Poison information center
Poison information center
Content
• Importance of having a PIC and its various functions
• Organization of a PIC
Objective:
After completion of this lecture, student will be able to:
• Describe the importance of having a PIC and its various functions
• Describe the organization of a PIC
Definition
• Provision of information regarding the identification and treatment aspects related to poisoning with any compound
Reason for establishing PIC
• To end accidental poisoning deaths in children
• To provide rapid access to information valuable in assessing & treating the poisoning
• To assist with poison prevention
Functions
• Assess and make treatment recommendations during poisonings
• Provide public and professional educational programs
• Collect & analyze the data on poisoning
• Perform research
• Assist public and healthcare providers during hazardous material spills
Differences between DIC & PIC
a) Clientele
DIC -- HCP (only 10% from public)
PIC -- Public (88%)
b) Call volume
DIC -- < 7 calls /day
PIC -- 103 calls/day/regional center (range: 33 to 213)
c) Administration difference
i) Hours of operation
DIC: 9 AM to 5 PM on weekdays
PIC: 24 hours a day year round
ii) Cost
DIC: Less expensive
PIC: More expensive
iii) Staffing
DIC: Pharmacist, Less number
PIC: Pharmacist / Physician / Nurse, More number
iv) Funding
DIC: Sponsoring hospital/medical centre
PIC: Public/ industry contacts / organized donation program
d) Procedural difference
i) Response time
DIC: Average 15 to 30 minutes (may extend to days)
PIC: Immediate response (average time --5 minutes)
ii) Call complexity
DIC: More complex
PIC: Less complex
iii) References
DIC: Less number of references
PIC: More number of references
iv) Documentation (DIC & PIC)
• General epidemiological data (date, time & reason)
• Caller characteristics (site and place)
• Patient characteristics (age, sex, pregnancy)
• Exposure characteristics (substance, route and site of exposure)
• Clinical course (clinical status, medication given)
• Medical management (therapeutic intervention)
Organization of PIC
In organizing a PIC, consider “ideal human exposure call volume” anticipated
a) Personnel
• Is important element of PIC
• Needs unique qualifications and training
• Has distinct responsibilities
i) Medical director
• Responsible for all medical aspects of PIC’s operation
• Regular review of and authorization of all poisoning management protocols
• Authorization of poison center polices and procedures
• Participation in staff training
• Provision of an-call clinical support for PIC staff
• Participation in quality assurance activities
• Liaison with local medical societies, physicians
• Promotion of research
• Co-ordination of professional educational efforts
ii) Manager/supervisor
• Pharmacist/ physician/ nurse with training in the area of clinical toxicology
Duties:
• Budgeting
• Purchasing
• Staffing schedule
• Staff supervision
• Staff training
• Maintenance of continuous quality improvement program
• Development of departmental policies/ procedures
• Preparation of administrative reports
• Media response
• Professional education
• Co-ordination of program with the sponsoring entities
iii) Poison information specialists
• Backbone of PIC
• Directly interact with HCP and patients
• PI specialist must be both clinicians and counselors
• Pharmacist / nurse are suitable
Duties:
-Elicit complete history
-Assess correctly the severity of exposure
-Provides management plan
-Proper communication
-Follow up
iv) Public Education Co-ordinator
• To reduce the incidence of accidental poisoning in their service areas by teaching /educating public how to prevent poisonings
• Should have a background in education and media communication and experience as PI specialist
Duties:
• Development, distribution and evaluation of poison prevention programs and materials
• Co-ordination of regularly occurring public education messages through the media
• Networking with schools and other organizations to provide cost-effective public education
• Co-ordination of poison prevention through poison information specialist
v) Other personnel
• Secretarial staff
• Volunteer
• Postdoctoral fellowship
• Attender
(b) Facility consideration
i) Location
» Can be anywhere (but there should be access to telephone)
» Ideal location is adjacent to emergency department
» Other locations include library, pharmacy & schools of pharmacy
ii) Space
• 100 to 200 square feet/ workstation
• Room for director / supervisor – should be adjacent to work place
• Rest room
• Proper ventilation, lighting, aeration & furniture etc
(c) Equipment's
• Telephone system – enough incoming lines (3 way calling)
• Computers
• Fax machine, Internet, filing cabinets
• Refrigerator (if not located near cafeteria)
• Shelving to store articles and books
• UPS/ generator
(d) Resources
• Primary
• Secondary
• Tertiary
• Online data
(e) Policies and Procedures
• It may vary from center to center
• Method of operation
• Position of each persons and responsibilities
(f) Training of PI specialists
Centre should provide training to staff in the following area
(i) Clinical toxicology
(ii) Communication
(iii) Information retrieval
(iv) Data collection/coding
(v) Critical thinking
(vi) Handling of telephone and other equipments
Performance evaluation
Staff
• Knowledge
• Skills
• Retrieval
• Communication
Quality Improvement Program
• To assess the level of performance of PIC
• To meet the demands of the need of the public/ health care providers
• If the demands are not met ,Centre should develop:
-Strategies and policies,
-Implement and re- assess in order to promote or increase the level of performance
Summary
• Provision of information regarding the identification and treatment aspects related to poisoning with any compound
• Functions of PIC
• Difference between PIC AND DIC
• Organization of PIC
• Quality improvement programs
0 Comments: