Hospital Placement 2017: My First Two Weeks

I have now completed two weeks on hospital placement, one week at Lakeridge Health Whitby, and the second week at Lakeridge Health Oshawa.

Lakeridge Health Whitby is a smaller hospital, that provides continuing care, Geriatric Assessment and Rehabilitation (GARU), a regional dialysis unit, home hemodialysis and an ambulatory rehabilitation centre. During my first week, I completed the following:

Monday

I was introduced to filling MedSelect machines on hospital floors, and witnessed stocking MedSelect with narcotics by two Registered Pharmacy Technicians (RPhTs) so there is a double count (NAPRA 1). I stocked patient specific bins on hospital floors with traditional stock drugs (NAPRA 3). I witnessed compounding of drugs, order entry, and tech-check-tech of orders entered (NAPRA 3), and completed runs to the hospital floors throughout the day to check for orders and deliver additional traditional stock items (NAPRA 3).

Tuesday

I picked drugs off the shelf for traditional orders to be filled (NAPRA 3). I helped fill MedSelect machines on hospital floors (NAPRA 3; 4). I witnessed the process of signing in narcotics to the narcotic safe on the hospital floors, with the need for a nurse to sign as a witness that she received the narcotics (NAPRA 1). I practiced deciphering orders (NAPRA 3). As well, I completed runs to the hospital floors throughout the day to check for orders and deliver additional traditional stock items (NAPRA 3).

Wednesday

I selected drugs off the shelf to be packaged for the traditional order refill list (NAPRA 3). I helped fill MedSelect machines on hospital floors (NAPRA 3; 4). I witnessed the process of signing in narcotics to the narcotic safe on the hospital floors, with the need for a nurse to sign as a witness that she received the narcotics (NAPRA 1). I helped return unused unit dose drugs to the pharmacy shelves (NAPRA 4). I witnessed how to return narcotics from the hospital floors to the Centrack cart, and how to document narcotics that are to be discarded (NAPRA 1; 4; 5; 9). I helped take inventory of ward stock on the hospital floors, and put away a McKesson order in the pharmacy (NAPRA 4). Again, I completed runs to the hospital floors throughout the day to check for orders and deliver additional traditional stock items (NAPRA 3).

Thursday

I filled drugs on the traditional order refill list (NAPRA 3). I observed picking narcotics for the hospital floors from the Centrack cart in the pharmacy (NAPRA 3; 4). I unpacked the order from Lakeridge Health Oshawa of unit dose strips, put them into floor specific bins, and I helped fill MedSelect machines on hospital floors (NAPRA 3; 4). I checked the pharmacy traditional stock on the shelves for expiry dates, and made sure opened bottles of drugs were marked with a one year expiry from the date of being opened, as per Ontario College of Pharmacists (OCP) regulations (NAPRA 1; 4; 9). I made a suspension compound, and double checked the drugs and batch number of the RPhT who pulled the drugs (NAPRA 3). Also, I completed runs to the hospital floors throughout the day to check for orders and deliver additional traditional stock items (NAPRA 3).

Friday

I filled drugs on the traditional order refill list (NAPRA 3). I observed picking narcotics for the hospital floors from the Centrack cart in the pharmacy (NAPRA 3; 4). I unpacked the order from Lakeridge Health Oshawa of unit dose strips, put them into floor specific bins, and I helped fill MedSelect machines on hospital floors (NAPRA 3; 4). I helped return drugs from hospital floors to the pharmacy shelf if they were in sealed unit dose packaging, and discarded the rest into the appropriate container (NAPRA 1; 4; 5; 9). I observed processing returns in the computer to be sent back to Lakeridge Health Oshawa (NAPRA 4). I completed runs to the hospital floors throughout the day to check for orders and deliver additional traditional stock items (NAPRA 3).

My second week was at Lakeridge Health Oshawa, which is a large general hospital. In the pharmacy, each staff member is assigned a specific area and task each shift. My second week, I completed the following:

Monday

I witnessed filling MedSelect machines with narcotics on assigned hospital floors, as well as assisted filling MedSelect machines with non-narcotics (NAPRA 3; 4). I witnessed the process of signing in the narcotic methadone in tang to the narcotic safe on a hospital floor (NAPRA 1), and witnessed my supervisor catch a near miss (NARPA 9), as when signing in the next day’s dose of methadone in tang, she observed that the patient had only received a portion of the current day’s dose as the auxiliary label stating to drink all contents was not read properly. I also witnessed the operation of the unit dose packaging machine, and helped package the rolls of unit dose drugs into parcels for delivery to Lakeridge Health Whitby (NAPRA 3; 4).

Tuesday

I shadowed a RPhT who completed Medication Reconciliations in the emergency department for patients being admitted. I witnessed the process of using additional sources of medication history, such as Ontario Drug Benefit files and community pharmacy medication history, before interviewing the patient to obtain a Best Possible Medication History (BPMH) (NAPRA 2; 6; 7).

Wednesday

I worked in the unit dose packaging room, and helped organize rolls of unit dose packaged drugs from the machine into hospital floor specific bins, as well as added additional needed drugs from picking bins (NAPRA 3; 4). I saw how to replace unit dose paper into the machine when it ran out, and how to add drugs to the machine when they were low (NAPRA 4). I packaged narcotics with the table top unit dose machine, and I packaged blisters of drugs for the picking bins (NAPRA 3; 4). I helped stock unit dose drugs into the bins that were low in the traditional stock filling area (NAPRA 4). I attended a meeting on a new Pharmacy Order Verification Process that will soon be implemented, to eliminate the process of matching order hard copies with printed labels to be checked, as it will become computerized (NAPRA 4; 7).

Thursday

I observed the process of matching order hard copies with printed labels, and passing those orders to be either double checked against the printed labels, or filled if any traditional stock needed to be dispensed (NAPRA 3). I helped fill some traditional orders (NAPRA 3). I observed the use of the tube station to send orders to specific hospital floors (NAPRA 4). I helped stock MedSelect machines on certain hospital floors (NAPRA 3; 4). I attended a Pharmacy Technician meeting for staff addressing any problems or concerns and ideas on how to keep workflow at its best (NAPRA 7; 8).

Friday

I worked in the stock room, and helped pick drugs to add to hospital floor specific bins, to be put into the MedSelect machines (NAPRA 3; 4). I helped check ward stock expiry dates and inventory on specific hospital floors, and gathered drugs needed for ward stock from the pharmacy (NAPRA 1; 4; 9). I added barcode stickers to iv bags (NAPRA 4). Unit dose drugs that were returned to the pharmacy from the emergency department were processed, and I restocked those drugs into traditional stock drug bins (NAPRA 4). I also did a run to specific hospital floors for orders, and delivered some traditional orders (NAPRA 3).

Advertisements

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s