April 08, 2020

Challenges Faced at Northwestern Memorial

Lara Ellinger
Medication Safety Pharmacist, Northwestern Memorial Hospital

Major challenges include patient movement and ensuring appropriate Omnicell updates are made to adjust stock and par levels, and subsequently, communicating this out to pharmacy and nursing staff in real time. In addition, restrictions to the administration of some medications, based on patient location, changes as patients are moved and areas of the hospital are repurposed exclusively for COVID care.

Another challenge is optimizing our drug supply and understanding the unique requirements and clinical nuances of this population. This has warranted operational changes such as transitions to pre-made intravenous infusions where applicable or temporary dispensing of medications from ADCs that were previously sent from the inpatient pharmacy.

Another difficulty is ensuring strategies put in place to reduce occupational exposure risk and PPE use for healthcare staff do not compromise safety efforts in place. This may include smart pump movement outside of patient rooms, widening the nursing administration window for medications, and removing dual signature requirements. New practices have been employed for inhaler labeling to dispense upon discharge, how to handle COVID patient own medication, and best practices for disposing of medication. Overall, keeping staff calm and informed and providing accurate info in a timely manner in this ever-evolving landscape has been the biggest, over-arching challenge.

I am sharing useful guidelines for handling essential patient-owned medications (POM-Guidance-COVID-19.pdf) and our inhaler process for Covid-19 patients (COVID-19-NMH-Take-Home-Inhaler-Workflow.pdf) so that others may leverage as needed.

DISCLAIMER

The views and opinions expressed in this blog are those of the authors and do not necessarily reflect the official policy or position of any other agency, organization, employer or company. Assumptions made in the analysis are not reflective of the position of any entity other than the author(s). These views are always subject to change, revision, and rethinking at any time and may not be held in perpetuity.

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