Must Know Terminology for the Long Term Care Consultant Pharmacist

Just like anything, long term care has its own language.  I’m going to breakdown a few of the most important acronyms and terminology that any consultant pharmacist in long term care should know.

  1. DRR or MRR.  Drug regimen review (or medication regimen review) is the primary component of what a consultant pharmacist does on at least a monthly basis in long term care.  It is a review of the medical record to look for adverse effects, appropriate prescribing, drug interactions, unnecessary medications, etc.
  2. The MAR.  MAR is the medication administration record.  MAR is terminology that is certainly found in other healthcare settings, but it is so critical in long term care, I had to include it.  From PRN use, to patients refusing medications, to medication errors, to identifying potential drug diversion, I’ve used the MAR countless times to make sure long term care residents are receiving safe and effective medication therapy.
  3. DON or DNS.  The director of nursing or director of nursing service is going to be your go to person when there is problem that needs to be corrected.  They are essentially the healthcare leader of a long term care facility.
  4. MDS.  Minimum Data Set.  The MDS contains a wealth of clinical information.  I’ve definitely used it to help assess the benefits of medication.  From behavioral health, to urinary assessments, there is substantial information to be gained when you need it.
  5. F-tags.  F-tags are simply survey deficiencies that the state’s department of health gives out or potentially the feds if a federal survey has been done.  Understandably, no one likes F-tags, and especially ones that are of high severity.  A consultant pharmacist needs to do their very best to try to help the facility be deficiency free when it comes to medication related deficiencies. There are tons of nuances with survey deficiencies, but the 4 pharmacy related major ones include F-329, F-425, F-428, F-431.  They involve appropriate use, reviewing medications, identification of unnecessary medications, as well as appropriate storage and procurement of medications.
  6. GDR.  Much of a consultant pharmacists time is in assessing medication for possible Gradual Dose Reduction.  The primary targets for GDR, and psych and sleep medications.

I’m going to be creating a how to do long term care consulting webinar and educating how to utilize the following items outlined below.  What else would you like to know?

Nursing Home Consulting

  1. H&P
  2. Orders
  3. Assessments
  4. Mar
  5. Nurses notes
  6. Vitals
  7. progress notes
  8. Labs
  9. Gdr’s
  10. F-tags
  11. Surveyors
  12. Pharmacist documentation
    1. Location
    2. Amount
    3. How and who to write them to
  13. Controlled substances
  14. Meetings
  15. Quarterly report
  16. Behavior charting
  17. Med errors
  18. High risk meds in ltc
  19. Psych
  20. Med admin by nurses
  21. Reviewing policies
  22. Fallls tracking/review
  23. Reducing meds/polypharmacy stopping strategies
  24. Med rec
  25. Monthly review
  26. Availability for consult
  27. Care plans
  28. Physician documentation challenges
  29. Documentation consitancy
    1. Nurses – behaviors/target behavior compared to diagnosis given by Dr.
  30. Assessing drug benefits
  31. Pricing of consultant services
  32. Hospital stays
  33. Hospice
  34. Administration/nurse/med direction/provider/aids/social services
  35. Patient/family perspectives
  36. Regulatory education
  37. Inservice/educational role of consultant pharmacist
  38. Medication storage inspection
  39. Med pass audits

What else would you like to know?

 

7 Comments

  1. Heidi Annette Tuttle

    When is this webinar scheduled for?

    Reply
    • Eric Christianson

      Thanks for the question, my target is by late May – it will be a recorded webinar, but I will offer a really big initial discount. Thanks for the question! – Eric

      Reply
  2. Veronica Henry

    Thanks! This will be very helpful!

    Reply
    • Eric Christianson

      Thanks for the comment Veronica!

      Reply
  3. Mom PharmD

    Antibiotic stewardship & how to convince nurses not to escalate every foul-smelling urine to a urine culture & uti treatment because they bugged the doc on call; how to get a sane insulin regimen in a patient who is newly uncontrolled because of diet (sliding scale insulin is hard & scary because of the risk of error); use of standing orders & how the pharmacy should track this if house meds are available.

    Reply
    • Eric Christianson

      Those are great ideas for sure, will try to incorporate – thanks!

      Reply
  4. Elizabeth

    Definitely SSI and alternatives to, plus how to spot if someone is actually getting hypoglycemic because of their SSI. Optimizing med pass times when a patient is on a bisphosphonate, a ppi, a thyroid med, and a calcium or iron supplement. How to document when a patient has a major psych dx and their high-risk meds really shouldn’t be GDR’d.

    Reply

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Written By Eric Christianson

April 5, 2017

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