What are others doing to get phenobarbital loading doses to the bedside STAT?

We are facing the challenge of RNs needing 10+ vials of phenobarbital to get a loading dose into patients and weighting the risk/benefit of compounding at the bedside versus in the IV room. With the guidelines specifying a maximum # of components per preparation we are running into the challenge of immediate use compounding at the bedside versus creating a faster STAT turn around time through the central pharmacy...

thanks Jess

Jessica Rogers, PharmD, BCPS

Does your site require a "Chemo Competent RN" to administer non-hazardous monoclonal antibodies for non-oncologic indications (i.e. rituximab)? We currently do, but this practice is being questioned due to causing delays in patient care.

I'm not finding a reference/consensus statement published anywhere, but the few orders I have found refer to required RN training in monoclonal antibody administration.

Any feedback would be greatly appreciated! Thank you.

Good morning,

If your organization has converted to ENFit:
1. Is your outpatient pharmacy supplying any ENFit disposables (syringes, adapters, bottle transfer lids, etc.)?
2. If so, are these items being charged to the patient or are the items provided as part of the prescription?
3. At discharge from inpatient, are any supplies provided?

My organization converted in October 2020 and as more facilities in our region convert, the need for certain disposables has changed as patients become more saavy with the connections. I appreciate your input.

A recent question was asked:

Which infused medications(FDA approved medications and not investigational) require patient consent?

What regulation(s) require the consent? I understand this may be federal, state or locally driven but I am having a difficult time finding the federal regs. Is there a source that defines the medication classes that require the consent?

We are attempting to hardwire feedback of errors across our system (or at least within our department). One aspect is when/how we communicate back about a specific error. Regardless of if we had human error and system-level influences, the person who made or at least contributed to an error needs to be made aware. During these feedback sessions, system-level contributions that can be worked on are uncovered. While this occurs with the vast majority of errors that have some sort of Pharmacy contribution, we cannot verify that it happens 100% of the time.

Does your institution routinely monitor narcotic prescribing practices by your providers to determine appropriateness or outliers? If yes, please provide some details of what your monitoring program entails. Thanks!!

Wanted to compare practices across organizations regarding required baseline laboratory monitoring for anticoagulation in response to the Joint Commission National Patient Safety Goal (NPSG) for anticoagulation.

Hello!

I was wondering how facilities handle orders/authorization for medications to be administered outside the established administration window. Are nurses able to do this for certain meds (i.e. non-time-critical) per their discretion? Is a provider's order required each time a med is to be administered outside of the admin window? If so, how is that implemented in a CPOE environment? Any information you have is greatly appreciated! Thank you!

Amber Lorenzen, PharmD

Have had multiple areas in our organization requesting to use aromatherapy (QueaseEase) for nausea. Our understanding is that the Joint Commission expectation is that aromatherapy used for specific therapeutic purpose would be considered a medication and would need to be treated as such.

Would like to hear how others have addressed this issue--including formulary management approach, supply from pharmacy or from warehouse/storeroom, policies/procedures.

Thanks!

Don

Have had multiple areas in our organization requesting to use aromatherapy (QueaseEase) for nausea. Our understanding is that the Joint Commission expectation is that aromatherapy used for specific therapeutic purpose would be considered a medication and would need to be treated as such.

Would like to hear how others have addressed this issue--including formulary management approach, supply from pharmacy or from warehouse/storeroom, policies/procedures.

Thanks!

Don