Regional Palliative Care Services Fall 2007
|
|
- Norma Curtis
- 6 years ago
- Views:
Transcription
1 Regional Palliative Care Services Fall 2007 Our 6th Newsletter The purpose of this newsletter: transdisciplinary communication tool for palliative care in Northern Health Topics will include: information on drug therapy, symptom management, and psychosocial issues education opportunities contact information for consultation team across Northern Health Who should read this newsletter? Any health professional caring for palliative patients in acute care, residential care, or the home setting. Submissions, ideas, or questions? If you have an article you would like to submit or have a request for a particular article please contact me at the below. The newsletter will be published 3-4 times annually. Nikki Dahlen, B.Sc.Pharmacy NH Palliative Pharmacist Lead Phone: Ext 2490 Fax: nicole.dahlen@northernhealth.ca In This Issue. Case Report Pediatric Methadone...Pg 1 NH Nurse Champion CPG s...pg 4 More Education...Pg 5 Contact Information Pg 5 Case Report Provision of Methadone Infusion by a Community Pharmacy for a Pediatric Patient Requiring Palliative Care Background There is an increasing trend towards devolving health care from acute care/institutional settings to the home when suitable. In light of this, our community pharmacy was designed with a clean room and laminar air flow hood for preparing sterile preparations such as intravenous antibiotics or total parenteral nutrition for administration at home. Pharmacy technicians who are hired have completed a pharmacy technician course, at an accredited college, that includes aseptic technique, and all receive in-house training in aseptic technique. The function of the laminar airflow hood is certified annually. Report A 6 year old girl with primary liver cancer and bone and lung metastases was discharged from a tertiary centre for palliative care at home in a small city far from the tertiary centre. Both the pediatric palliative specialist and local family physician were prepared to support SD and her family s wish for her to die at home. Pain control with morphine was inadequate, yet she was quite sedated; breakthrough pain was severe. It was suspected that SD was experiencing a tremendous amount of nerve pain due to cancer involvement in her pelvis. The patient s family physician applied for and was granted permission by the British Columbia College of Physicians and Surgeons to prescribe methadone for pain for this patient. Her daily oral morphine dose was almost 400mg on the last day that she received Issue 6
2 morphine exclusively. With close follow-up from the specialist, SD was prescribed oral methadone: an initial dose of 5mg, followed by 2.5mg to 5mg every 3 to 4 hours, and morphine for breakthrough doses. Within 36 hours, morphine was discontinued and methadone was used for breakthrough pain as well. In less than 24 hours the family noticed an improvement in pain control and after 3 days the change was dramatic. Her speech became very clear, she was keenly aware of and participated in conversations going on around her, and was able to rest comfortably, including appropriate cycles of deep sleep. Several days after SD had begun methadone, she became paralyzed from the hips down and then from the waist down, which also contributed to an improved level of comfort. She continued with the oral methadone for 3 weeks, until she no longer wanted to swallow the methadone solution and the decision was made to switch her to intravenous methadone. Methods We followed the process for preparing methadone infusion aseptically used by the University of Alberta hospital pharmacy (personal communication*). The family physician applied for a special authority so that the intravenous medications would be paid for by the palliative program of BC Pharmacare. The initial dose was 50mg of methadone in 250ml 0.9% sodium chloride (0.2mg/ml). A pharmacist confirmed that the dosage conversion from oral to intravenous was in the appropriate range. The infusion was run at between 9 and 11ml per hour using a volumetric pump and infused into a central line. Two 2ml syringes of methadone 1mg/ml were prepared for bolus doses when necessary. The concentration was increased to 0.28mg/ml on Day 2 of the infusion. A new bag and 2 syringes were prepared each day because the stability of the infusion beyond 28 hours is not known. On Day 4 the concentration was increased to 0.32mg/ml. SD s pain control was assessed by her parents and by her aunt, a nurse who had primary responsibility for maintaining the intravenous line, pump, and infusion rate. SD stayed in the same prone position for 5 weeks, and although her level of activity never did improve, she was comfortable and mentally in control. In terms of adverse effects she was not constipated, occasionally had vivid dreams, experienced no hallucinations, and developed a face-picking habit (that was distressing for the family). SD received 8 days of methadone infusion, with 5 bolus doses for breakthrough pain, and died at home with her family around her. Discussion Pediatric palliative care is a challenging area for several reasons. The pharmacokinetics of some pain medications differ in children compared to adults, and there are few published studies. Methadone