Pharmacy CS Setup

I am documenting here how to partially set-up the CS package. I don't cover initializing the inventory here, mostly because the receiving function relies on IFCAP/Prime Vendor functionality which I don't have set-up. I also don't cover how to set-up printing green sheets. Consult the technical manual for that.

The main reason I am setting up the package is to tell inpatient pharmacy which CS drugs are ward stock at which Wards.

Menu
The main menu for pharmacy is PSD MENU. For nurses it's PSD NURSE MENU.

Keys
To initialize the package, you need the following keys:
 * PSDMGR
 * PSD TRAN
 * PSD PARAM

Package users rely on the same keys as Inpatient Pharmacy (PSJ RPHARM and PSJ RNURSE)

Jobs
PSD PURGE should be run daily after the package is intialized.

Define CS Site
Select the site you made for Ward Stock, and tell VISTA it's to be used for Controlled Substances as well.  UD    Unit Dose Medications ...   W      Automatic Replenishment ...   PDM    Pharmacy Data Management ...   NDF    National Drug File Menu ...   BCMA   Medication Administration Menu Pharmacy ...   NUD    Controlled Substances Nurses' (CS) Menu ...   PSD    Controlled Substances Menu ...

Select Pharmacy Menus Option: psd Controlled Substances Menu

Controlled Substances Inpatient Site Name: INTRACARE SOUTH

Please contact your Pharmacy Coordinator. You have not defined a pharmacy Dispensing Site

Supervisor (CS) Menu ...         Technician (CS Pharmacy) Menu ...          Pharmacist Menu ...          Production Reports ... Barcode Drug Labels for Vault

Select Controlled Substances Menu Option: SUPervisor (CS) Menu

Set Up CS (Build Files) Menu ...         Management Reports ... Balance Adjustments Destructions Menu ... Add Existing Green Sheets at Setup Correction Menu ... Print Pharmacist ID Labels Inspectors Label Print Unscheduled Order Report

Select Supervisor (CS) Menu Option: SET Up CS (Build Files) Menu

Site Parameters Enter/Edit Menu ... Ward (for Drug) Transfer Add/Delete Ward (for Drug) Inactivate NAOU Inactivate NAOU Stock Drug Transfer Stock Entries ... Sort NAOUs in Inventory Group Print CS Set Up Lists ... Check Stocked Drugs for CS Use Initialize Balance at Setup

Select Set Up CS (Build Files) Menu Option: SITE Parameters INTRACARE SOUTH You may enter a new INPATIENT SITE, if you wish This contains the name of the Inpatient Site. A VAMC may have more than one inpatient site name, i.e. for multi-divisional sites or nursing homes. A second site name would be used, for example, whenever differen t parameters are required.

Select INPATIENT SITE NAME: `1 INTRACARE SOUTH

Is INTRACARE SOUTH selectable for Controlled Subs: YES // Y YES

Mark Drugs for CS Package Use
Before you go on, collect the following on the drugs that are treated as controlled substances in your pharmacy: After that, go and mark each drug for CS use.  Select Set Up CS (Build Files) Menu Option: enter/Edit Menu
 * Drug Name
 * DEA # for reference
 * Location in Pharmacy (which safe, which shelf, position on shelf)
 * Location in each of the Nursing Units (if available)
 * Breakdown Units and Package Size. A breakdown unit is how much would you give nursing at one time. Typically, for UD packaged drugs, that's 10.

Mark/Unmark Drugs for Controlled Substances Use Inventory Types - Enter/Edit Enter/Edit CS Drug Location Codes Create/Edit the Narcotic Area of Use Stock CS Drugs - Enter/Edit Manufacturer, Lot #, and Exp. Date - Enter/Edit Narcotic Breakdown Unit/Package Size - Enter/Edit NAOU Inventory Group - Enter/Edit

Select Enter/Edit Menu Option: mark/Unmark Drugs for Controlled Substances Use

Select DRUG: adder,5ADDERALL AMPHETAMINE/D-AMPHETAMINE 5MG TAB         CN801

A CONTROLLED SUBSTANCES ITEM? No// y (Yes)

Select DRUG: adder,10ADDERALL AMPHETAMINE/D-AMPHETAMINE 10MG TAB         CN801

A CONTROLLED SUBSTANCES ITEM? No// y (Yes)

Select DRUG: etc...

