I am reaching out to see what other facilities are doing in regards to low volume intermittent infusions in the NICU.
After our institution converted to Alaris from Medfusion Pumps in our Neonatal ICU, there was a lot of confusion on the process and questions of what is the best process for administering intermittent medications whose volumes were less than 0.8 mL (i.e., just enough volume to clear tubing + ports). We are currently priming to the baby and then running a flush at the rate of the medication however this is causing some confusion.

Hello all,

If your organization has outpatient oncology infusion centers, do you have any established metrics around error reporting? We are working with a multidisciplinary team on what that would look like and how we can normalize the data to compare sites of different sizes. Some studies report error rates per 100 clinic visits or 1,000 medication orders.

Does anyone have a similar metric for outpatient infusion error reporting?

Thanks,
Gina Gayed

Happy Friday,
Anyone successfully build an orderable to document an implanted pain pump (multicomponent) continued from home in EPIC? If yes, please can you share the order build to making it visible on the MAR and process for nursing documentation?

Thank you!

What is the return to pharmacy/ADC process look like at your institution? Do you have internal and/or external return bins for your ADCs whereby users/nurses return any unused medications to the return bin? Do you allow/expect returns to be done back to the ADC pockets by nursing? Do you have the same return process for controlled substances and non controlled substances?

Our organization is looking to move all doses of cefazolin, ceftriaxone, and cefepime to IVP. While this may work from a clinical and financial perspective, I'm concerned about the risks associated with moving from commercially-available products to pharmacy-compounded syringes (risk of error, contamination, expired product management, etc.).

Has any other large hospital or health system moved forward with this conversion and have some "lessons learned" to share with us? Thank you in advance!

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!

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.

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.

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.

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: