Instruct patients and families on taking home or keeping medications in the hospital pharmacy. Document which family member takes medications home. If medications go to the pharmacy, they are bagged, sealed, labeled and receipt placed in patient chart. Controlled medications are counted by two nurses and secured. Medications are documented on an inventory form with date, time and list. Standing orders may be used if specified by physician.

1. Pharmacy
Instruct patient and family that medications need to
be taken home or kept in the hospital pharmacy. Send
medications home if at all possible.
 If medications are sent home, document in CPSI
which family member took possession of the
medications.
 If medications are sent to the pharmacy, they are
bagged, sealed and appropriately labeled in a
patient valuable bag. These bags are found in the
Business Office at the Cashier’s desk if none are
available on the unit.
Continued on next slide

2. Pharmacy (continued)
• Once medications are placed in the bag the receipt is torn
from the patient valuable bag and placed in the patient’s
chart indicating there are medications to be returned to the
patient at discharge.
• If home medications contain any controlled medications
then the admitting nurse will count and cosign receipt with
another nurse at the patient’s bedside and secure bag
These medications are documented along with date, time and
list of medications sent to pharmacy on the Home Medication
Inventory eform. If medications are sent home no medication
inventory eform is required.

3. Pharmacy (continued)
If a patient’s home medication is unavailable from the hospital
pharmacy:
 The nurse or pharmacist will contact the physician and request
to use the home medication.
 If physician agrees, the patient is notified and permission is
requested to use the home med.
 If the patient does not agree, pharmacy is notified.
 If the patient agrees, an order is written specifying the patient’s
home medications may be used.
 The pharmacist then verifies the identity of the medication
prior to administration of the first dose.
 If the medication is a controlled substance, the medication will
be kept in the Pyxis and a patient specific controlled drug
administration record is kept.

4. Pharmacy (continued)
Home Medication Inventory eform
 When medications can not be sent home and are sent to the
pharmacy the Home Medication Inventory eform is used to list
the names and amounts of medications sent to the pharmacy.
 This form is used for both non-controlled medications and
controlled medications.
 These medications will pull from the Home Medication List eform
so they will not have to be retyped.
 If there are controlled medications taken to the pharmacy, two
nurses along with the patient or family member (if available) will
sign the form when the medications are counted, bagged,
sealed and removed from the patient’s room.

5. Pharmacy (continued)
Home Medication Inventory eform continued:
 The eform is then signed by nursing and pharmacy when the
medications are taken to pharmacy AND when they are taken back
from pharmacy.
 When the medications are returned to the patient or family, the
Home Medication Inventory eform is signed by the nurse and the
patient or family member who is taking possession of the
medications.
 The eform is then placed in the patient’s chart under the nurses’
notes tab.
 It is important to always check at discharge to see if the patient
has any medications in the pharmacy that need to be returned to
the patient.
 If a patient's home medications are not picked up within 30 days
following discharge, they are discarded in accordance with health
department regulations related to controlled and non-controlled
medications.

6. Pharmacy (continued)
Standing Orders
 The physician must write “May Use Standing Orders” in order to use
their standing orders
 If the physician does not write this, they are called for orders as
needed
 Standing orders are written on an as needed basis, for example, if
your patient needs something for nausea you would check the
physician on call’s standing orders and write the order for the
appropriate medication. It is written S.O. /MD’s name/Nurse’s name
 The order is then faxed to the pharmacy

7. Pharmacy (continued)
 Transdermal TNG patches ordered once daily are left in
place for 12 hours during a 24-hour period unless the
physician specifically requests an alternate schedule
 Transdermal TNG patch is placed on the upper arm or
chest in a clean, dry area as free from hair as possible
 Patches should not be over scar tissue or areas of obvious
skin irritation
 Transdermal patches should be removed prior to MRI
studies and replaced upon return
 The standard administration times of TNG patches are:
• 9:00 a.m. - patch applied
• 9:00 p.m. - patch removed

8. Pharmacy (continued)
 Medication information is provided regarding all medications
NEW to the patient’s routine
 Give medication information sheets to the patient at the
bedside with regards to all new medications that the patient
will be discharged home on
 Include instructions to the patient/caregiver regarding the
dose, use, times, food-drug interactions, cautions, and side
effects – Provide diet information for specific drugs requiring
dietary precautions
 When appropriate, education regarding current medications is
also included especially if patient is on high alert meds like
Coumadin or insulin or if the dosage of a current med has
changed