Kathy Augustine, CMA (AAMA), was hired recently to work for a primary care practice in her hometown. Kathy is responsible for managing phone calls and answering patient questions about their medication and prescriptions. P

QUESTION

 Kathy Augustine, CMA (AAMA), was hired recently to work for a primary care practice in her hometown. Kathy is responsible for managing phone calls and answering patient questions about their medication and prescriptions. Part of her job description is to follow the provider’s orders to administer medication to a wide range of patients. To be knowledgeable about the administrative side of medication management, and to give medications to patients accurately and safely, Kathy must understand the basic principles of pharmacology.

1. What should Kathy know about the management of controlled substances in the ambulatory care setting?
2. If Kathy is not familiar with medication, how can she learn about the properties of the drug?
3. Is it important that Kathy understand the clinical uses of prescribed drugs and over-the-counter (OTC) drugs?
4. The practice uses an electronic prescription program as part of its electronic health record (EHR) package. How does Kathy transmit the provider’s drug orders electronically?
5. A primary care practice has patients of all ages. What factors related to age might affect the action of medications on Kathy’s patients?
6. What role does patient education play in drug safety?

ANSWER

Ensuring Safe Management of Controlled Substances in the Ambulatory Care Setting

Introduction

In the ambulatory care setting, the management of controlled substances is a critical responsibility that requires careful adherence to legal regulations and best practices. Kathy Augustine, CMA (AAMA), recently hired for a primary care practice, must be well-informed about the principles of pharmacology to ensure accurate and safe medication administration. In this essay, we will explore the key aspects of managing controlled substances in an ambulatory care setting and highlight the importance of patient education in drug safety.

Understanding the Management of Controlled Substances

Legal and regulatory requirements: Kathy must familiarize herself with the laws and regulations surrounding controlled substances. This includes knowledge of DEA classifications and schedules, as well as state-specific regulations. Compliance with these regulations is crucial to prevent misuse and diversion of controlled substances.

Storage and security: Proper storage and security measures are essential for controlled substances. Kathy should be aware of the necessity to keep these medications in securely locked storage areas, with limited access granted only to authorized personnel. Accurate inventory records must be maintained to ensure accountability.

Documentation and record-keeping: Accurate documentation is vital when managing controlled substances. Kathy must understand the requirements for recording the receipt, administration, disposal, and transfer of controlled substances. These records help to track usage and maintain compliance with legal and regulatory obligations.

Learning about Medication Properties

If Kathy is not familiar with a particular medication, there are several ways she can acquire knowledge about its properties: 

Drug references and resources: Kathy can consult reputable drug references, such as the Physicians’ Desk Reference (PDR), package inserts, or online resources provided by pharmaceutical companies. These sources provide comprehensive information about drug properties, indications, contraindications, side effects, and dosage guidelines.

Continuing education and professional development: Kathy can participate in training programs, workshops, and seminars that focus on pharmacology and medication management (National Academies Press (US), 2011). These educational opportunities provide up-to-date information and allow healthcare professionals to enhance their knowledge and skills.

Collaborating with healthcare providers: Kathy can seek guidance from the healthcare providers in her practice. Physicians, nurse practitioners, and pharmacists are valuable resources who can provide insights into specific medications and their properties.

Importance of Understanding Clinical Uses of Drugs

Kathy’s understanding of both prescribed drugs and over-the-counter (OTC) medications is crucial for effective patient care. Clinical knowledge allows her to:

Provide accurate information to patients: When patients have questions about their medications, Kathy can offer precise explanations regarding the drug’s purpose, expected outcomes, and potential side effects. This empowers patients to make informed decisions about their healthcare.

Identify drug interactions and contraindications: Understanding the clinical uses of drugs helps Kathy recognize potential interactions between medications or contraindications that may exist for certain patients. This awareness enables her to prevent adverse reactions and ensure patient safety.

Transmitting Provider’s Drug Orders Electronically

In an ambulatory care setting utilizing an electronic health record (EHR) package, Kathy can transmit provider’s drug orders electronically through the following steps: 

Access the patient’s electronic health record: Kathy will navigate the EHR system to locate the patient’s profile and medication-related information.

Select the prescribed medication: Kathy will select the prescribed medication from a list of available options within the EHR system.

Verify and transmit the order: Kathy will review the order details, ensuring accuracy and completeness. Once verified, she can transmit the order electronically to the pharmacy or designated healthcare provider for fulfillment.

Factors Related to Age and Medication Action

In a primary care practice with patients of all ages, Kathy must consider various factors that can influence medication action:

Body composition and metabolism: Age-related changes in body composition and metabolism affect how medications are absorbed, distributed, metabolized, and eliminated. Dosage adjustments may be necessary for pediatric or geriatric patients.

Organ function: Age-related changes in organ function, such as renal and hepatic impairment, can impact medication clearance and dosage requirements (Marcum & Fried, 2011). Kathy should be aware of these changes and adjust medication management accordingly.

Developmental considerations: Pediatric patients may require liquid formulations or adjusted dosages based on weight and age. Geriatric patients may have comorbidities or take multiple medications, increasing the risk of drug interactions or adverse effects.

The Role of Patient Education in Drug Safety

Patient education plays a vital role in ensuring drug safety and promoting optimal health outcomes. Kathy should engage in effective patient education practices by: 

Providing clear and concise medication instructions: Kathy should communicate medication instructions in an understandable manner, emphasizing dosage, frequency, potential side effects, and any necessary precautions.

Encouraging active patient participation: Kathy should encourage patients to ask questions and actively engage in their treatment plan (Vahdat et al., 2014). This empowers patients to make informed decisions, improves medication adherence, and reduces the risk of medication errors.

Promoting medication adherence: Kathy should emphasize the importance of taking medications as prescribed and educate patients about the potential consequences of non-adherence. Utilizing tools like medication calendars, pill organizers, or smartphone applications can aid in adherence.

Conclusion

As Kathy Augustine assumes her role in managing medication administration and answering patient queries, understanding the principles of pharmacology is vital. By adhering to legal regulations, familiarizing herself with medication properties, recognizing the clinical uses of drugs, utilizing electronic prescription systems, considering age-related factors, and prioritizing patient education, Kathy can enhance medication safety and contribute to the overall well-being of the patients in her care.

References

Marcum, Z. A., & Fried, L. P. (2011). Aging and antihypertensive medication-related complications in the chronic kidney disease patient. Current Opinion in Nephrology and Hypertension, 20(5), 449–456. https://doi.org/10.1097/mnh.0b013e32834902ad 

National Academies Press (US). (2011). Transforming Education. The Future of Nursing – NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK209885/ 

Vahdat, S., Hamzehgardeshi, L., Hessam, S., & Hamzehgardeshi, Z. (2014). Patient Involvement in Health Care Decision Making: A Review. Iranian Red Crescent Medical Journal, 16(1). https://doi.org/10.5812/ircmj.12454