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?