Check DEA #'s for Drugs
Here, I actually notice that my Midrin is missing a DEA#. So I will fix that.



Select Set Up CS (Build Files) Menu Option: print CS Set Up Lists

Drug File Stats for CS Drugs DEA Special Handling List Print Inventory Types List CS Drug Location Codes Show Narcotic Area of Use Stock Drug Print (Stock Level and Location) Stock Drug List (Inventory Type and Location) Breakdown/Dispensing Unit Report Inventory Group List (80 column) Manufacturer and Narcotic Information Report

Select Print CS Set Up Lists Option: dea Special Handling List

This report lists Drug name, DEA Special Handling, and NDC information for all drugs marked for Controlled Substances use.

This report is designed for an 80 column format.

DEVICE: ;;9999 TELNET

DEA SPECIAL HANDLING FOR CS PHARM DRUGS SEP 17,2011                             PAGE: 1

DEA SPECIAL DRUG NAME                                       HANDLING             NDC ---

ACETAMINOPHEN/CODEINE 300MG/30MG TAB            3A            68084-372-01 ALPRAZOLAM 0.25MG TAB                           4             68084-018-01 ALPRAZOLAM 0.5MG TAB                            4             68084-019-01 ALPRAZOLAM 1MG TAB                              4             51079-790-20 AMPHETAMINE/D-AMPHETAMINE 10MG TAB              2C            00185-0111-01 AMPHETAMINE/D-AMPHETAMINE 15MG TAB              2C            00555-0777-02 AMPHETAMINE/D-AMPHETAMINE 20MG TAB              2C            0555-0973-02 AMPHETAMINE/D-AMPHETAMINE 5MG TAB               2C            00555-0971-02 BUPRENORPHINE 2MG TAB SL                        3A            0054-0176-13 BUPRENORPHINE 8MG TAB SL                        3A            00054-0177-13 CHLORDIAZEPOXIDE 10MG CAP                       4             51079-0375-20 CHLORDIAZEPOXIDE 25MG CAP                       4             51079-141-20 CHLORDIAZEPOXIDE 5MG CAP                        4             51079-0374-20 CLONAZEPAM 0.25MG TAB ODS                       4             49884-0307-02 CLONAZEPAM 0.5MG TAB                            4             51079-0881-20 CLONAZEPAM 1MG TAB                              4             51079-0882-20 CLONAZEPAM 2MG TAB                              4             51079-0883-20 DEXMETHYLPHENIDATE 10MG TAB                     2C            0093-5277-01 DEXMETHYLPHENIDATE 2.5MG TAB                    2C            00093-5275-01 DEXMETHYLPHENIDATE 5MG TAB                      2C            0093-5276-01 DIAZEPAM 2MG TAB                                4             51079-284-20 DIAZEPAM 5MG TAB                                4             68084-359-01 DIAZEPAM 5MG/ML 2ML INJ PFS                     4             0409-1273-32 DIPHENOXYLATE/ATROPINE 2.5MG/0.025MG TAB        5             51079-0067-20 DRONABINOL 2.5MG CAP                            3C            68084-0174-01 HYDROCODONE/APAP 10MG/325MG TAB                 3A            0406-0367-62 HYDROCODONE/APAP 5MG/325MG TAB                  3A            68084-0368-01 HYDROCODONE/APAP 5MG/500MG TAB                  3A            0904-3440-61 HYDROCODONE/APAP 7.5MG/750MG TAB                3A            63739-131-10 LISDEXAMFETAMINE 30MG CAP                       2C            59417-0103-10 LISDEXAMFETAMINE 40MG CAP                       2C            59417-0104-10 LISDEXAMFETAMINE 50MG CAP                       2C            59417-0105-10 LORAZEPAM 0.5MG TAB                             4             68084-0088-01 LORAZEPAM 1MG TAB                               4             68084-0089-01 LORAZEPAM 2MG TAB                               4             68084-0090-11 LORAZEPAM 2MG/ML 1ML INJ                        4             10019-0102-01 METHYLPHENIDATE 10MG TAB                        2C            00406-1122-01 METHYLPHENIDATE 18MG TAB ER                     2C            50458-0585-01 METHYLPHENIDATE 20MG TAB                        2C            0781-5753-01 METHYLPHENIDATE 27MG TAB ER                     2C            50458-588-01 METHYLPHENIDATE 36MG TAB ER                     2C            50458-0586-01 METHYLPHENIDATE 54MG TAB ER                     2C            0591-2718-01 METHYLPHENIDATE 5MG TAB                         2C            0406-1121-01 MIDRIN CAP                                      NOT LISTED    62584-0139-01 MODAFINIL 100MG TAB                             4             63459-0101-30 PHENOBARBITAL 30MG TAB                          4             51079-095-20 TEMAZEPAM 15MG CAP                              4             51079-418-20 TEMAZEPAM 30MG CAP                              4             51079-419-01 TRAMADOL 50MG TAB                               NOT LISTED    62584-559-01 ZOLPIDEM 10MG TAB                               4             68084-0226-01

