Inpatient Medication Inventory Management: Ward Stock

1. Inpatient Medication Inventory Management: Ward Stock June 2011

2. Course Objectives • Compare and Contrast both the risks and benefits of using health information technology in managing pharmacy inventory and ward stock stored throughout the facility. • Develop a strategy to identify items that are appropriate for distribution to non-pharmacy locations. • Identify the results of marking drugs as ward stock in pharmacy work reports

3. Inventory (Ward Stock): What? Where? When? Who? • All medications intended for patient use • Everywhere • At all times • Pharmacy is ultimately responsible for all drug supplies within a facility. Drugs should be stored securely, maintained at proper temperature, in date, in adequate quantities • Acquisition >Storage > Use > Disposal • Accountability

4. Inpatient Quirks • Inpatient medications are provided on a dose-by-dose basis by the facility and administered by nursing or other services. • Provision of inpatient medication: processes include: • Meds stocked in nursing closets, cabinets, and refrigerators • Meds in Automated Dispensing Units • Meds provided by pharmacy (med cart) on a daily basis

5. Wards and Ward Groups • Divide the operation into logically defined units such as ICU or PEDS or L&D. • Configured in the Supervisor’s menu of the Unit Dose package. • Uses ward locations already in system. • A group of several wards can be used to print reports and the pick lists rather than each ward separately. • Most impatient reports and worksheets can be selected by Wards and Ward Groups.

6. RPMS Inpatient Ward Stock Management Program • Automatic Replenishment/Ward Stock: • Computer-assisted manual process • Labor intensive • Full use of program not advocated • Marking items for Ward Stock: • Each item to be designated WS is entered as stock items file. • Do not mark Ward Stock in the drug file.

7. Do not mark Ward StockIn Drug File (PDM) • This entry is marked for the following PHARMACY packages: • Outpatient • Unit Dose • IV • Non-VA Med • MARK THIS DRUG AND EDIT IT FOR: • O - Outpatient • U - Unit Dose • I - IV • W - Ward Stock No! • D - Drug Accountability • C - Controlled Substances • X - Non-VA Med • A - ALL No! Enter your choice(s) separated by commas :

8. What is Ward Stock • Drugs that are stocked in nursing units or other locations that allow non-pharmacy personnel access at all times. • Ward stock items are site specific and depend on: • Formulary • Using cart exchange system • Omnicell / Pyxis in use • 24/7 Pharmacy coverage • Storage types available in remote location • Security

9. Items often designated Ward Stock: OTCs Insulin Narcotics Oral liquids Premixed IVPB’s Inhalers / Nebulizer solutions Items will be shown as ward stock on the daily pick list for medication cart fills. (“WS” in UNITS NEEDED column)

10. Why is this important?Unit Dose PICK LIST • As part of the inpatient medication delivery process, the pick list is printed daily and contains: • List of med orders • Number of dosage units needed for 24 hours for those items not Ward Stock. • Items not to be filled: • Ward Stock • Refill on request

11. Sample Inpatient Medication Pick List • Used for the “Classic” inpatient medication process – cart exchange. • Tells technician how many units to stock in the drawer and the pharmacist when the technician’s work is verified. • Has limited usefulness at sites using automated dispensing machines. • Can be printed by Ward or Ward Group.

12. Preparing to build AR/WS files(Before logging into RPMS) • Determine which items will be ward stock: • Decide where they will be stored (AOU). • Give each storage location a descriptive name. • Since items can be entered for specific wards (i.e., stocked in ICU but must come from pharmacy if used elsewhere), Wards and Ward Groups must be set up.

13. AR/WS Supervisor Menu Automatic Replenishment Option: supervisor's Menu Set Up AR/WS (Build Files) ... Prepare AMIS Data ... Management Reports ... Obsolete Data Purge ... Select Supervisor's Menu Option: set Up AR/WS (Build Files) Enter/Edit Inventory Types Item Location Codes - Enter/Edit Create the Area of Use Stock Items - Enter/Edit Expiration Date - Enter/Edit Ward (For Item) Conversion Add/Delete Ward (for Item) Transfer AOU Stock Entries Inactivate AOU Inactivate AOU Stock Item AOU Inventory Group - Enter/Edit Print Set Up Lists ... Edit 'Person Doing Inventory' Sort AOUs in Group Site Parameters

14. Setting up the AR/WS files • Set up Inventory Types • IV, C2, C3, inhaler, etc. • Set Up Item Location Codes • Specific locations, ie. Cupboard #1 • Create the Area of Use • Like ICU, PEDS, etc. • Enter Stock Items • You’ll be glad you entered the other three on this page • Site Parameters • Set Up Inpatient Site Name • Make it selectable for AR/WS

15. Sample Ward Stock Item

16. Auto Replenishment Reports • Auto Replenishment Reports: • List Stock Items (132 column) • Expiration Date Report (80 column) • Inventory Outline (80 column) • Ward/AOU List for an Item (80 column) • Item Activity Inquiry (80 column) • Percentage Stock On Hand (132 column) • Returns Analysis Report (80 column) • Usage Report for an Item (80 column) • Zero Usage Report (80 column)

17. Questions?