Just in Time POD Training Part 2

1

• Just in Time POD Training Part 2
• Roles and Responsibilities

2
Facility Manager

• Employee of the physical facility (e.g. school
  system employee) with adequate knowledge of
  building layout and access to available
  equipment, systems and utilities.

3
POD Manager

• Coordinates and manages all functions required
  to set-up, operate and demobilize a POD through
  the Department Operations Center at JCDH

4
POD Manager

• Duties include but are not limited to
• Staff direction
• Coordination with EMA and JCDH management
• Coordination of support services (food, supplies)
• Working with facility owner/manager
• Maintain client throughput by adjusting POD flow
  as needed
• News media (as directed by PIO)

5
Triage Clinicians

• Every client/representative must go through
  Triage to determine where medication will be
  dispensed
• MD/CRNP/RPh will triage and mark/initial
  appropriate drug for Express dispensing
• DUR, Family and Support Services will be referred
  to expedite the triage process

6
Clinician in Charge

• Duties include but are not limited to
• Staff assignments, orientation and JITT (Just in
  Time Training)for triage clinicians
• Communicates staffing and supply needs to POD
  manager
• Functions as Triage Clinician if needed
• Maintains smooth flow of operations
• Makes appropriate referral if client cannot
  receive medications available at the POD
• Functions as First Aid/Emergency medical services
  if needed
• Assists with demobilization

7
Team Leader-Clinician

• Duties include but are not limited to
• Assist Clinician in Charge with staff
  assignments, orientation and JITT for triage
  clinicians
• Communicates staffing and equipment needs to
  Clinician in Charge
• Maintains smooth flow of operations for the team
• Functions as Triage Clinician
• Monitors team for S/S (signs/symptoms) of stress
  and fatigue
• Coordinates breaks and lunch with Clinician in
  Charge
• Assists with demobilization

8
Clinician

• Reviews client history form for completeness
• Determines and documents what dispensing line
  client should be directed to
• If EXPRESS-determines, documents and initials
  medication(s) to be dispensed according to the
  ADPH Algorithm and directs client to a Guide
• If Support Services, Family or DUR- marks form
  and directs client to a Guide

9
Nurse in Charge

• Coordinates with the POD manager and EMA to
  help prepare the site for client assessment and
  dispensing operations-may also function in a
  regular nursing role

10
Nurse in Charge

• Duties include but are not limited to
• Staff assignments, orientation and JITT including
  appropriate labeling and documentation of
  medication dispensed
• Communicates staffing and equipment needs to POD
  manager
• Maintains smooth flow of operations
• Monitors nursing staff for S/S of stress and
  fatigue
• Schedules breaks and lunch
• Fills in as needed in any other nurse position
• Assist with demobilization

11
Team Leader-Nurse

• Duties include but are not limited to
• Functions in the nursing role
• Assists Nurse in Charge with staff assignments,
  orientation and JITT including appropriate
  labeling and documentation of medications
  dispensed
• Communicates staffing and equipment needs to
  Nurse in Charge
• Monitors team for S/S of stress and fatigue
• Coordinates breaks/lunch with Nurse in Charge
• Assists with demobilization

12
Dispensing Nurses-Express

• Reviews client history form and determines if
  antibiotic chosen is appropriate (e.g. Client has
  marked allergy to Cipro and Cipro has been
  ordered-take the client history form to the Nurse
  Team Leader)
• Provides abbreviated counseling to client and
  reinforces verbally the importance of completing
  the entire regimen and follow-up instructions

13
Dispensing Nurses-Express

• Answers any client questions
• Instructs the client to sign the client history
  form
• Completes documentation and labeling including
  BCP precaution sticker
• Dispenses medication, drug information sheet and
  PCP referral form (green form)
• Requests supplies as needed using Supplies
  Needed Sign

14
Dispensing-Family

• Client history form will be reviewed by
  Pharmacist/Pharmacy Student and appropriate
  medication determined
• Review Doxy crushing instructions and dosing
  chart based on weight for children. If weight is
  unknown, estimate.
• Mark appropriate dosage on the instruction sheet
  and include each childs name
• Provide abbreviated counseling to client and
  reinforce verbally the importance of completing
  the entire regimen and follow-up instructions

