Open Forum

Would anyone be willing to share their sample medication process?

We had a joint commission survey and they did not like our dispensing process. 

1. They want to see documentation of how the provider verifies the dosage and medication prior to the nurse dispensing.  I am curious how you all document that.

2. They also had concerns about how the medication is ordered.  Often we order the medication to the pharmacy and give them a sample so they can get started while the PA is processing.  The concern was that we did not have 2 orders in the system (one for the pharmacy order and one for the sample).  Are you putting in 2 orders?

3. If you are putting in 2 orders how do you make that clear on the AVS so the patients med list does not have the medication listed twice?  (we use EPIC)

------------------------------
James Taylor
Director - Practice Management
Memorial Hospital
Jasper IN
(812)639-1091
------------------------------

Original Message:
Sent: 6/30/2022 1:19:00 PM
From: James Taylor
Subject: Sample Medication Process

Would anyone be willing to share their sample medication process?

We had a joint commission survey and they did not like our dispensing process. 

1. They want to see documentation of how the provider verifies the dosage and medication prior to the nurse dispensing.  I am curious how you all document that.

2. They also had concerns about how the medication is ordered.  Often we order the medication to the pharmacy and give them a sample so they can get started while the PA is processing.  The concern was that we did not have 2 orders in the system (one for the pharmacy order and one for the sample).  Are you putting in 2 orders?

3. If you are putting in 2 orders how do you make that clear on the AVS so the patients med list does not have the medication listed twice?  (we use EPIC)

------------------------------
James Taylor
Director - Practice Management
Memorial Hospital
Jasper IN
(812)639-1091
------------------------------

James
Due to the strict regulations and documentation requirements, including monthly counts, my facility and many others in our hospital system stopped having samples over 10 years ago. The responsibility is overwhelming and over the years developed alternative programs to help patients who cannot afford medications.
Diane Resnick,AMB-BC
Riverview Family Health Center
Hackensack Meridian Health

Sent from my iPhone


Original Message:
Sent: 6/30/2022 1:19:00 PM
From: James Taylor
Subject: Sample Medication Process

Would anyone be willing to share their sample medication process?

We had a joint commission survey and they did not like our dispensing process. 

1. They want to see documentation of how the provider verifies the dosage and medication prior to the nurse dispensing.  I am curious how you all document that.

2. They also had concerns about how the medication is ordered.  Often we order the medication to the pharmacy and give them a sample so they can get started while the PA is processing.  The concern was that we did not have 2 orders in the system (one for the pharmacy order and one for the sample).  Are you putting in 2 orders?

3. If you are putting in 2 orders how do you make that clear on the AVS so the patients med list does not have the medication listed twice?  (we use EPIC)

------------------------------
James Taylor
Director - Practice Management
Memorial Hospital
Jasper IN
(812)639-1091
------------------------------

We have samples only of inhalers and insulin. Our process involves a paper record for dispensing in our sample cupboard/fridge, I too would like a better process. In response to your specific questions: 1). We don't do this either. The only documentation from the provider is the cosigned sample medication order in EPIC. 2). We do put two orders in for this. The sample order has a specific button for sample in Epic and then we also change the end date to the day we dispense. That answers 3). When you change the end date it will only show up as a "duplicate" for that day. Therefore there are two on the AVS but going forward no duplicates on the patient med list.  Hopefully that is somewhat helpful!

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Becky Biship BSN RN
Monument Health
Belle Fourche SD
(605)939-9868
------------------------------

Original Message:
Sent: 06-30-2022 13:19
From: James Taylor
Subject: Sample Medication Process

Would anyone be willing to share their sample medication process?

We had a joint commission survey and they did not like our dispensing process. 

1. They want to see documentation of how the provider verifies the dosage and medication prior to the nurse dispensing.  I am curious how you all document that.

2. They also had concerns about how the medication is ordered.  Often we order the medication to the pharmacy and give them a sample so they can get started while the PA is processing.  The concern was that we did not have 2 orders in the system (one for the pharmacy order and one for the sample).  Are you putting in 2 orders?

3. If you are putting in 2 orders how do you make that clear on the AVS so the patients med list does not have the medication listed twice?  (we use EPIC)

------------------------------
James Taylor
Director - Practice Management
Memorial Hospital
Jasper IN
(812)639-1091
------------------------------

Hi James

we currently have samples in certain clinics. Per FDA, when dispensing drugs in your clinic you are acting as a pharmacy and only those with prescribing rights can dispense medications. For that reason, only practitioners are allow to physically hand the patient the medication. It is documented twice. once in our sample med log and also in the medical record. I have attached a copy of the log used for this. 

my goal is to get rid of all samples as maintaining is cumbersome.

------------------------------
Kristyl McCray MSN RN-BC
RN Clinical Director, Education & Prof. Practice
PIH Health Physicians
Whittier CA
(562)698-0811
------------------------------

Original Message:
Sent: 06-30-2022 13:19
From: James Taylor
Subject: Sample Medication Process

Would anyone be willing to share their sample medication process?

We had a joint commission survey and they did not like our dispensing process. 

1. They want to see documentation of how the provider verifies the dosage and medication prior to the nurse dispensing.  I am curious how you all document that.

2. They also had concerns about how the medication is ordered.  Often we order the medication to the pharmacy and give them a sample so they can get started while the PA is processing.  The concern was that we did not have 2 orders in the system (one for the pharmacy order and one for the sample).  Are you putting in 2 orders?

3. If you are putting in 2 orders how do you make that clear on the AVS so the patients med list does not have the medication listed twice?  (we use EPIC)

------------------------------
James Taylor
Director - Practice Management
Memorial Hospital
Jasper IN
(812)639-1091
------------------------------

Original Message:
Sent: 7/7/2022 2:30:00 PM
From: Kristyl McCray
Subject: RE: Sample Medication Process

Hi James

we currently have samples in certain clinics. Per FDA, when dispensing drugs in your clinic you are acting as a pharmacy and only those with prescribing rights can dispense medications. For that reason, only practitioners are allow to physically hand the patient the medication. It is documented twice. once in our sample med log and also in the medical record. I have attached a copy of the log used for this. 

my goal is to get rid of all samples as maintaining is cumbersome.

------------------------------
Kristyl McCray MSN RN-BC
RN Clinical Director, Education & Prof. Practice
PIH Health Physicians
Whittier CA
(562)698-0811
------------------------------

Original Message:
Sent: 06-30-2022 13:19
From: James Taylor
Subject: Sample Medication Process

Would anyone be willing to share their sample medication process?

We had a joint commission survey and they did not like our dispensing process. 

1. They want to see documentation of how the provider verifies the dosage and medication prior to the nurse dispensing.  I am curious how you all document that.

2. They also had concerns about how the medication is ordered.  Often we order the medication to the pharmacy and give them a sample so they can get started while the PA is processing.  The concern was that we did not have 2 orders in the system (one for the pharmacy order and one for the sample).  Are you putting in 2 orders?

3. If you are putting in 2 orders how do you make that clear on the AVS so the patients med list does not have the medication listed twice?  (we use EPIC)

------------------------------
James Taylor
Director - Practice Management
Memorial Hospital
Jasper IN
(812)639-1091
------------------------------