has advantages for treating cancer pain in children, although it is not approved in Canada for this indication. It is a potent opioid with a long pharmacokinetic half-life (12-50 hours) and good bioavailability, is relatively inexpensive, and is devoid of active metabolites that can cause adverse effects. Methadone can cause prolongation of the QT interval and this must be kept in mind if the patient is receiving other medication with this effect. Methadone is hepatically metabolized by cytochrome P450 enzymes (substrate of CYP2C9 [minor], 2C19 [minor], 2D6 [minor], 3A4 [major]; inhibits CYP2D6 [moderate], 3A4 [weak]); therefore, there is potential for interactions with other drugs metabolized by the same pathways. In addition, there is a dissociation between the pharmacokinetic half-life and the pharmacological half-life; frequent monitoring must be done when converting from another opioid to methadone and when making dose changes. Indeed, conversion from another 2 Issue 6
3 opioid to methadone should only be undertaken by those experienced in its use because dose equivalence with other opioids is not clearly established. Methadone is available commercially in 1,5,10, and 25mg tablets and 1 and 10mg/ml oral solutions. It can be difficult to switch dysphagic patients who are stabilized on oral methadone to another opioid intravenously and maintain pain control. A preparation for subcutaneous or intramuscular, but not intravenous, injection can be obtained via special access from Health Canada. Solutions of methadone for intravenous administration can be prepared in facilities that have the appropriate equipment and trained personnel. For initiating methadone in children, the World Health Organization guidelines recommend 0.2mg/kg orally every 4-8 hours or 0.1mg/kg subcutaneously or intravenously every 4-8 hours (oral:parenteral dose conversion 2:1). While we hope that we will not encounter the situation of a pediatric patient requiring palliative care again, it was satisfying to be able to offer this service and contribute to effective pain management for SD. Pharmacists can play an integral role in palliative care in various ways, such as assisting with conversion from one or a combination of opioids to another or from one route of administration to another, recommending options for adjuvant therapy or for control of adverse effects, and as in this case, compounding alternative dosage forms. Pharmacists with particular expertise in palliative care are also involved in assessing level of pain control and severity of adverse effects. Written by: Lori Bonertz and Nancy Dyck are pharmacists at the Fort St. John Pharmacy and Wellness Centre. Valerie Kantz is the senior pharmacy technician at Fort St. John Pharmacy and Wellness Centre, Fort St. John, B.C. The authors dedicate this article to the memory of SD and to her family, who encouraged us to pursue publishing this case report in the hope that is could help other children in pain. Reproduced with permission from the Canadian Pharmacist Journal, September / October 2007, Vol 140 / No 5. References 1. Capital Health Regional Drug Information Center (RDIC). Recipe Database; Methadone 2mg/ml for injections (online database). Revised May 19, Available: (accessed July 30, 2007). 2. Lugo RA, Satterfield KL, Kern SE. Pharmacokinetics of methadone. J Pain Palliat Care Pharmacother 2005; 19: Lexi-Comp Reader Version , Copyright 2006, Lexi-Comp Ince. PDA database. 4. Ripamonti C, Groff L, Brunelli C, et al. Swithcing from morphine to oral methadone in treating cancer pain: what is the equianalgesic dose ratio? J Clin Oncol 1998; 16: Repchinsky C, editor. Compendium of pharmaceuticals and specialties. 42 nd ed. Ottawa: Canadian Pharmacists Association; 2007: p Pain in children with cancer: the World Health Organization IASP Guidelines. Available: /IASP_guidelines.html (accessed November 13, 2006). 3 Issue 6
4 Educational Opportunity for Nurse Champions Clinical Practice Guidelines Home and Community Care reminds all Nurse Champions and other interested nurses to participate in a distance education program, a series of eight monthly teleconferences to introduce the remaining Clinical Practice Guidelines (CPGs), facilitated by Lori Amdam, RN, MSN, Nursing Consultant, Gerontology, Harrigan Consulting, Vancouver. Invitations have been going to "nurse champions" within home and community care, mental health services and acute care. From that, interest has spread to home support, physio, and other health care professionals. So far the sessions have been well attended. The primary focus of the teleconference educational sessions is for Nurse Champions and other interested nurses (potential nurse champions) to lead the implementation of the Clinical Practice Guidelines (CPG s). These teleconferences will provide an opportunity to share knowledge and expertise, network with colleagues about issues of importance, and develop strategies for introducing best practice standards in our nursing settings. The first Guideline that was reviewed was Fall Prevention in October The upcoming schedule will be as follows: November End of Life / Palliative Care December none January Promoting Urinary continence February Alcohol and substance use March Least Restraint April Promoting Nutrition May Assessment & Management of Persistent Pain, and, Prevention of constipation June Skin Integrity Each CPG topic will be offered three times monthly 1st Thursday - 2 pm to 3 pm (3 pm to 4 pm - mst) 2nd Wednesday - 1pm to 2 pm (2 pm to 3 pm - mst) 3rd Thursday - 2 pm to 3 pm (3 pm to 4 pm - mst) Participants will be asked to register for their preferred dates. If they cannot attend a session, they must ask a colleague to attend in their place. Upon registration, the teleconference call-in number will be forwarded to each participant. Prior to each session, a printable electronic version of the CPG, power point teaching slides and one recent article or relevant material of interest to read before the program will be forwarded by . Please note that, although this program will review a new CPG each month, there will be no change in the mandate for Nurse Champions to introduce standards in their facilities and programs at an appropriate and manageable pace. There is no cost for participants to enroll in this program and a certificate will be provided at the conclusion. To register for one of the sessions, please contact Mona Kelley by mona.kelley@northernhealth.ca or by telephone *Right now the CPG s are not posted to docushare, but will be part of the new I-Portal development. 4 Issue 6
5 More Education. Victoria Hospice Medical Care of the Dying Course March 3-7 th, 2008 Victoria Hospice Pyschosocial Care of the Dying and Bereaved Course February th, 2008 Victoria Hospice Spiritual Care Course January 26 th, 2008 See for more information and registration forms Northern Health Iportal On November 26, 2007, Northern Health will launch iportal which replaces our current Intranet site. The palliative care page with be located under clinical resources in this site. For more information about iportal, please or contact the ITS Service Desk. To review some of our most frequently asked questions, visit the iportal FAQ. Contact Information Palliative Care Physician Leads Northwest: Dr. Elizabeth (Biz) Bastian ( ) Northern Interior: Dr. Inban Reddy ( ) Northeast: Dr. Stephen Ashwell ( ) Palliative Care Nurse Consultants Northwest: Smithers: Lynn Shervill ( ) Terrace: Elaine Minifie ( ) Pr.Rupert: Joan Patriquin ( ) Northern Interior: PG: Cathy Czechmeister ( ) Outside PG: Judy Lett ( ) Northeast: Sandi Armitage ( ) Palliative Care Pharmacist Lead NHA: Nikki Dahlen ( ext 2490) Palliative Care Social Work Lead NHA no hire as of yet All information provided in newsletter is in accordance with our endorsed text: Medical Care of the Dying, 4 th Edition, Victoria Hospice Society. 5 Issue 6
Introduction to Pharmacy Practice
Introduction to Pharmacy Practice Learning Outcomes Compare & contrast technician & pharmacist roles Understand licensing, certification, registration terms Describe advantages of formal training for technicians
More informationPROCESS FOR INITIATING A SYRINGE DRIVER FOR COMMUNITY NURSE PATIENTS OUT OF HOURS
STANDARD OPERATING PROCEDURE PROCESS FOR INITIATING A SYRINGE DRIVER FOR COMMUNITY NURSE PATIENTS OUT OF HOURS Issue History Issue Version one Purpose of Issue/Description of Change To facilitate patients
More informationPOLICY FOR ANTICIPATORY PRESCRIBING FOR PATIENTS WITH A TERMINAL ILLNESS Just in Case
POLICY FOR ANTICIPATORY PRESCRIBING FOR PATIENTS WITH A TERMINAL ILLNESS Just in Case DOCUMENT NO: DN116 Lead author/initiator(s): Sarah Woodley Community Health Services Pharmacist sarah.woodley@ccs.nhs.uk
More informationPalliative Care Anticipatory Prescribing
Palliative Care Anticipatory Prescribing Guidelines Gippsland Region Palliative Care Consortium Clinical Practice Group Policy No. Title Keywords Ratified GRPCC-CPG008 Anticipatory Prescribing Guidelines
More informationCaring for me Advanced Care Planning
Caring for me Advanced Care Planning Supporting guidance for Healthcare Professionals and Administrative Staff This care plan is aimed as a guide to treatment and intended to aid the documentation of patient
More informationPrescribing for Symptom Control in End of Life Care. Dr Deborah Robertson Senior Lecturer University of Chester
Prescribing for Symptom Control in End of Life Care Dr Deborah Robertson Senior Lecturer University of Chester #hellomynameis Dr Debs Robertson Programme leader NMP Nurse and pharmacologist Champion of
More informationNHS Fife. Patient Group Direction for Named Community Pharmacists to Supply
Patient Group Direction for Named Community Pharmacists to Supply Senna tablets 7.5mg or Senna syrup 7.5mg/5ml (Total sennosides calculated as sennoside B) For patients aged 16 years and older prescribed
More informationScottish Palliative Care Guidelines Rapid Transfer Home in the Last Days of Life
Rapid Transfer Home in the Last Days of Life Management Follow five steps below to: facilitate a peaceful death in the patient s preferred place facilitate seamless transfer from hospital or hospice to
More informationClinical Check of Prescriptions in Ward Areas
Pharmacy Department Standard Operating Procedures SOP Title Clinical Check of Prescriptions in Ward Areas Author name and Gareth Price designation: Deputy Director of Pharmacy Clinical Services Pharmacy
More informationFollowing are some common questions and answers from the hospital perspective regarding Manufacturing and Compounding :
