Happy Monday!

I just had general inquiry that I would like some input on. To preface, I am at a large pediatric institution that currently dispenses insulin pens to all patients requiring doses. This could potentially result in administration errors and poses a significant cost-implication. Accordingly, we are looking to transition all basal insulin doses (i.e. detemir, glargine) to be prepared by the central pharmacy in subcutaneous syringes. This recommendation has been acknowledged by the ISMP in 2017.

Hi All,
Does your hospital require administration of IRB medications via Smart Pump? If so, how is the IRB IVPB or continuous medication built in the pump?

We are curious as to whether there is a better process than what we currently have.

We do not have interoperability yet, but we do have Alaris as our Smart IV Pump. We had built a generic IRB medication as a fluid, but received complaints recently from some nurses that they are unable to run IRB IVPBs as a secondary because of the constraints of the fluid build.

Thank you and stay safe!
Susan

Good morning everyone -

Our smartpump committee would like to develop a Guardrail "how-to-guide" to assist the various pharmacist, residents, and others involved in helping us develop library items for new products that may not be familiar with the components of the system. If anyone has already developed something like this and is willing to share the reference, we would greatly appreciate it.

Thanks,

Amaris

Does your facility allow you use a longer BUD than is stated in the PI of a sterile product if there is a published reference for it (and it does not exceed USP 797 guidelines)? Example: the PI for Ferrlecit brand sodium ferric gluconate in complex (and the Hikma generic product) says to "use immediately" after dilution. There is an article published in Current Medical Research & Opinion that shows a generic Sodium ferric gluconate in complex product (Nulecit) is stable for 24 hours at room temp and 7 days refrigerated (0.625 mg/mL and 1.25 mg/mL in NS).

I am trying to convince my oncology RNs and RPhs that we do not need to pump exact diluent volumes into an empty bag for most chemotherapy. Our practice has been to pump exact volumes for chemo that is infused over several hours, all peds chemo, and IVPBs with large med volumes. Their rationale was that the unknown amount of overfill in the bag could cause the infusion to last an extra hour or 2, which turns into many hours for a 5 day chemo regimen. I consulted Dennis Tribble's blog post on ASHP titled "The Illusion of Accuracy".

We have the ability to give subcutaneous hydration therapy after preparing the subcutaneous space using hylenex. Does anyone have information on medications that can be given via this route? If you have policies to share I would appreciate it.

Does any organization include monoclonal antibodies (regardless if they are being used for oncologic indications) on their High Alert policy?

We are working on providing data as far as how we are doing in common medication safety metrics, but for many items I am struggling with finding benchmark goals, which are being requested from upper management. For example, we use ISMP's guidance for Alaris Guardrail use and aim for a target goal of 95%, for BCMA we use Leapfrog which has 95% for patient and med identified.

I am curious what others are doing for goals for the below metrics.... Am also curious the size and scope of your organization in order to compare.

We are working on providing data as far as how we are doing in common medication safety metrics, but for many items I am struggling with finding benchmark goals, which are being requested from upper management. For example, we use ISMP's guidance for Alaris Guardrail use and aim for a target goal of 95%, for BCMA we use Leapfrog which has 95% for patient and med identified.

I am curious what others are doing for goals for the below metrics.... Am also curious the size and scope of your organization in order to compare.

Hi everyone,

We are working on removing promethazine injectable from our formulary. I am curious if your institution has done any of the following:
A. Removed promethazine injectable from formulary entirely and do not use non-formulary
B. Allowed injectable promethazine to be used for IV if diluted in pharmacy only
C. Allowed promethazine injectable to be used for IM but not for IV use
D. Removed promethazine from formulary but still allow for use under specific criteria (i.e. cyclic vomiting or refractory to other antiemetics)