Hi all,

Our organization has seen a pattern of paclitaxel precipitation specifically in the infusion set. This is despite using non-PVC bags, low sorb tubing, compatible CSTD (ChemoClave), and appropriate final concentrations within the PI recommended of 0.3 to 1.2 mg/mL.

Have other institutions been experiencing this and do you have any strategies to prevent precipitation during either the preparation or administration phase?

Thank you!

If you are using leech therapy. What policies and procedures do you have? In terms of how the pharmacy stores and dispenses. Also, what are your nursing procedures around application of the leeches?

question for the group regarding concentrated oral opioids (e.g., morphine 20 mg/mL and oxycodone 20 mg/mL):

1) which concentrated oral opioids do you keep on formulary?

2) are they restricted to comfort care?

3) if not restricted to comfort care, any use restrictions?

Sandy Hammer, PharmD, BCPPS | Cottage Health

Medication Safety and Quality Pharmacist Specialist

Office 805.569.8379 Mobile 541.905.3143

Hello MSOS Group,

With the recall of the nasal epinephrine 30 mL vials with the removable cap to allow pouring into a bowl in the OR to facilitate soaking pledgets for ENT surgery cases, what are other sites doing instead?

These pourable bottles have previously been featured in ISMP newsletters in lieu of stocking the injectable 30 mL vials which have been involved with accidental IV administration during these cases.

Is anyone using the Neffy spray to spray onto the pledgets? Other alternatives?

Thank you,

Lynda

Hello all.

Our organization is evaluating opportunities to improve BCMA compliance associated with saline flushes.

Some ideas that we have include:

1. Eliminating the barcode scanning requirement
2. Removing saline flushes from BCMA compliance reports
3. Modifying the scanning frequency from qshift (i.e. q8hrs) to q12hrs (scheduled times TBD)

Have your organizations encountered similar challenges and if so, what strategies were implemented/successful in improving BCMA compliance?

What pitfalls should we consider in our decision?

Does anyone have a link to insulin luer lock syringes that are currently available. We typically use BD products, but it looks like the BD one was maybe discontinued? Thank you!

Does anyone have a policy for medication patch use specifically for the behavioral health setting?

Thanks!
Rachel

See attached.

I'm interested in hearing if those who have used Emerphed syringes (ePHEDrine 25 mg/5 mL) from Nexus received reports of difficulty administering. Specifically, the syringe connects via Luer but solution is not able to be pushed through the tip. We reported an event to Nexus in February and they responded that they haven't received any similar reports and will monitor. We recently experienced an additional event and are now looking at alternatives.

Hello All,

Our current orders for long-acting insulins include an order question prompt "If NPO:" with options of Give dose as ordered, Contact provider for instruction, Decrease dose by: 25% or 50%, and Other (see instructions). The response defaults to "Decrease dose by 50%." The orders also have admin instructions that state "If the patient has a future NPO order, use the reduced dose starting 12 hours prior to the NPO order. Continue the reduced dose while patient is NPO. Resume full dose when a diet is resumed."