In our sometimes overwhelming age of digital information, our users may find any answer to their health question, but how will they know it is the right answer?
Healthcare professionals remain our users’ best and safest resource on matters regarding medication and disease. That’s why the CIUSSS has introduced RXVigilance to clinical teams throughout the network. Now staff can all refer to the same, reliable software to access information on drugs and medical conditions, which is also available in handy pamphlets to give to patients and residents under their care, and clients who turn to them for advice.
“RXVigilance is definitely an upgrade over our previous sources,” says Marie-Claude Poulin, Medication Safety Officer with the Quality, Evaluation, Performance, Ethics and Archives Directorate. Ms. Poulin notes that in the past, staff at certain sites usually referred to paper reference manuals that were kept on nursing units and in physicians’ offices, notably the Canadian Pharmacists Association (CPS) book.
The software is saved in favourites in the CIUSSS folder on the network’s intranet (Explorer) rather than through a desktop shortcut because it is updated monthly. Where another commonly used drug and pathology databank, Up-to-date, is an American reference, RXVigilance is Canadian, and therefore more ‘complete’ in the medications listed, and also bilingual. At the Jewish General Hospital, it is also possible to log into the intranet on a mobile using wi-fi, which is especially helpful for hospital physicians, points out Ms. Poulin.
A comprehensive list of medications includes individual entries for each possible dosage, as well as pharmaceutical form (for example chewable tablet, syrup or caplet). RXVigilance can be used to search either generic or commercial brands, which Ms. Poulin explains is an especially useful tool for Emergency Department clinicians, who may have patients walk in with a long list of unfamiliar brand-name medications. For the patient’s safety, before they undergo an emergency procedure or are given medication, it is important for the healthcare professional to be able to swiftly identify all of the drugs they are already using.
“I find it’s a very well-designed and intuitive research tool, clear and easy to use,” says Michelle Marcoux, who has been a nurse with Info-Santé for 10 years. “We receive calls, for instance, from women who have just learned they are pregnant, who are taking a specific medication and want to know, ‘Can I continue to take this drug without harm to the fetus?’. For the more complex questions, of course we direct them to a pharmacist, but we can see straightaway with the software if there is an absolute contraindication, and will tell them so immediately.”
“There are also times when community pharmacists are not available, perhaps overnight,” adds Ms. Marcoux. “If a parent has returned from the Emergency with a child who was prescribed a specific antibiotic at the hospital, they may ask, ‘What are the dosage intervals overnight?’. The program also gives all of the relevant information for pediatrics, regarding dosing and side effects, for instance, so it is extremely helpful.”
Patient experience surveys conducted at the Jewish General Hospital and within the Rehabilitation directorate in 2018 indicated that patients would welcome more information from staff about medication. “This tool now supports our employees to more consistently involve our users in their care by educating and informing them about medication and health matters,” notes Ms. Poulin. “By improving our inclusiveness, we are closing the loop—delivering what patients have told us they value.”
RXVigilance provides patient information leaflets that can be turned over to users, with select entries even offered in Spanish and Italian, explaining what new medications are for and identifying their side-effects. These manuals are also customizable—the healthcare professional can indicate a schedule specifying the time(s) of day the medication is to be taken, whether with a meal or at bedtime.
There is also the option to edit individual fact sheets to personalize it for the user, removing information that is not directly relevant to them and adding any other instructions or information that is needed, perhaps with respect to drug interactions. These information pamphlets can also be searched for an overview of a wide variety of medical conditions and diseases, from anemia to hepatitis, from migraines to the Zika virus.
Any of that information shared with users must be documented by the healthcare team, points out Chantal Bellerose, Coordinator of Quality, Risk Management, Accreditation and the Patient Experience. When the patient is ready for discharge or the user has reached the end of one episode in their care, the healthcare professional keeps a record in the medical chart with details about patient comprehension. “This step enhances the partnership with our user, because it helps them to become more proactive in their own care,” attests Ms. Bellerose. “It also improves the discharge process, because we can be certain of exactly the steps we’ve taken to inform the patient. It follows that we can expect a smoother continuum of care, because the next practitioner will be able to ascertain whether their patient is informed about their condition or medication.”
“It was important for our network to harmonize our medication information software because every site had its own practice,” remarks Ms. Poulin. “The use of this tool must become ingrained in our day-to-day clinical activities as part of our commitment to providing the highest quality care and services to our users within a safe environment.”
Staff who encounter technical problems using the software should request assistance from the IT department at their facility. For any questions regarding RXVigilance, contact Ms. Poulin at 514-340-8222, extension 25707.