Health Canada Manufacturing and Compounding Drug Products in Canada: A Policy Framework : Guidelines for P.E.I. Community and Hospital Pharmacists October 2001 In response to pharmacists questions about
More informationMCKINLEY SYRINGE DRIVER COMPETENCY FOR THE THEORY AND PRACTICAL ASSESSMENT FOR REGISTERED NURSES
COMPETENCIES MCKINLEY SYRINGE DRIVER COMPETENCY FOR THE THEORY AND PRACTICAL ASSESSMENT FOR REGISTERED NURSES (REGISTERED NURSES UPDATE EVERY TWO YEARS) New Registered Nurses to the Trust COMPETENT TO
More informationU: Medication Administration
U: Medication Administration Alberta Licensed Practical Nurses Competency Profile 199 Competency: U-1 Pharmacology and Principles of Administration of Medications U-1-1 U-1-2 U-1-3 U-1-4 Demonstrate knowledge
More informationFine Bore Tubing Set
Negotiations Meetings with CME Director (lived on East coast, but came to meet me here on a few occasions) Asked for 2 pumps on loan for a few months Discussed use of locking drivers, so they can only
More informationThe Newcastle upon Tyne Hospitals NHS Foundation Trust. Injectable Medicines Policy
The Newcastle upon Tyne Hospitals NHS Foundation Trust Injectable Medicines Policy Version No.: 4.3 Effective From: 24 March 2017 Expiry Date: 21 January 2019 Date Ratified: 11 January 2017 Ratified By:
More informationPatient Controlled Analgesia Guidelines
Patient Controlled Analgesia Guidelines Date: August 2005 Ref : PCD005 Vers : 2 Policy Profile Policy Reference Number PCD005 Version 2 Status Approved Trust Lead Director of Nursing/Acute Pain Team Implementation
More informationDepartment Policy. Code: D: MM Entity: Fairview Pharmacy Services. Department: Fairview Home Infusion. Manual: Policy and Procedure Manual
Department Policy Code: D: MM-5615 Entity: Fairview Pharmacy Services Department: Fairview Home Infusion Manual: Policy and Procedure Manual Category: Home Infusion Subject: Chemotherapy Purpose: Ensure
More informationStaff Responsible Procedure Rationale/Reason
Subject: Patient Controlled Analgesia Date: October 2011 UPMC St. Margaret UPMC St. Margaret Harmar Outpatient Center Clinical Practice Council Policy #2005 Overview: To promote appropriate PCA use and
More informationHospice Palliative Care
Position Statement Hospice Palliative Care A Position Statement September 2011 HOSPICE PALLIATIVE CARE: A SEPTEMBER 2011 i Approved by the College and Association of Registered Nurses of Alberta () Provincial
More informationRequired Organizational Practices Resources for 2016
Required Organizational Practices Resources for 2016 ROPs Tests for Compliance Things to Consider Available Resources CLIENT IDENTIFICATION Working in partnership with clients and families, at least two
More informationPalliative and Hospice Care In the United States Jean Root, DO
Palliative and Hospice Care In the United States Jean Root, DO Hello. My name is Jean Root. I am an Osteopathic Physician who specializes in Geriatrics, or care of the elderly. I teach and practice Geriatric
More informationAdministration of Intrathecal Cytotoxic Chemotherapy in NHS Grampian
Administration of Intrathecal Cytotoxic Chemotherapy in NHS Grampian Lead Author/Coordinator: Jeff Horn / Sarah Howlett Macmillan Haematology CNS/ Pharmacist Reviewer: Gavin Preston Consultant Haematologist
More informationName: Unit: Contact details:
Royal Children s Hospital Generic Oral and Injectable Medication Learning Package 2012. (Part A) Medication Endorsed Enrolled Nurses formerly known as Division 2 Name: Unit: Contact details: The aim of
More informationInterim Final Interpretive Guidelines Version 1.1
Interim Final Interpretive Guidelines Version 1.1 Big Changes from November 2008 to January 2009 418.54 Condition of participation: Initial and Comprehensive assessment of the patient L522 418.54(a) Standard:
More informationPHARMACY TECHNICIAN PROGRAM OBJECTIVES PROGRAM OVERVIEW CAREER OPPORTUNITIES PREREQUISITES GRADUATION REQUIREMENTS
PROGRAM OBJECTIVES The Pharmacy Technician diploma program will provide the student with the required knowledge base, and practical hands-on skills necessary to pursue licensure as a Pharmacy Technician
More informationDerby Hospitals NHS Foundation Trust. Drug Assessment
Drug Assessment for Preparation and Administration of Oral, Enteral, Ophthalmic, Topical, PR, PV, Inhaled, Subcutaneous and Intramuscular Medicines to Patients (N.B. The preparation and administration
More informationMEDICATION ADMINISTRATION: BELOW THE DRIP CHAMBER
KINGSTON GENERAL HOSPITAL MEDICATION ADMINISTRATION: BELOW THE DRIP CHAMBER LEARNING GUIDE FOR REGISTERED NURSES AND REGISTERED PRACTICAL NURSES Prepared by: Nursing Education Date: 2001 November Revised:
More informationSARASOTA MEMORIAL HOSPITAL NURSING DEPARTMENT POLICY
PS1006 SARASOTA MEMORIAL HOSPITAL NURSING DEPARTMENT POLICY TITLE: NURSING AND PHARMACY GUIDELINES FOR THE ADMINISTRATION OF IV EPOPROSTENOL (FLOLAN, VELETRI ) POLICY #: EFFECTIVE DATE: REVISED DATE: POLICY
More informationSystemic anti-cancer therapy Care Pathway
Network Guidance Document Status: Expiry Date: Version Number: Publication Date: Final July 2013 V2 July 2011 Page 1 of 9 Contents Contents... 2 STANDARDS FOR PREPARATION AND PHARMACY... 3 1.1 Facilities
More information201 KAR 20:490. Licensed practical nurse intravenous therapy scope of practice.