15
Dispensing-Family

• Answer any client questions
• Instruct client to sign client history form
• Complete documentation and labeling
• Dispense medication with drug information sheet
  and PCP referral form (green form) at
  Pharmacists direction

16
Dispensing-Support Services

• Social Worker, Interpreter or other POD worker
  may provide assistance as needed in this area
  (such as completing client history form,
  assisting with translation or help with
  unaccompanied minors)
• Client history form will be reviewed by
  Pharmacist or Pharmacy Student and appropriate
  medication determined
• Provide abbreviated counseling to client and
  reinforce verbally the importance of completing
  the entire regimen and follow-up instructions

17
Dispensing-Support Services

• Answer any client questions
• Instruct client to sign client history form
• Complete documentation and labeling
• Dispense medication with drug information sheet
  and PCP referral form (green form) at
  Pharmacists direction

18
Clinical Supply Coordinator

• Answers directly to POD Manager
• Supervises runners
• Establishes separate storage area for supplies
• In charge of all drugs, forms, supplies and
  equipment
• Receives, organizes and documents drugs/supplies
• Maintains adequate security in drug/supply area
• Coordinates replenishment orders
• Coordinates breaks and lunch for supervised staff
• Assists with demobilization

19
Runners

• Watch for Supplies Needed signs to be displayed
  at any station
• Provide supplies as requested
• Recycle POD items as needed
• Report any problems with supplies to Coordinator
• Assist with any additional needs identified
  including the Support Services area

20
Social Worker in Charge

• Responsible for JITT and supervision of
  non-medical staff, including volunteers if
  utilized
• Monitor individuals exhibiting extreme signs of
  distress, including staff
• Make appropriate referrals if needed
• Provides assistance with support services
• Assist with client flow if needed
• Provide staff support if needed
• Coordinates breaks and lunch with supervised
  staff

21
Social Worker

• Monitor individuals exhibiting extreme signs of
  distress, including staff
• Make appropriate referrals if needed
• Provides assistance with support services
• Assist with client flow if needed
• Provide staff support if needed
• Coordinates breaks and lunch with supervised
  staff

22
Clerk in Charge

• Coordinates POD worker registration process (this
  includes sign in/sign out and vest pick
  up/return)
• Responsible for JITT and supervision of clerks in
  all areas of the POD
• Maintains clerical supplies (clipboards, forms,
  pens, etc.)
• Ensures signage is properly displayed
• Maintains staffing/shift rosters
• Observes clerks for signs of stress/fatigue
• Schedules regular breaks
• Assists with demobilization

23
Team Leader-Clerk

• Assists Clerk in Charge with POD worker
  registration process
• Maintains clerical supplies (clipboards, forms,
  pens, etc.)
• Ensure signage is properly displayed
• Observe clerks for signs of stress/fatigue
• Coordinate breaks and lunch for clerical staff
  with Clerk in Charge
• Functions as a Clerk

24
Clerk

• Assists with POD worker registration process
• Assist clients with the registration process-this
  includes forms, educational material, pens,
  labels for medication
• May assist clients with completion of form
• Directs clients to Greeter and POD entrance
• Maintain clerical supplies-request additional
  supplies from runner as needed

25
Greeter in Charge

• Duties include but are not limited to
• Staff assignments, orientation and JITT for
  Greeter staff and Team Leaders
• Communicates staffing and equipment needs to
  Social Worker in Charge
• Maintains smooth flow of operations (this may
  include areas outside of the POD)
• Coordinate breaks and lunch for supervised staff
• Fill in as needed in Greeter position
• Assist with demobilization

26
Greeter in Charge

• Note For this exercise only, the Greeter in
  Charge will be responsible for Traffic Control
  and will answer directly to the POD Manager. In a
  real event, traffic control would be the
  responsibility of the Local Law Enforcement
  Agency.

