MSOS Discussion Board

**No BUD or Expiration Date Items**

Hera Djihanian's picture

Forums: 

We have come across several items in pharmacy (such as Eucerin cream, vitamin E, Lubriderm, etc) that do not have BUDs or expiration dates. We have contacted the manufacturers for information on several of the items we identified, but I'm sure there are more.

Have you identified a list of items in pharmacy that do not have BUDs or expiration dates? How do you keep track of them? Any policy on addressing such items?

Thank you!

Propofol treated as a controlled substance

Tina Marie Collins's picture

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Do any of your organizations currently treat propofol as a controlled substance? If so, speak to how it is handled both inside the pharmacy and outside the department (in the ADCs).
If you do not, please discuss what processes you utilize to decrease potential diversion.

Informing Staff of Handling Hazardous Drugs

Prad B. Ananthasingam's picture

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Does anyone have any exact verbiage to use to inform staff that they are handling hazardous medications? we are wondering if anyone has already had employees sign an attestation that they know they are handling HDs. If anyone can share how they informed staff and if they have documents that they had staff sign.

Intravenous lidocaine for pain management

Jacyntha Sterling's picture

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1. Does your facility permit intravenous lidocaine for pain management?
2. How is it dosed/provided?
3. What kind of monitoring is required?
4. Does it have any formulary restrictions?

Some prescribers have expressed interest in intravenous lidocaine as an opioid alternative in some emergency department patients and some inpatients. Although this has been evaluated in some clinical trials, this indication is currently not listed as a use in our primary drug information/formulary reference.

Investigation template

Joanie Cook's picture

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Hi there, does anyone use a standard template for investigating/following up on potentially preventable events, and/or is anyone willing to share your ideas? We're thinking about using a template that we would email to individual pharmacy staff members if they may be familiar with a reported event. In-person communication is preferred but we can't always to that. Maybe something like this:

independent double check policy: what to check?

Jacqueline Kao's picture

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Hello,

What does your institution's policy specify with regards to what is reviewed during a nursing independent double check? The 5 rights, 7 rights, or more? Does the 2nd nurse checking the primary nurse's medication check fewer "rights," such as indication?

Thanks!

SMOF Lipids

Natalie Kuchik's picture

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Hi.

Our nursing staff especially in NICU is experiencing issues with administration of SMOF lipids. It looks like every time they have to pause SMOF infusion to administer intermittent medication, they have issues restarting the infusion. They have to troubleshoot and even sometimes disconnect the lines.
Does anyone experiencing the same issues?

Thank you

preventing look-alike antibiotic syringe mixups

Julie Kindsfater's picture

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Any novel ideas beyond segregating storage, tallmanning, different syringe sizes, and barcode scanning? I am part of recently merged health care organization. Half used to color code ceFAZolin 1 and 3 gram and cefTRIAXone 1 and 2 gram syringes, the other used white labels.

I tend to be in the white label camp along w/ISMP to force people to read/not foster reliance on color, but also see the value that colors help you see if one syringe is misstocked in the wrong bin and you can match syringes to color coded bins in addition to barcoding.

Alaris pumps - "communication error"

Diane Schultz's picture

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We are experiencing an increase in events in which our Alaris infusion pumps abruptly stop delivering medications with the alarm stating "Communication Error". These are not during transport, but while patients are receiving in-room infusions. We are currently working with the manufacturer to investigate. It is unclear at this time if these events are tied to current recalls on these pumps.
Is anyone experiencing this type of error? Our immediate mitigation is to increase our pump par level on the units in case they need to be switched out quickly. Thank you.

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