201 KAR 20:490. Licensed practical nurse intravenous therapy scope of practice. RELATES TO: KRS 314.011(10)(a), (c) STATUTORY AUTHORITY: KRS 314.011(10)(c), 314.131(1), 314.011(10)(c) NECESSITY, FUNCTION,
More informationD DRUG DISTRIBUTION SYSTEMS
D DRUG DISTRIBUTION SYSTEMS JANET HARDING ORAL MEDICATION SYSTEMS Drug distribution systems in the hospital setting should ideally prevent medication errors from occurring. When errors do occur, the system
More informationNursing Dosage Calculations Conversions Practice
Conversions Practice Free PDF ebook Download: Conversions Practice Download or Read Online ebook nursing dosage calculations conversions practice in PDF Format From The Best User Guide Database NURSING
More informationCIVAS IN SWITZERLAND 2002
CIVAS IN SWITZERLAND 2002 William Griffiths Pharmacy September 13th, 2002 Lugano, Switzerland. William Griffiths, Pharmacie des HUG, Lugano sept. 2002 1 INTRODUCTION HOSPITAL PHARMACY General orientation
More informationAbbreviations used in Care Pathway. CNS Clinical Nurse C Chaplain / clergy / religious adviser
Patient's Name: D.O.B: Patient GP: Named Nurse: Name: Adapted LCP Version 12 PALLIATIVE CARE PATHWAY (End Stage) PRIMARY CARE DO NOT PUT PATIENT ON THIS PATHWAY UNLESS The Multi-professional Team have
More informationCPS response to NHS England Items Which Should Not Be Routinely Prescribed: A Consultation on Guidance for CCGs
Prescribed: A Consultation on Guidance Prepared by: Amanda Rae Head of Policy & Development amanda.rae@cps.scot Who are Community Pharmacy Scotland (CPS) & what do they do? Who we are We are the organisation
More informationUnless this copy has been taken directly from the Trust intranet site (Pandora) there is no assurance that this is the most up to date version
Policy No: OP49 Version: 4.0 Name of Policy: Patient Controlled Analgesia in Adult Patients Effective From: 28/11/2017 Date Ratified 21/09/2017 Ratified Medicines Group Review Date 01/09/2019 Sponsor Director
More informationPalliative and End-of-Life Care
Position Statement Palliative and End-of-Life Care A Position Statement Month Year PALLIATIVE AND END-OF-LIFE CARE MONTH YEAR i Approved by the College and Association of Registered Nurses of Alberta ()
More informationSARASOTA MEMORIAL HOSPITAL NURSING DEPARTMENT POLICY
PS1006 SARASOTA MEMORIAL HOSPITAL NURSING DEPARTMENT POLICY TITLE: NURSING AND PHARMACY GUIDELINES FOR THE ADMINISTRATION OF IV TREPROSTINIL (REMODULIN ) Job Title of Reviewer: Director, Pharmacy POLICY
More informationPolicy for Anticipatory Prescribing and Just in Case Bags
Policy for Anticipatory Prescribing and Just in Case Bags This policy was developed by Milton Keynes End of Life Care Medicine Group and has been adopted by all partner organisations (MK Clinical Commissioning
More informationIf viewing a printed copy of this policy, please note it could be expired. Got to to view current policies.
If viewing a printed copy of this policy, please note it could be expired. Got to www.fairview.org/fhipolicies to view current policies. Department Policy Entity: Fairview Pharmacy Services Department:
More informationRecommendations from National Patient Safety Agency alerts that remain relevant to the Never Events list 2018
Recommendations from National Patient Safety Agency alerts that remain relevant to the Never Events list 2018 January 2018 We support providers to give patients safe, high quality, compassionate care within
More informationTop tips for prescribing in palliative care. Dr Stephanie Lippett
Top tips for prescribing in palliative care Dr Stephanie Lippett contents Tips Pain management Anticipatory prescribing DNACPR 3 things that primary care can do to improve things for patients/themselves
More informationOverview of Presentation
End-of-Life Issues: The Role of Hospice in The Nursing Home Susan C. Miller, Ph.D. Center for Gerontology & Health Care Research BROWN MEDICAL SCHOOL Overview of Presentation The rationale for the Medicare
More informationNBCP PO C Administration of injections
POLICY CATEGORY: POLICY FOCUS: POLICY NAME: Administration of injections policy (EN) LAST UPDATED: February 2014 MOTION NUMBER: C-14-02-08 OTHER: GM-PP-I-03 (Supplement to administration of injections
More informationVICTORIA HOSPICE & PALLIATIVE CARE
D R. G. M I C H A E L D OWNING C L I N I C A L A S S O C I AT E P R O F E S S O R PA L L I AT I V E M E D I C I N E D I R E C T O R O F R E S E A R C H & D E V E LO P M E N T V I C T O R I A H O S P I
More informationQuality Assurance Program Guide
2012 2013 Quality Assurance Program Guide Quality Assurance Committee Orientation Manual Quality Assurance Program Table of Contents 1. Overview 2 2. Two Part Register 3 3. Learning Portfolio 7 4. Self-Assessment
More informationObjective Competency Competency Measure To Do List
2016 University of Washington School of Pharmacy Institutional IPPE Checklist Institutional IPPE Team Contact Info: Kelsey Brantner e-mail: ippe@uw.edu phone: 206-543-9427; Jennifer Danielson, PharmD e-mail:
More informationWe need to talk about Palliative Care. The Care Inspectorate
We need to talk about Palliative Care The Care Inspectorate Introduction The Care Inspectorate is the official body responsible for inspecting standards of care in Scotland. That means we regulate and
More informationPATIENT CARE MANUAL PROCEDURE
PATIENT CARE MANUAL PROCEDURE NUMBER III-130 PAGE 1 OF 5 APPROVED BY: CATEGORY: Vice President and Senior Operating Officer, Rural Health Services & Professional Practice Lead Medication Administration
More information9/8/2014. I have no conflicts of interest to disclose. I have no conflicts of interest to disclose
How to Start an APN Run Pain Service: From Conception to Continuation Mechele Fillman RN-BC, APRN, NP-C Acute Pain Service Nurse Practitioner Stanford Hospital and Clinics Carrie Brunson RN-BC, APRN, ANCS-BC
More informationUS Compounding 2515 College Ave Conway, AR (800)
PCAB Compounding Accreditation Accreditation Summary US Compounding 2515 College Ave Conway, AR 72034 (800) 718 3588 www.uscompounding.com Date of Last In-Pharmacy Survey: June 2008 Next Scheduled In-Pharmacy
More informationMcKinley T34 Ambulatory syringe pump Used in the provision of adult palliative and end of life care
Health Guidance McKinley T34 Ambulatory syringe pump Used in the provision of adult palliative and end of life care Publication Code: HCR-0214-083 Publication date: 26 February 2014 Page 1 of 7 Health
More informationPolicy Statement Medication Order Legibility Medication orders will be written in a manner that provides a clearly legible prescription.