Set-up Inventory Types
These were set-up from the WS package.

 Select Enter/Edit Menu Option: inventory Types - Enter/Edit

Select NAOU INVENTORY TYPE NAME: ? Answer with AOU INVENTORY TYPE NAME Choose from: ALL INJECTIBLES ORAL MEDS You may enter a new AOU INVENTORY TYPE, if you wish Answer must be 3-30 characters in length

Set-up Location Codes
Here I will enter my abbreviations for safes, shelves, and medication cabinets.  Select Enter/Edit Menu Option: enter/Edit CS Drug Location Codes

Select DRUG ADDRESS CODE: ? You may enter a new AOU ITEM LOCATION, if you wish Answer must be 1-3 characters in length Select DRUG ADDRESS CODE: MC Are you adding 'MC' as a new AOU ITEM LOCATION (the 1ST)? No// Y (Yes) AOU ITEM LOCATION CODE EXPANSION: Medication Cabinet DRUG ADDRESS CODE: MC// CODE EXPANSION: Medication Cabinet//

Select DRUG ADDRESS CODE: S1 Are you adding 'S1' as a new AOU ITEM LOCATION (the 2ND)? No// Y (Yes) AOU ITEM LOCATION CODE EXPANSION: Shelf 1 DRUG ADDRESS CODE: S1// CODE EXPANSION: Shelf 1//

Select DRUG ADDRESS CODE: S2 Are you adding 'S2' as a new AOU ITEM LOCATION (the 3RD)? No// Y (Yes) AOU ITEM LOCATION CODE EXPANSION: Shelf 2 DRUG ADDRESS CODE: S2// CODE EXPANSION: Shelf 2//

Create Narcotic Areas of Use
My hospital has a pretty standard set-up for a small hospital. The "VAULT" is the Inpatient Pharmacy; and each of the Wards (4) has a Narcotic Cabinet. So I have 5 areas of use: 1 vault and 4 cabinets.  Select Enter/Edit Menu Option: create/Edit the Narcotic Area of Use

Select NAOU: INPATIENT PHARMACY Are you adding 'INPATIENT PHARMACY' as    a new DRUG ACCOUNTABILITY STATS? No// Y (Yes)

CONTROLLED SUBSTANCES SITE : INTRACARE SOUTH

Select one of the following:

