[Index]

4.12 DISCHARGE MEDICATIONS

POLICY

1.   Discharge medications must be filled in community pharmacies in order to meet all the
legal requirements for an outpatient prescription.

2.   RN/LPN may not give an inpatient supply of medication to patient upon discharge.

      3.   Exceptions:
            Discharge medications will be provided to:

                A.  Solid Organ Transplant (SOT) patients

• Only medications approved by BC Transplant Society

• Medications to be dispensed from Solid Organ Transplant Clinic Pharmacy

                B.  Emergency Department discharge patients (see details below)

                C.  Travelling patients who are unable to fill medication at local pharmacy

                D.  Registered Day Care Patients

• Only parenteral cytotoxic medications

PROCEDURES:

A. Solid Organ Transplant (SOT) Patients

Physician:    1. Writes the prescription for approved medications separate from any other
                       discharge medication.

Pharmacist:  2. Dispenses medication from the Transplant Clinic Pharmacy.

                   3. Maintains a patient medication profile utilizing the Pharmanet system.

B. Emergency Discharge Patients

Physician:    1. Writes discharge prescription for filling at community pharmacy. A 24 hour service
                       pharmacy is available on Broadway.

                   2. Exceptions: see “Nurse” below

Nurse:         3. May provide to the patient upon discharge, on the written order of a physician,

                       Acetaminophen 325 mg with codeine 30 mg (Tylenol #3) 6 pack vial.  The medication

                       is packaged and labeled with instructions by the Pharmacy department and available as

                       ward stock in the Emergency Department. 

                   4. After pharmacy hours of operation, if it is necessary to begin the patient’s medication
                        immediately and the patient cannot fill the prescription at the 24 hour pharmacy on
                        Broadway, on the written order of a physician, the nurse may give a maximum of 24 hour
                        supply from Omnicell (or from the patient’s in-patient medication supply) to the patient. 
                        It is a legal requirement that the following information be indicated on the envelope for each
                        individual medication dispensed: patient name, physician’s name, drug name, strength,
                        dosing instructions using specially marked envelopes. Chart the number of doses provided.

C. Travelling Patients

Patients discharged from the hospital may only have medication(s) provided to them if they must travel long distances to their home and are unable to get a prescription filled in a local community pharmacy prior to travelling.

Physician:    1. Writes an order on the Physician’s order and indicates the quantity to be given to the
                       patient. The quantity ordered should be enough to last the duration of the travel period.
                       The travel medication order will state:

- the time of departure
- the number of doses required for the travel period

Pharmacist:  2. Process order. Ensure patient name, physician name, drug name, strength, brand or
                      manufacturer name, dosing instructions appear on the label.

                   3. Dispense oral medications in safety cap vials.

C. Registered Day Care Patients

Physician:    1.Writes the prescription on a discharge prescription form or a Physician's order form
                       one day Prior to treatment.

Nurse:         2. Faxes the prescription to the T15 Pharmacy satellite.

Pharmacist:  3. Dispenses prescription as per hospital's cytotoxic policies.

                   4.  Sends the medication to the day care unit with porter service.