POLICY POLICY PURPOSE: The purpose of this policy is to provide a foundation for safe communication of medication and nutritional orders in-scope, thereby reducing the potential for preventable medication
More informationPCAB Compounding Accreditation Accreditation Summary
PCAB Compounding Accreditation Accreditation Summary McGuff Compounding Pharmacy Services, Inc Santa Ana, California compounding pharmacy 2921 W. MacArthur Blvd., Ste.142 Santa Ana, CA 92704 Telephone:877-444-1133
More informationDEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES
Use for a resident who has potentially unnecessary medications, is prescribed psychotropic medications or has the potential for an adverse outcome to determine whether facility practices are in place to
More informationBe comfortable with comfort Meds
DIAMOND PHARMACY SERVICES Be comfortable with comfort Meds Understanding Hospice medications Presented By: Daniel Barnes, RN Infusion RN Annual Educational Conference Thursday, April 16, 2015 1 Diamond
More informationImproving Care and Decreasing Costs
Improving Care and Decreasing Costs Utilizing the Macy Catheter for End of Life Symptom Management Natalie Latuga, PharmD, BCPS, Clinical Pharmacy Advisor Mary Gordon RN, IPU Director Paula Farwell RN,
More informationROUND LAKE Journey Toward Healthy. Treatment Centre
ROUND LAKE Treatment Centre Culture is Treatment HARM REDUCTION HARM REDUCTION Photo Credits: Carla Hunt HARM REDUCTION WELLNESS IS A JOURNEY NOT A DESTINATION (FNHA) OPIOID AGONIST THERAPY METHADONE SUBOXONE
More informationStandards. Prescribing Standards for Nurse Practitioners
Standards Prescribing Standards for Nurse Practitioners June 2018 PRESCRIBING FOR NURSE PRACTITIONERS JUNE 2018 i Approved by the College and Association of Registered Nurses of Alberta () Provincial Council,
More informationPrescriptive Authority for Pharmacists. Frequently Asked Questions for Pharmacists
Prescriptive Authority for Pharmacists Frequently Asked Questions for Pharmacists Disclaimer: When in doubt, the text of the official bylaws should be consulted. They are available at: http://napra.ca/content_files/files/saskatchewan/proposedprescribingbylawsawaitingtheministerofhealt
More informationProtocol for patient controlled analgesia (PCA) with morphine in obstetrics (CG567)
Protocol for patient controlled analgesia (PCA) with morphine in obstetrics (CG567) Approval Approval Group Job Title, Chair of Committee Date Maternity & Children s Services Clinical Governance Committee
More informationPalliative Management of Major Haemorrhage in an Adult Patient with Advanced Cancer Reference Number:
This is an official Northern Trust policy and should not be edited in any way Palliative Management of Major Haemorrhage in an Adult Patient with Advanced Cancer Reference Number: NHSCT/11/409 Target audience:
More informationEnd-of-Life Care Action Plan
The Provincial End-of-Life Care Action Plan for British Columbia Priorities and Actions for Health System and Service Redesign Ministry of Health March 2013 ii The Provincial End-of-Life Care Action Plan
More informationEnd of Life Terminology The definitions below applies within the province of Ontario, terms may be used or defined differently in other provinces.
