EO 009.02 Managing Unserviceable Medications (Dari)

1. EO 009.02 Managing Unserviceable Medications(Dari) 01/09/2013

2. Importance of Lesson(Dari) • Insert Dari • As previously discussed, unserviceable medications like expired medications can have negative impacts on patient care. • Especially, for Intravenous medications unserviceable medications, in addition to loss of potency, can harm the patient and even cause death. • This lesson will review how to detect, handle and account for unserviceable medications. AFAMS

3. Overview EO 009.02(Dari) • Identifying unserviceable medications • Segregating unserviceable medications • Accounting and disposal • Lesson Review • Quiz • Insert Dari AFAMS

4. Defining UnserviceabilityDari . دواهای تاریخ گذشته )آنتعداد از دواهایکه تاریخ شان گذشته است( وآنتعداد از دواهایکه غیر قابل استفاده میباشد )یعنی دواهایکه دارای کیفیت پائین، نیاز بر نگهداری شان در یخچالها را دارد ولی دارای درجه نگهداری به اساس یک زنجیر سرد را نمیداشته باشند، و بعضآ به درجه حرارت بیرون در معرض خطر قرار میگیرد بنآ نیاز بر نگهداری شان در فریزر میباشد، ازهمین لحاظ باید مستقیمآ با مقامات ذیصلاح تماس گرفته تا هرچه زودتر هدر ساخته شود( باید برای مریض توزیع نگردد. • Pharmaceuticals that are deemed to be: • of poor quality • require refrigeration but did not have proper cold chain management and were exposed to temperatures outside of specified parameters • required to be frozen but thawed and can’t be used according to the manufacture’s recommendation, and/or • items directed by the proper authority to be destroyed (MMQC message) • Remember: • that the stability of a medication is based on its storage conditions. • the expiry date is based on the stability of the medication while being stored under the manufacturer’s recommended conditions. NHS AFAMS

5. Stability ReviewDari Stability of a pharmaceutical product is defined by USP-NF as the: “extent to which a product retains, within specified limits and throughout its period of storage and its use (i.e., its shelf life), the same properties and characteristics that it possessed at the time of manufacture.” • Five types of stability: chemical, physical, microbiological, therapeutic and toxicological. • Stability is based on the medication being stored under the manufacturer’s recommended conditions. Pharmacy Tech News

6. Stability ReviewDari Chemical stability: the chemical structure of the active ingredient remains intact and that the potency is acceptable. (retains 90% potency) Physical stability: the way the product appears (e.g., discoloration), tastes and smells, and if the product remains a solution or suspension. Microbiological stability: the sterility of the product (remains free of bacterial or fungal growth. Therapeutic stability: the product is able to exert the same actions in the body, leading to its effects against the disease it is intended to treat. Toxicological stability: an increase in toxicity does not occur as time passes. Pharmacy Tech News

7. Simple Stability Tests Pharmacy Tech News

8. When to Medication ServiceabilityDari • Receipt of an order • Shipping an order • Dispensing medication to: • Patient • Nurse • Ward • Providing Ward stock • Whenever in doubt

9. Segregating Unserviceable DrugsDari • Unserviceable medications must be separated from other pharmaceuticals. • The location must be marked “Do Not Use; Expired Medications” in order to prevent accidental distribution or dispensing. • Insert Dari NMH Pharmacy SOP

10. Ward Stock NMH Pharmacy SOP

11. MMQC Messages for Quality ControlDari These messages can be used to direct batches/ lots of medications be deemed unserviceable. • Poor manufacture • Stored improperly • Contamination • Safety etc. • The MMQC message will direct how to dispose of the medications. Insert Dari

12. پیام های (MMQC) محتوی معلومات از سیسم منفعت عمومی. قرار ذیل اند: • توقف تجهیزات طبی . • گسترش دوره زخیره مدت ذخیره (موثریت تاریخ انقضا). • حالت آموزش . • معلومات بااهمیت دیگر کنترول کیفیت. MMQC messages contain information of system-wide interest. This includes: Suspension of medical materiel. Extension of storage time periods (potency expiration dates). Disposition instructions. Other significant QC information.

13. کورس ادراه و منجمنت لوجستیک صحی اردوی ملی مسولیت های جوزتام Unit Responsibility فعالیت های که تحت سیستم غیر اتوماتیک قرار دارد باید دارای یک سیستم شماره ای باشد. Activities under a manual system must maintain a register in numerical sequence معلومات کلیدی که شما از مسج های (MMQC) نیاز دارید از : Key Info you need from a MMQC message • تاریخ دریافت... • نمبر پیام ....... • نمبر ستاک ملی. • فهرست علایم... • عمل لازم......... • ملاحظات.......... 1)Date received. 2)Message number. 3)National Stock Number. 4)Nomenclature. 5)Action required. 6)Remarks.

14. Drug RecallsDari NMH Pharmacy SOP

15. Drug RecallsDari NMH Pharmacy SOP

16. Under Control/ Controlled DrugsDari Insert Dari • Similar to other medications unserviceable Under Control medications must be segregated but, must also be kept secure. • Destruction of Under Control medications must be accounted for in the Perpetual Log. At minimum: • Segregate unserviceable medications • Once destroyed indicate destruction in the log with the signatures of witnesses. OTSG Expired Medications Policy

17. Destruction ProceduresDari Unserviceable medications, in accordance with MEDCOM and NMH policies, are to be accounted for and destroyed in the same manner as expired medications. • Three witnesses are required. Insert Dari

18. QuestionsDari

19. ReviewDari

20. QuestionsDari

21. End of EODari