1. SecureVault SecureVault DUMC North Central Pharmacy: First Dose TRAINING MODULE: 1 DUMC NCP

2. Purpose This training provides information needed to ensure accurate and consistent practices as it relates to operation of the central pharmacy SecureVault software. All transactions that occur via the central pharmacy vault will be logged through this software. DUMC NCP First Dose2

3. Order Controlled Substances DUMC NCP First Dose3 Ordering and receiving of controlled substance medications occur weekly and shall be completed in compliance with the Controlled Substance Handling Policy. 1.Orders for controlled substances are placed weekly by the pharmacist assigned to the controlled substances vault. Supplemental orders may be submitted to satisfy patient specific needs or compensate for unexpected usage. 2.A standardized order list is maintained by the pharmacy buyer at N:\IntraNet\Division\North_Central\Narcotics_Vault\CII-CIII-CV Order Sheet. 3.The order sheet is printed out and active inventory is compared to the par level on the product bin. 4.The pharmacy buyer or manager of pharmacy procurement places the order with the wholesaler. 5.Any item(s) that will not be filled or if a substitute item will need to be ordered must first be communicated by the buyer to the controlled substance pharmacist submitting the order. Alternate items will only be ordered on approval from the controlled substance pharmacist. 6.A copy of the order submitted by the buyer will be returned to the controlled substance vault and paired with the orders sheet.

4. Receiving Controlled Substances All controlled substances are delivered directly to the Controlled Substance Pharmacist in the North Central Pharmacy. To receive the inventory select Storeoom>>>Receive DUMC NCP First Dose4 1. Select Vendor (Cardinal is default) 2. Invoice# (Invoice # or shipping number if a non-cardinal vendor) 3. Ref# (Invoice # & DEA222 # for CIIs) 4. Item and select 5. Receive Qty = # of Doses Received (SKU type) Note: Bulk Liquid Bottles may be counted by the mL. 6. Click Commit 7. When all items have been entered, click Done/Print The pharmacist signs and dates the vendor invoice indicating accountability for all items and quantities listed. The invoice is forwarded to the ACPO or designee in charge of area. Any discrepancies on the order, shortage or breakage, must be documented on the invoice, and the wholesaler must be notified immediately.

5. Dispensing of Controlled Substances (ADC Batch) DUMC NCP First Dose5 Dispensing (issuing) of controlled substances is determined by the location to which the product will be issued. For cabinets below par select Daily>>>Normal Restock 1.Click UNSELECT ALL button** 2.Click RUN 1.Click on >> to bring all areas over 2.Click on Save Button 3.Click on Select, Click OK 4.For Cabinets not to be picked, UNCHECK Box 5.Click on Pick 1.Delivery Forms will print for each Cabinet 2.“Normal Restock Summary” prints last- This gives the TOTAL for the Item 1 2 3 4 5

6. DUMC NCP First Dose6 Dispensing of Controlled Substances (NON-ADC batch) The following slides how to distribute (issue) product to a non-ADC location or a single item to a cabinet. To issue a product select Daily>>>Issue 1.Select Cost Center Where Item is being sent to: a.One Time Dose: Use Patient Specific b.Omnicell Cabinets: Specific item c.NON-ADC Location 2.Select Item ( to select Item) 3.Special Instructions: Free Text Field (only if patient specific) 4.Enter Qty: Note if by the “ML” or Each 5.Click Commit – Repeat for additional items to that location 6.Click Done/Print 1 2 3 4 5 6

7. Reconciliation of Dispensed Controlled Substances (ADC) DUMC NCP First Dose7 At the completion of daily restocking of ADCs, the End-of-Cycle report is generated to check for any discrepancies between items intended for restock and items actually restocked. Select DAILY>>>End of Cycle. 1 End of Cycle Paper Work will print out Place together with paper work generated since the End of Cycle Run was run, give to pharmacist reviewing report. 2

8. Reconciliation of Dispensed Controlled Substances (Clinics) 8 Reconciliation of clinic dispensed doses occurs via the usage form at the time a clinic requests a resupply. Select Daily>>>Usage Form 1.Select Start 2.Scan or type form number 3.Correct quantity administered expired or waste 4.Select Return Form 5.If multiple items, select “No” 6.Select Done/Print 1 2 3 4 5 6 Prior to dispensing a resupply the original usage from must be returned by the clinic!

9. Expired or Destroyed Controlled Substances When an item in the vault becomes unusable due to damage or reaching its expiration the product must be removed from active inventory. Select Stockroom>>Return Of Importance is the origin of the product: If the product is part of the vault inventory follow the steps outlined below If the product is from a clinic or ADC location, the product should first be returned to the vault active inventory, then be eliminated from active inventory as outlined 1.Select Cost Center 2.Select Item 3.Return Type: Use drop down arrow to select the type of return 1.Expired: Returns Box 2.Damage: “To be Destroyed” 3.Destroyed “Red Bin” 4.Enter Quantity 5.Click Commit 6.Comment Box comes up: Enter the source/location of Item & what happened to the Item 7.Click Done/ Print 8.Expired, Waste, Destroyed sheets will print 1 2 3 4 5 7

10. Daily Counts To ensure accuracy of the vault inventory a count will be performed daily. On Monday and Friday a pharmacist will conduct a full count of all inventory items in the vault On Tuesday, Wednesday, and Thursday a Pharmacist will count all items with activity On Saturday and Sunday the technicians assigned to the C1 and C2 roles will complete the vault count The following slides will explain generation of the count sheets. Completed sheets will be filed in binders within the vault. DUMC NCP First Dose10

11. Partial Count DUMC NCP First Dose11 To generate the partial count sheets, select Output>> Reports. Print two copies of the report one for CII items and one for CIII-CV. Category = Transactions Report = Transaction Summary Active #1 1. Select Filter On 2. Select Dates Select “Last ? Hours” Enter the number of hours since the previous inventory count sheet was run (rounded to the nearest whole hour) 3. Select Start 1 3

12. DUMC NCP First Dose12 Complete Count To generate the Complete count sheets, select Output>> Reports. Category = Inventory Report = Central Inventory Worksheet 1.Select Filter On 2.Sort by Item Description 3.Select Schedule 4.Select count sheet filter a)For CII count sheet select “Equals 2” b)For CIII-CV sheet select “Is Greater or Equal to 3” 5. Select Start 1 3 1 2 5

13. DUMC NCP First Dose13 Take the quiz!

14. Questions 1. Controlled substance orders are placed weekly, but supplemental orders may be placed if needed. 1.True 2.False 2. Who is able to create controlled substances orders? 1. Pharmacy Buyer 2. Manager of Pharmacy Procurement 3. Unit Dose Distribution Manager 4. 1 and 2 5. All of the above 3. Sending an individual item to a cabinet requires the same steps in SecureVault as sending the daily restock. 1.True 2.False 4. Which of the following steps must be completed prior to resupplying a clinic location with controlled substances? 1. Returning the usage form 2. Receipt of the original usage form issued to the clinic 3. Paging the pharmacy manger 4. 1 and 2 5. All of the above 5. When generating the partial count sheets, how many copies should be printed 1. One 2. Two 3. None, they are stored electronically. DUMC NCP First Dose 14