End of Life Terminology The definitions below applies within the province of Ontario, terms may be used or defined differently in other provinces. Terms Definitions End of Life Care To assist persons who
More informationForm CMS (5/2017) Page 1
Use this pathway for a resident who has pain symptoms or can reasonably be expected to experience pain (i.e., during therapy) to determine whether the facility has provided and the resident has received
More informationPREPARATION AND ADMINISTRATION
LESSON PLAN: 12 COURSE TITLE: UNIT: IV MEDICATION TECHNICIAN PREPARATION AND ADMINISTRATION SCOPE OF UNIT: Guidelines and procedures for preparation, administration, reporting, and recording of oral, ophthalmic,
More informationSTANDARDIZED PROCEDURE HEPATIC ARTERY INFUSION OF CHEMOTHERAPY (Adults, Peds)
I. Definition Hepatic arterial infusion (HAI) of chemotherapy is accomplished by a small drug delivery system or pump that is implanted in a subcutaneous pocket in the lower abdomen. The pump reservoir
More informationUNIVERSITY OF WISCONSIN HOSPITAL AND CLINICS DEPARTMENT OF PHARMACY SCOPE OF PATIENT CARE SERVICES FY 2017 October 1 st, 2016
UNIVERSITY OF WISCONSIN HOSPITAL AND CLINICS DEPARTMENT OF PHARMACY SCOPE OF PATIENT CARE SERVICES FY 2017 October 1 st, 2016 Department Name: Department of Pharmacy Department Director: Steve Rough, MS,
More informationExpiry Date: January 2009 Template Version: Page 1 of 7
YOU MUST BE AUTHORISED BY NAME, UNDER THE CURRENT VERSION OF THIS PGD BEFORE YOU ATTEMPT TO WORK ACCORDING TO IT Clinical Condition Indication: Inclusion criteria: Exclusion criteria: Cautions/Need for
More informationManaging medicines in care homes
Managing medicines in care homes http://www.nice.org.uk/guidance/sc/sc1.jsp Published: 14 March 2014 Contents What is this guideline about and who is it for?... 5 Purpose of this guideline... 5 Audience
More informationAll Wales Continuous Subcutaneous Infusion Medication Administration Record AWMR10
All Wales Continuous Subcutaneous Infusion ication Administration Record AWMR0 Why do we need a standardised chart? The All Wales Palliative Care Pharmacists Group (AWPCPG) collated information on how
More informationThe CMS State Operations Manual Overview and Changes
The CMS State Operations Manual Overview and Changes Omnicare, Inc. Page 1 Overview of the CMS State Operations Manual Executive Summary Historical Perspective The Requirements Pharmacy Services Labeling
More informationAlert. Patient safety alert. Actions that can make anticoagulant therapy safer. 28 March Action for the NHS and the independent sector
Patient safety alert 18 Alert 28 March 2007 Immediate action Action Update Information request Ref: NPSA/2007/18 Actions that can make anticoagulant therapy safer Anticoagulants are one of the classes
More informationBest Practice Guidelines - BPG 9 Managing Medicines in Care Homes
Best Practice Guidelines - BPG 9 Managing Medicines in Care Homes Medicines in Care Homes 1 DOCUMENT STATUS: Approved DATE ISSUED: 10 th November 2015 DATE TO BE REVIEWED: 10 th November 2017 AMENDMENT
More informationSymptom Relief Kit. Guidelines
Symptom Relief Kit Guidelines Hospice Palliative Care Teams for Central LHIN August 20, 2015 Hospice Palliative Care Teams for Central LHIN 1 Table of Contents 1. Definition... 3 2. Why Order a SRK?...
More informationMEDICAL DIRECTIVE Advanced Life Support (ALS): Intraosseous (IO) Cannulation and Infusion
Authorizing physician(s) LHO - Code Blue, Emergency Department & Critical Care Physicians LHB - Emergency Department and Critical Care Physicians LHPP - Emergency Department Physicians Authorized to who
More informationReconstitution Nursing Dosage Calculation Practice Problems
Reconstitution Practice Problems Free PDF ebook Download: Reconstitution Download or Read Online ebook reconstitution nursing dosage calculation practice problems in PDF Format From The Best User Guide
More informationCriteria and Guidance for referral to Specialist Palliative Care Services
Criteria and Guidance for referral to Specialist Palliative Care Services FEBRUARY 2007 Introduction This guidance is for health professionals caring for patients who may need referral to specialist palliative
More informationDosage Calculations For Medical Assistant Practice Tests
For Practice Tests Free PDF ebook Download: For Practice Tests Download or Read Online ebook dosage calculations for medical assistant practice tests in PDF Format From The Best User Guide Database Page
More informationAdvanced Pain Management
Advanced Pain Management Application Policies and Guidelines Accreditation for Pharmacists The American Society of Health-System Pharmacists is accredited by the Accreditation Council for Pharmacy Education
More informationAdult Patient Controlled Analgesia (PCA)
Contents... 1 Policy... 1 Scope/Audience... 1 Associated Documents... 1 Statement... 2 Criteria... 2 Patient and Whanau Education... 2 Procedural Considerations... 3 Pre Administration... 3 Patient Monitoring...
More informationPrescribing Standards for Nurse Practitioners (NPs)
Standards Prescribing Standards for Nurse Practitioners (NPs) Month Year PRESCRIBING FOR NURSE PRACTITIONERS MONTH YEAR i Approved by the College and Association of Registered Nurses of Alberta () Provincial
More informationNational care of the dying audit for hospitals, England Executive summary May 2014
National care of the dying audit for hospitals, England Executive summary May 2014 Foreword We only have one chance to get end of life care right and sadly sometimes we don t. There are few surprises in
More informationPatient Safety and Quality Measures for CRRT: The UAB Experience. Ashita Tolwani, M.D. University of Alabama at Birmingham CRRT 2012
Patient Safety and Quality Measures for CRRT: The UAB Experience Ashita Tolwani, M.D. University of Alabama at Birmingham CRRT 2012 Quality Healthcare Quality is the extent to which health services for
More informationLESSON ASSIGNMENT. Professional References in Pharmacy.
