MSOS Discussion Board

Quality Assurance - Hospital Pharmacy Operations

RAYA ALZAYADEEN's picture

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Dear safety partners

I am trying to establish a quality assurance program in pharmacy with a focus on operations and production, addressing different stages of the medication use process. Appreciate sharing any resources or examples you may have Raya_z@hotmail.com

Epidural Tubing Shortage - BD Alaris Pumps

Sarah Gallup's picture

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We currently use the BD Alaris PCA pump module for epidural administration. Our purchasing team is telling us there is not a yellow striped epidural tubing set available for use. They went on backorder awhile back and now we're being told there isn't an option to use with this pump module that has the stripe at all. Anyone else use this pump for epidural administration? What tubing are you using? Thank you!

Epinephrine kits - errors

Julie A DAmbrosi's picture

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With the ongoing shortage of epinephrine "bristojets" and recall of 503b 1 mg/10 ml syringes, we are discussing potential failures of stocking epinephrine kits (containing epinephrine 1 mg/ml vial/ampule, sodium chloride for dilution to 10 ml, syringe with luer lock, filter needle, alcohol wipe, and preprinted syringe label for diluted product) in code carts for cardiac arrest events. What failures have other institutions considered/seen in practice? This epinephrine preparation is NOT intented for anaphylaxis as we have EpiPens widely available on all patient care units.

Controlled Substance Documentation

Sherstin Willyerd's picture

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In regards to controlled substance drips and PCAs, I was wondering how your facilities view/calculate the amount used within the shift or within 24 hours. We have Cerner for an EHR. Nursing and pharmacy are doing a lot of manual calculation to figure out the total 24 hour mg used. Our main purpose is to be able to easily see all the controlled substance use and waste to ensure that we can make accurate clinical adjustments in dose. Our biggest concern is with intubated or hospice patients that are the most likely to use pain and/or sedation drips.

Expedited Partner Therapy (EPT)

Kelsey Keeley's picture

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The New York State Department of Health recommends Expedited Partner Therapy (EPT) to facilitate partner management among individuals diagnosed with chlamydia, gonorrhea, and/or trichomoniasis -- it's the clinical practice of providing individuals
with medication or a prescription to deliver to their sexual partner(s) as presumptive treatment for a STI, without completing a clinical assessment of those partners.

Do any of your facilities have established workflows for EPT that you would be willing to share?

Thanks in advance!

Pain / Opioid Committee

Manisa Tanprayoon's picture

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Dear Members,

At my institution, our pharmacy has been asked (by Regulatory & Quality Department) to take over the lead of the Pain/Opioid Committee. I would like to ask how your organizations structure this committee/taskforce. For example: who is the chair/co-chair? Which departments participate in this committee. Meeting objectives and agendas...etc. Thank you in advance for your time.

Manisa

Compliance goals in Emergency Department

Stacie Ethington's picture

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For those of you that utilize BCMA and Pump Interop in your Emergency Departments, what goals have you set for compliance %? We recognize the ED is a unique environment and want to help them set realistic goals.

Thanks!
Stacie Ethington MSN, RN
Medication Safety Nurse Specialist
Nebraska Medicine

Alerts Optimization Team- structure and

Laura Frantz's picture

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Hello!

Our system Alerts Optimization Team is lead by Medication Safety in partnership with Clinical Informatics/ Willow (Epic). We are re-evaluating our committee structure and scope, and plan to develop a charter. If you have a charter in place for your alerts/Clinical Decision Support team, would you mind sharing your charter with me at lrfrantz@novanthealth.org? Please provide brief responses to the questions below:

MAR warning messages - Hazardous Medicines - Occupational Exposure

Andrew Sobey's picture

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Dear all,

We're interested in what advice other health services provide on their EMR/MAR in relation to the occupational risk posed by cytotoxic and other hazardous medicines.

- Are MAR notes or labels used?
- How is it presented?
- Is PPE advice provided?
- Do you link to external resources for this information?
- How is this information maintained (e.g., for new medicines)?

Any other advice is appreciated.

Kind regards,

Andy Sobey
Electronic Medication Systems Pharmacist
Canberra Health Services

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