M        MASTER VAULT S        SATELLITE VAULT N        NARCOTIC LOCATION

LOCATION TYPE: MASTER VAULT NAOU: INPATIENT PHARMACY// ASK MFG/LOT #/EXP.DATE?: N NO AUTO GENERATE DISPENSING #'S?: Y  YES LOW DISPENSING #: 1 HIGH DISPENSING #: 999999999 LAST DISPENSING #: 1 PRINT GREEN SHEET: ? Enter "YES" to print the Green Sheet after process only, "NO" to print after RPh Verification. Choose from: 1       YES 0       NO PRINT GREEN SHEET: GREEN SHEET STOCK: DISPENSING WORKSHEET SORT: DEFAULT GREEN SHEET PRINTER: DEFAULT REPORT PRINTER: DEFAULT LABEL PRINTER: EMERGENCY ORDER PRINTER: ORDER ENTRY BANNER: THERE ARE NO LINES! Edit? NO// ALLOW ONE-TIME REQUESTS?: PRIME VENDOR?:

Select NAOU: ADULT Are you adding 'ADULT' as a new DRUG ACCOUNTABILITY STATS? No// Y (Yes)

CONTROLLED SUBSTANCES SITE : INTRACARE SOUTH

Select one of the following:

M        MASTER VAULT S        SATELLITE VAULT N        NARCOTIC LOCATION

LOCATION TYPE: NARCOTIC LOCATION NAOU: ADULT// PRIMARY DISPENSING SITE: INPATIENT PHARMACY USING PERPETUAL INVENTORY?: Y YES Is this a Pharmacy NAOU for Working Stock?: N NO ADJUSTMENT MAIL GROUP: TIME LIMIT FOR DELAYED DOSES:

... the rest of the NAOUs are Narcotic Locations ...

Configure Drugs in VAULT
The next step is to configure each of the drugs in the Vault. No joke--that's very time consuming. Here's one.  Select DRUG: ADD,10ADDERALL AMPHETAMINE/D-AMPHETAMINE 10MG TAB         CN801 Are you adding 'AMPHETAMINE/D-AMPHETAMINE 10MG TAB' as    a new DRUG (the 2ND for this DRUG ACCOUNTABILITY STATS)? No// Y (Yes) LOCATION: NS,S1,2 Select TYPE:   ORAL MEDS Select TYPE: STOCK LEVEL: 100 (Ideal Stock Level) REORDER LEVEL:  (When should you re-order?) QUANTITY TO REORDER: (How much to reorder?) BREAKDOWN UNIT: TAB (How dispensed? Liquids may be mLs) PACKAGE SIZE: 20 (Multiples of this are transferred to a Ward Location at a time) LIQUID?: RESTRICT FROM NAOUS?: (Restrict from One-Time unscheduled requests) ALWAYS PRINT VA FORM 10-2638?: (Should a green sheet always print?) MAXIMUM QUANTITY PER ORDER: (Wards cannot exceed this) MANUFACTURER: LOT #: EXPIRATION DATE:

Configure Drugs in Narcotic Ward Locations
Now that you have entered all the drugs into the VAULT, it's time to add them to each of the wards. Note that (logically) you cannot add drugs that are not in the main VAULT.

 Select Enter/Edit Menu Option: STOCK CS Drugs - Enter/Edit

Select NAOU: ? Answer with DRUG ACCOUNTABILITY STATS PHARMACY LOCATION Choose from: ADOLESCENT ADULT CHILDREN'S       DAPA INPATIENT PHARMACY Select NAOU: DAPA

Do you wish to ADD or EDIT stock drugs? ADD//

You may select only CS drugs stocked in your dispensing vault.

Select DRUG: AMBIEN,10AMBIEN ZOLPIDEM 10MG TAB         CN309 ARE YOU ADDING 'ZOLPIDEM 10MG TAB' AS A NEW DRUG (FOR THIS DRUG ACCOUNTABILITY S TATS)? Y// ES LOCATION: MC Select WARD (FOR DRUG): DAPA 3R 314-326 S   Select WARD (FOR DRUG): Select TYPE: STOCK LEVEL: 20 REORDER LEVEL: QUANTITY TO REORDER: MANUFACTURER: LOT #: EXPIRATION DATE:

Conclusion
For my purposes, I am done. All narcotics on wards will now be recognized as ward stock by the UD package.

//Sam