LESSON ASSIGNMENT LESSON 1 Professional References in Pharmacy. TEXT ASSIGNMENT Paragraphs 1-1 through 1-8. LESSON OBJECTIVES 1-1. Given a description of a reference used in pharmacy and a list of pharmacy
More informationNATIONAL PROFILES FOR PHARMACY CONTENTS
NATIONAL PROFILES FOR PHARMACY CONTENTS Profile Title AfC Banding Page Pharmacy Support Worker Pharmacy Support Worker Higher Level Pharmacy Technician 4 4 Pharmacy Technician Higher level 5 5 Pharmacist
More informationHome therapy programme
Home therapy programme A guide for GPs Information for GPs Clinical Immunology and Allergy Unit page 2 of 8 Introduction This booklet is to give GPs an outline of the immunoglobulin replacement home therapy
More informationHospira Sapphire PCA/Epidural Pump Handout
Important Information You Need to Know 1. Order Sets Have been updated to reflect the new device terminology 2. Terminology: Crosswalk Current (Gemstar) New (Sapphire) Continuous Dose Continuous Rate Bolus
More informationPRESCRIBING SUPPORT TECHNICIAN:
PRESCRIBING SUPPORT TEAM AUDIT: CARDURA XL (Updated Sept 09) DATE OF AUTHORISATION: AUTHORISING GP: PRESCRIBING SUPPORT TECHNICIAN: SUMMARY Cardura XL is a once daily, extended release preparation of doxazosin
More informationSafe Medication Practices
Safe Medication Practices Patient Safety: Preventing Adverse Events OHA Conference Renaissance Toronto Hotel at SkyDome Toronto June 14, 2004 David U President & CEO, ISMP Canada Agenda ISMP Canada Patient
More informationSURVEY ON THE PRODUCTION AND PREPARATION OF CYTOSTATIC DRUGS
Please fax the complete questionnaire to: +49 (40) 79 14 36 01 SURVEY ON THE PRODUCTION AND PREPARATION OF CYTOSTATIC DRUGS Date: 1. Identification of your institution Institution: No. of departments:
More information2. Pharmacy Settings A. Retail (p 16) B. Institutional (p 17) C. Long Term Care (p 18) D. Other (p 19) E. Sample Questions (p 20)
Module One The Pharmacy Technician and Pharmacy Settings Table of Contents 1. The Pharmacy Technician A. Personal Standards of a Pharmacy Technician (p 2) B. Duties of a Pharmacy Technician (p 3) i. Tasks
More informationPolicies and Procedures. Title:
Policies and Procedures Title: PATIENT CONTROLLED ANALGESIA (PCA) LPN Additional Competency: Patient Controlled Analgesia with an Established Plan of Care RN Entry-Level Competency Authorization: [X] Former
More informationAdministration of Medications A Self-Assessment Guide for Licensed Practical Nurses
Administration of Medications A Self-Assessment Guide for Licensed Practical Nurses March 2018 College of Licensed Practical Nurses of Nova Scotia http://clpnns.ca Starlite Gallery, 302-7071 Bayers Road,
More informationSafer use of anticoagulants: the NPSA patient safety alert Steve Chaplin MSc, MRPharmS
Safer use of anticoagulants: the NPSA patient safety alert Steve Chaplin MSc, MRPharmS Steve Chaplin describes the NPSA s anticoagulant patient safety alert and the measures it recommends for making the
More informationCh. 113 PHARMACY SERVICES 28 CHAPTER 113. PHARMACY SERVICES A. GENERAL PROVISIONS Cross References
Ch. 113 PHARMACY SERVICES 28 CHAPTER 113. PHARMACY SERVICES Subchap. Sec. A. GENERAL PROVISIONS... 113.1 This chapter cited in 28 Pa. Code 101.31 (relating to hospital requirements). Subchapter A. GENERAL
More informationCanadian Paediatric High Alert Medication Delivery
Canadian Paediatric High Alert Medication Delivery Paediatric Opioid Safety - Phase 3: Education, Knowledge Translation and Implementation Final Report January 16, 2013 Respectfully Submitted by Elaine
More informationPenticton & District Community Resources Society. Child Care & Support Services. Medication Control and Monitoring Handbook
Penticton & District Community Resources Society Child Care & Support Services Medication Control and Monitoring Handbook Revised Mar 2012 Table of Contents Table of Contents MEDICATION CONTROL AND MONITORING...
More informationRNSP: Advanced RN Intervention
Policies and Procedures RNSP: Advanced RN Intervention Title: CHEST TUBES: IRRIGATION AND/OR ADMINISTRATION OF A MEDICATION TO THE PLEURAL SPACE I.D. Number: 1016 Authorization: [X] SHR Nursing Practice
More informationUnit 301 Understand how to provide support when working in end of life care Supporting information
Unit 301 Understand how to provide support when working in end of life care Supporting information Guidance This unit must be assessed in accordance with Skills for Care and Development s QCF Assessment
More informationMount Druitt Palliative and Supportive Care PCOC Presentation. Suzanne Coller (Clinical Nurse Consultant)
Mount Druitt Palliative and Supportive Care PCOC Presentation Suzanne Coller (Clinical Nurse Consultant) ABOUT THE SERVICE The palliative care unit is a 16 bed free standing unit located in the grounds
More information