The package insert for vincristine recommends labeling the final product with "FOR INTRAVENOUS USE ONLY – FATAL IF GIVEN BY OTHER ROUTES". However, when they changed their labeling at the FDA's request a while back, they stopped providing the labels.

Has anyone found a company that makes a sticker with that text ("FOR INTRAVENOUS USE ONLY – FATAL IF GIVEN BY OTHER ROUTES")? I sure hope no one would try to administer solution from an IV bag intrathecally, but...

Good afternoon,

For those that are administering casivirimab-imdevimab inpatient, what monitoring requirements do you have in place? We are a pediatric institution looking to assess what level of care will be necessary for inpatient administration (med surg, IMCU, PICU, etc.)

Thank you,
Haley Grunwald, PharmD, BCPPS
Medication Safety & Quality Coordinator

Does anyone have a chemo library set up in your IV smart pump? Would you be willing to share the library? We do not have a chemo library with the historical reasoning that these medications are complicated and patient specific. We are working to improve compliance with using guardrails infusions but will never reach the ISMP goal without a chemo library. As I continue to learn, I am having trouble understanding this rationale - other than the time involved in developing the library. I am hoping that others will share their experience to help us improve. Thank you.

Carol

Good afternoon.

Does anyone use a salt/sod bicarbonate/water mouthwash for patients receiving chemotherapies that cause mucositis? How is this being managed?

We recently discovered that our oncology unit is making a solution of 1 teaspoon salt/1 teaspoon baking soda to 8 oz water, providing to the patients with instructions to swish 4 times a day. The more questions I ask, the more questions come to mind.

I appreciate any information. Thank you!

Carol

I currently lead a monthly, multi-disciplinary medication safety meeting. I would really like to change the format of the meeting from what it is to help with engagement. It currently is more of a reporting session of the previous month's events. I would love for it to allow for more discussion.
Our hospital is ~220 beds and will be adding 40 more beds within a year so discussing each error is difficult. Would any of you be willing share your current meeting formats and how you are able to get other departments involved? Thank you!

Our hospital currently implements Epic pump integration with our smart pump, when reviewing NICU CCA, our nurse currently is running any NICU fluids under "IVF plain" or "IVF additive" in the pump, for example, 1/2 sodium acetate with heparin, D5W, D10W...this has caused MAR device not scanned warning on Epic and NICU RN needs to manual entry and set up the pump.

Does your organization have all NICU fluids added to the pump drug library?

We are in the process of developing general guidelines for taking care of MCAS patients with anaphylaxis s/sx admitted to urgent care or ED from our outpatient Allergy clinic.

The key questions are what medications and doses are to be used (e.g. diphenhydramine IVP vs. infusion) and what level of monitoring is warranted.

There is a lack of good quality literature on this subject. I would greatly appreciate any insight or best practices you could share.

Thank you.

Daniel Kudryashov
Keck Medicine of USC

We are seeing more providers wanting to titrate paralytic agents to "ventilator synchrony". Our current titration goal parameter is TOF. What are your default titration goal parameters for neuromuscular blockers?

a) Train of Four
b) Ventilator synchrony
c) other

If titrating to ventilator synchrony, how do you define and measure it? Any additional insight you can provide is appreciated.

Thank you.

Daniel Kudryashov
Keck Medicine of USC

I would be interested in what your policy is if you are using DOACs for pediatric patients. Thanks in advance. Rivaroxaban is our current formulary item. We may add it to our High Alert Medication list soon...