This is an idea and suggestion for ISMP, open for discussion. Please add your thoughts and insights.

Hi all,
Given Akorn's bankruptcy, alfentanil is no longer available after being on shortage for 6 months+.

ASHP shortage website has no alternatives.
https://www.ashp.org/drug-shortages/current-shortages/drug-shortage-deta....

Do any of your clinic sites stock and administer Triptodur (triptorelin)? If yes, how do you maintain compliance with USP 800 in the clinic setting knowing this administration system requires manipulation and is not a closed system? I am aware that future NIOSH suggests this will be moved to table 2, but to be compliant now, what are your sites doing?

Since patient pain rating is subjective data, the American Society for Pain Management Nursing states that “the practice of prescribing doses of opioid analgesics based solely on pain intensity should be prohibited.” At our facility our nursing team would like to remove this practice by transitioning to allow other patient specific factors to also be assessed for more individualized pain regions. However, removing pain scale verbiage within PRN orders and maintaining compliance for nursing administration has been a challenge for our team.

Good morning! We are inquiring with other children's hospitals to find out if a parental consent is required for Synagis (palivizumab) administration. We currently require consent using an immunization consent form, but we are reviewing the current process to possibly remove the requirement for consent.

We are planning to improve ADR documentation on the patient electronic medical record.

Currently on our practice ADR is being documented under the Allergy section. (we are using Cerner)

I want to know how do you document ADR on your practice?
Is there a specific section for it? (Other than the allergy)
And Who’s responsible to document ADR?

I’ll appreciate if you can share a screenshot of your ( ADR Alert) window.

Thanks

Looking for those that use Cerner that can provide any details as to how you manage sharing a medication history platform with your provider offices. This is in regards to the prescriptions that populate on the medication history (RX bottle icon) versus the scroll entries that are not actual prescriptions. We are seeing prescription entries hang out in the med history that patients are no longer taking.

We are an ambulatory care pharmacy within a clinic that has an opioid use disorder program. The clinic is in the process of revising their procedures.

Pharmacy is looking for perspectives on the standard of care regarding maximum daily dose of suboxone. Are other pharmacies noting chronic use of greater than 24 mg/day?

Hello,
Do you utilize protocols in the Ambulatory setting? If so--could you give a few examples? Do you use an "Initiate Protocol" order?

We have several inpatient protocols, but have some providers interested in expanding to the ambulatory space.

Thanks,
Stacie Ethington MSN, RN
Nebraska Medicine

Hello All,