27
Team Leader-Greeter

• Duties include but are not limited to
• Assisting Greeter in Charge with staff
  assignments, orientation and JITT for Greeter
  staff
• Communicates staffing and equipment needs to
  Greeter in Charge
• Maintains smooth flow of operations (this may
  include areas outside of the POD)
• Functions in the Greeter position
• Assists with demobilization

28
Greeter

• Greet clients as they arrive and answer any
  initial questions
• Direct client flow to appropriate areas (may
  include areas outside of the POD)
• Identify any issues or needed assistance that may
  need to be addressed
• Assist in any other area as directed by Greeter
  in Charge

29
Guide in Charge

• Duties include but are not limited to
• Staff assignments, orientation and JITT for Guide
  staff and Team Leaders
• Communicates staffing and equipment needs to
  Social Worker in Charge
• Maintains smooth flow of operations-(this may
  include areas outside of the POD)
• Coordinate breaks and lunch for supervised staff
• Fill in as needed in Guide position
• Assist with demobilization

30
Team Leader-Guide

• Duties include but are not limited to
• Assists Guide in Charge with staff assignments,
  orientation and JITT for Guide staff
• Communicates staffing and equipment needs to
  Guide in Charge
• Maintains smooth flow of operations-this may
  include areas outside of the POD
• Coordinate breaks and lunch for supervised staff
• Functions in Greeter position
• Assists with demobilization

31
Guide

• Serves as gatekeeper and admits clients into
  appropriate areas as they become available
• Assists with client flow-notifies Guide in Charge
  of any problems (bottleneck)
• May escort clients needing assistance to the
  appropriate area

32

• Forms

33
Client History Form
This form is available at http//adph.org/CEP/asse
ts/SNS_NAPH_Form.pdf
34
Forms Review Flow Chart
35
Notification to Primary Care Provider
36
Referral Form
37
Doxy client Information Sheet
38
Cipro client Information Sheet
39
Doxy Crushing Instructions
40

• Labeling and Documentation

41
Doxycycline 100mg

• SNS label includes
• Name of Drug
• Strength
• Dosage
• Quantity

42
Doxycycline 100 mg

• SNS tear off label
• for client History Form
• Includes
• Name of Drug
• Quantity Dispensed
• Lot Number
• Expiration Date
• Prescription Number
• National Drug Code

43
For this exercise.

• Colored-coded labels (shown below) will be used
  to simulate the SNS tear off label. Do not tear
  off SNS label.

Doxycycline 100 mg 20 tabs
Ciprofloxacin 500 mg 20 tabs
44
Labeling for Dispensing
This label will be provided at registration-client
will write in name. In a real event, this label
would be affixed to the medication bottle, but
not for this exercise.

• ADPH-Donald Williamson, MD
• Emergency Prescription-June 5, 2014
• For questions call 1-866-543-9899
• client________________________

45
Labeling for Dispensing
This sticker will be added to medication if
client marks Yes to Birth Control Pills
This Antibiotic may decrease the
effectiveness of birth control pills
46
Documentation

• Client history should be completely filled
  out. This includes client name, address, phone
  number and medical history on each person
  represented on the form. Weights and birthdates
  for children may be estimated. Forms should be
  checked at every step of the POD process for
  completion. Form must be authorized and signed by
  the client picking up the medications at the time
  of dispensing.

47
Documentation
At Triage, the Clinician will determine if the
client and all household members are eligible to
receive medication through EXPRESS dispensing. If
so, the clinician will determine the medication
to be dispensed, circle it and initial. Then
he/she will circle EXPRESS at the bottom of the
form and send the client to a Greeter. Clients
not eligible for EXPRESS dispensing will be sent
to the appropriate line for dispensing by a
Pharmacist.
48
Documentation

49

• Documentation
• The Dispensing Nurse or Pharmacist will have the
  client sign the form, apply the appropriate label
  for the medication dispensed, print and sign
  his/her name, fill in POD location and date.

50
(No Transcript)
51
(No Transcript)
52
(No Transcript)
53
Questions?

• Call or email
• Julie Cobb, RN
• Jefferson County Department of Health
• Emergency Preparedness and Response
• 205-558-2124
• Julie.cobb_at_jcdh.org