Hello,

Our institution has been observing a recent increase in hypersensitivity reactions associated with fosaprepitant. The hypersensitivity reactions have been occurring within a minutes of infusion initiation, and has occurred with patients who have previously tolerated the infusion.

Has anyone observed any similar trends at their institutions?

Thank you,

Matthew Beaulac

Good afternoon everyone -

Women's Health services has contacted me regarding the possibility of offering IM magnesium sulfate for pre-eclampsia management in the event we are unable to obtain IV access for infusion. It has been noted that it would be reserved for exceptional cases but have a number of concerns given the concentrated electrolyte administration. If any institutions provide this pathway, can you share practices with dispensing and safeguards for administration of the therapy?

Thanks,

Alaris.

GI uses glycerin +/- castile soap with normal saline (NS) for retrograde enemas in patients with Malones. They need the ability to customize these to the patients’ needs and the current standards don’t work.
We've come up with some recommendations for standard concentrations, but apparently dont work for all patients. Our operational workflow is not optimal for Pharmacy to be be the ones to prepare leading to longer turnaround times.

Asking nursing to measure and prepare, seems to be our only option but it even looks clunky on the MAR (Cerner).

We're a pediatric hospital and unsure of the applicability in the adult hospitals. A request I hadn't seen in a long time just got asked about whether we would allow an order for MLS to be added to formula feeds. Other questions followed of course in terms of to write for it. Who would measure it? Where would the order appear so that nursing is aware of it? Would it need to appear on the MAR and of course how would it be obtained?

I'm uncertain if it would matter, but we're a Cerner shop. Would love to hear how others may be handling this.

Hello everyone,

I am a part of an integrated health care system that includes multiple academic medical centers as well as community hospitals. We are looking to establish a systemwide Medication Safety Subcommittee that would report to our systemwide P&T committee. We are hoping this subcommittee would be beneficial without duplicating work already being done at the individual sites.

I was wondering if anyone has any experience with creating a systemwide med safety committee and would be willing to share the committee charter?

I am curious if other sites are requiring an INT on all inpatient gestational patients who are either treated with medication and/or insulin. A preliminary search has been found no contraindications, but no strong evidence to support such order.

Thank you,
Sherry

We are currently only able to get Isovue (iopamidol) in 500 mL bottles - the smaller sizes we normally use are on shortage. Most of our OR cases use about 10 mL dose. Does anyone know if its OK to repack Isovue into 10 mL doses? If so, what BUD do you use? If allowed, does this need to be done in the hazardous drug cabinet? Any information provided is much appreciated!

Our organization is preparing to transition to RX Crush as our new device to use with ENFit syringes/pouches. It's been a few years since this topic was on the forum, so I wanted to reach out to learn from any organizations that have transitioned to this product.

1. Have you had issues with maintaining supplies for pouches, adaptors?
2. Are the nurses using one pouch/one syringe for each drug, or do they re-use the same syringe after flushing with water?
3. Are there lessons learned you can share with us about success/challenges post-transition?

Thanks!

Hi Everyone,

Wanted to ask what your organization's target goal is for auto-programming IV medications that are being infused via a Smart Pump (if you have bi-directional interoperability with your EMR)? Is it the same target goal as the one you use for compliance with the use of dose error-reduction systems (DERS) or do you make a differentiation?

Do you know of any national benchmark for this metric (I only can find benchmarks related to the use of DERS)?

Thank you! Much appreciated. Alex

Hi Everyone,

Wanted to ask what your organization's target goal is for auto-programming IV medications that are being infused via a Smart Pump (if you have bi-directional interoperability with your EMR)? Is it the same target goal as the one you use for compliance with the use of dose error-reduction systems (DERS) or do you make a differentiation?

Do you know of any national benchmark for this metric (I only can find benchmarks related to the use of DERS)?

Thank you! Much appreciated. Alex