Tag Archives: Distribution

Week 3: Distribution

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Monday and Tuesday: At Abbotsford Hospital
On my first day I followed the technician taking care the narcotics. This was my first introduction to the Pyxis machine and its usefulness in the distribution setting. I got a chance to access the machine and use it to obtain drugs following the specific steps. I found it to be very secure and accurate. The second day I learnt about the steps followed every morning to distribute the drugs to different wards. Today I recieved more detailed knowledge about the system in terms of different drawer types. At the end of the day I was examined on the Pyxis system and Clinical Data categories. It was a good exercise as it gives me feedback on which parts I need to improve my knowledge and helps me reinforce my existing knowledge.

Wednesday: As we had academic half-day today, we had limited time to spend at SMH to learn about TPN. We gowned up and observed the technician setting up for the procedure. Later on, we entered some adult and TPN orders using test and real patients.

Thursday: ERH
It was interesting to learn about a different distribution sytem besides traditional dose packaging and automated dispensing system. ERH follows the unit dose system packaging. They recently transitioned from carfill system to cartless system. As compared to the other sites I have been to, ERH is a relatively smaller site. I got a brief tour of the site and observed technicians performing their different roles. I got a chance to enter my first order. I thought it would be difficult to get a hang of it, but because of a technician’s and my preceptor’s help I was able to grasp it well. It would take me time to learn about different commands, learn about wardstock and pharmacy items depending on the site and get used to doctor’s handwriting. And all this would come with more practice and training. It was interesting to learn about the nurses’ opinion on the new cartless system. I talked to two nurses and they like the switch to the new system as it is more systematic, convenient and time-saving for them.

Friday: PDDC
I am glad I got a second chance to learn about the procedures and systems followed at PDDC to prepare drugs for different sites in Fraser Health. We had a brief tour of the center during our first week of Residency but it was quick and I didn’t register everything.

There are no pharmacists as part of the distribution system, but there are pharmacists located in offices above the facility for advice and direction. The standardized procedures are based on a “tech-check-tech” system.
Activities performed:
CIVA: Observed the pharmacy technician setting up the hood for mixing and preparing IV medications for different sites.
Learnt about PacMed and Pentapack unit dose packaging machines
Practised mixing medications with expired products

Overall, it was an interesting week as I gained knowledge about different drug distribution systems used at different sites and their merits and shortcomings.

Distribution Rotation: Week 1

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As I haven’t had any experience working in the community or hospital setting besides my pharmacy rotations, the distribution rotation is my first ‘real’ exposure to hospital pharmacy. My SPEP rotation was mainly clinical and I only spend couple of hours in the dispensary. Almost everyone in the dispensary has asked me about my previous pharmacy experience. I am trying to ask as many questions as I can and the pharmacists and assistants have been very helpful so far. So far I have performed the following activities:

Orientation
Observed pharmacy assistants filling out the orders and checking the end product, filled out some orders (this was helpful as I got to different dosage systems)
Observed and performed ward stock check
Observed delivery narcotic medications to different wards
Observed aseptic preparation of CIVA products
Discussion with preceptor regarding Fraser health policies and procedures e.g. Non-formulary drugs, Formulary drugs, Excluded drugs, Restricted drugs and Patient’s own medications
Discussion with preceptor regarding CIVA: advantages and disadvantages
Academic Half Day on Distribution at Vancouver General Hospital
Spent time in dispensary and checked some orders with the help of the pharmacist

Second week: I will be at the SES conference on Monday and Tuesday. On Wednesday we will discuss CIVA, PDTM (Parentral Drug Therapy Manual), TPN and site procedures in detail.
Thursday: Clinical Trial, Oncology, Pediatrics, NICU.
During my third week, I will be off site at different hospitals in Fraser Health gaining knowledge about different technology used for distributing medications.

I have been assigned two projects by my preceptor Raymond Lee so far:
1. Compile a list of pharmacies close to the hospital
2. Add links to useful pharmacy resources in addition to ones already available on the Fraser Health website
3. I will be doing a presentation in the last week: TBA

My goals for the rotation:

1. Be comfortable with assessing prescription order’s appropriateness in terms of necessity, effectiveness, safety.
2. Become more proficient at identifying and resolving Drug related problems.
3. Learn how to enter orders
4. Learn how to navigate the Meditech system