Patient Name block.
o Enter the patient’s name starting with the last name first, a comma, and then the first name
with no space in between (ie. Doe,John)
In the PHIN# block, enter the MRN# of the patient (ie. Just ‘12345’, NOT ‘M0012345’).
RFA (reason for admission) – found on the MAR
Dr. name (family physician)
Pharmacist (attending pharmacist in the hospital)
Pharmacy (patient’s community pharmacy)
Allergies
Admit (admission date)
Discharge (discharge date)
Ward (floor or unit they are on).
Enter everything except FAX DR. and HX boxes.
*Most blocks will contain a drop down screen to help you find your information.
If you don’t know the patient’s pharmacy, enter “Local Pharmacy”.
The discharge date is the date that appears on all reports (make sure that it is the actual date of discharge).
Step 7: Middle Card
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Place the cursor in the mnemonic code block.
o This is the drug mnemonic which consists of the first three letters of the generic drug name
(usually but some exceptions). For example put “met50” for metoprolol 50mg. Click on
arrow to bring down the drop down screen to scroll through the choices.
Click in the Sig Code box.
o Enter the sig as per the MAR. You can also get a drop down screen for different time
choices, etc. (ie. 1bid, 1od@noon, 1tidcc)
Click in the pt info section.
o Bring down the drop down screen for the various choices for which the drug is indicated.
Choose the appropriate one for that patient. You can also free text into this area.
Click on the ►* on the bottom of the middle card to enter the next medication.
Step 8: Lower Card
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Click on the Med History icon on the left (blue and white button). This area is for entering the
medications that the patient was on prior to entering the hospital. Enter the information from the
Home Med Sheet (obtained from the patients chart or the Home Med room).
o Enter the drug mnemonic in the first box to the left of the row (ie. fur40 = furosemide 40mg)
o Enter the schedule sig in the next box toward the right (taken from the MAR).
o If the drug is insulin, enter the particular doses in the next blue box in the row toward the
right (ie. 14units 20units).
o If the drug has been stopped or the dose altered in the hospital, indicate this with free text in
the last box in the row (far right) and click (checkmark) the little white box to the right of the
insulin box.
o Exit this section using the lower X in the right upper corner only.
Note to the Community Pharmacist free text area should include:
o Patient’s date of birth
o Information about Special Authorization
o Blister pack information
Note to the Patient free text area should include:
o Medications for which new Rx’s have been written
o If the patient has received their morning doses
o Any tapering regimes
o If the patient’s home medications have been returned.
The DRP button (used to flag medication changes – not a required field).
o Click on this icon.
o Enter generic drug name and pick the appropriate DTP classification.
o The information entered in the DRP section by the technician is just there to flag the
pharmacist. The medications entered could have been stopped, started or changes made to
their doses strengths during the patient’s stay in the hospital. The Pharmacist will then
elaborate in the Descriptive Note to the Pharmacist free text box any information that they
feel should be relayed to the community pharmacist.
o Exit this section using the lower X in the right upper corner only.
Step 9: Verification Sheet
A day or two prior to that patient’s discharge, print a verification sheet that the pharmacist will check
and flag medications that the physician should review and write Rx’s for.
How?
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Remember the patient’s counter number which is displayed to the right of the patient’s name.
Click on the Tables (database window) icon located on the toolbar.
Click on Reports in the left-hand column.
Double click on Verification.
When the Enter Parameter Value screen pops up, enter the counter number.
Click “ok”
When the report pops up, go to File on the toolbar.
Choose Print.
Make sure that the appropriate printer is chosen. Also, make sure there is pink paper in the printer.
Click “ok”.
You can escape out of the report.
DO NOT exit out of the Database Window as this will close down the whole program. Minimize this
window instead.
Step 10: Upon receiving notification that a patient is being discharged from the floor….
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Print a MAR for the patient.
Update current med regime in the Seamless Care software if needed.
Step 11: Consent Form
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Addressograph and fill out the consent form (check with the pharmacist to find out where
he/she keeps them).
Request that the patient sign it to allow you to share their personal information with the
community pharmacy and their family doctor.
Step 12: Check in current MAR to confirm that all morning doses have been given.
Step 13: Collect all home med (HM) bottles for that patient. Look in the Med Cart, Med cupboard
of non-verified drugs and the Pharmacy HM book if any are missing on the floor. Check even if HM
sheet states that the medications are not there. Puffers may be at the patient’s bedside.
Step 14: Review HM bottles and the information entered into Seamless Care with the pharmacist
to check for accuracy. The pharmacist may change any directions on the HM bottles or mark them as
discontinued as needed.
Step 15: Print the Medcard.
How?
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Remember the patient’s counter number which is displayed to the right of the patient’s name.
Click on the Tables (Database Window) icon.
Click on Reports in the left-hand column.
Double click on Patient Medication Card.
When the Enter Parameter Value screen pops up, enter the counter number.
Click Ok.
When the medcard screen pops up, go to File on the toolbar.
Choose Print.
Make sure that the correct printer is chosen. Also make sure that white paper is in the printer.
Click Ok.
You can then escape out of the report.
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DO NOT exit out of the Database Window as this will close down the whole program. Minimize this
window instead.
Step 16: Print the Physician report (2 copies)
How?
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Remember the patient’s counter number which is displayed to the right of the patient’s name.
Click on the Tables (Database window) icon.
Click on Reports in the left-hand column.
Double click on the Physician report.
When the Enter Parameter Value screen pops up, enter the counter number.
Click Ok.
When the report pops up, go to File on the toolbar.
Choose Print.
Make sure that the correct printer is chosen. Also make sure orange paper is in the printer.
Click Ok.
You can escape out of the report.
DO NOT exit out of the Database Window as this will close down the whole program. Minimize this
window instead.
One copy is for the physician’s mailbox and the other is for the patient’s chart. Extra mural may
require a third copy.
Step 17: Print or fax the Retail Pharmacy Report.
How?
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Remember the patient’s counter number which is displayed to the right of the patient’s name.
Click on the Tables (Database window) icon.
Click on Reports in the left-hand column.
Double click on the Retail Pharmacy Report .
When the Enter Parameter Number screen pops up, enter the counter number.
Click Ok.
To fax the report manually:
 When the report pops up, go to File on the toolbar
 Choose Print.
 Make sure that the correct printer is chosen. Also make sure white paper is in the printer.
 Click Ok.
 You can then escape out of the report.
 DO NOT exit out of the Database Window as this will close down the whole program. Minimize this
window instead.
To fax the report directly to the community pharmacy:
 When the report pops up. Go to File on the toolbar.
 Choose Print.
 Instead of choosing a printer, choose Winfax (only installed on some PC’s). Double click on it.
 When the Winfax program appears, scroll through the list of pharmacies on the right and double click
on that patient’s pharmacy.
 Click Send.
 After it sends, you can escape out of the report.
 DO NOT exit out of the Database Window as this will close down the whole program. Minimize this
window instead.
Step 18: Make sure that the “Discharge Medications and Instructions” sheet gets filled out by the
pharmacist. The nurses usually have to enter information as well. The chart then goes to the
wardclerk.