We are discussing SDS reference requirements and have a couple of questions.

1. Do you have SDS sheets online or in print?

2. Do you require printed copies of any of the following to be available?
Chemicals (e.g. bulk raw chemicals cleaning supplies), Medications
Hazardous (RCRA) medications

3. Which online databases do you use?

4. Who stores/maintains printed copies?
Nursing/patient care area
Pharmacy

If you have a policy to share it would be appreciated.

Thank you,
Damon

Hi,

Is anyone putting hazardous drugs (chemo or otherwise) in your automated dispensing cabinets (e.g., Pyxis, Omnicell)?

We likely will be, but wanted to ask in case I was overlooking any reasons not to.

Best,
Renu Bajwa, Pharm.D.
Medication Safety Coordinator
Community Memorial Health System
Ventura, CA

Topic: Independent Double Checks

Can anyone comment on the requirements of controlled substance continuous infusions to be in lock boxes while the patient is in the ICU? Is this a federal or state regulation. If state and people know NY please let me know.

Background: I just started at a new facility and all their controlled substance continuous infusions in the ICU are on PCA's so they could be locked up. I'm trying to see about making some changes.

Any other input/advice would be appreciated!

We plan to focus our energy with regard to safety in the TOC-space, by increasing Pharmacy involvement in Discharge Med Rec by partnering with providers across our system. Who else is working in this area? We would like to eventually get to a VA-type model, but would like to see what is commonly in place.

I was wondering if any of you have an effective process for evaluating anticoagulation safety practices and measuring the effectiveness of the actions. We are trying to determine metrics that are accessible without conducting a full MUE.

Thank you

We have had numerous errors where our providers use this field inappropriately by entering information that needs to be conveyed to nursing (Example: Hold if BP less than X). This information then has to be manually transferred to the nursing administration instruction field and many times this is missed upon pharmacy verification. I have tried to educate our providers about the importance of using the correct field however I am not being successful in this low strength strategy. There has been discussion about possibly turning this field off.

We recently transitioned to insulin pens and are having problems with the BD safety needles, pooling at the site of injection and difficulty with retraction of the safety guard despite re-training and additional education.

For those using insulin pens, is anyone else having these concerns? Also, are you using the BD safety needles or Novofine or others?

How are healthcare practitioners coached at your institutions to obtain an accurate, complete, home medication list in the setting of sensitive information (e.g. contraception, HIV/AIDS, mental health, terminal illnesses)? What about in the setting of generational, cultural or personal influences that may prevent the patient from disclosing his or her entire medication list? Does your institution educate patients and inform them that having a single, accurate, complete, medication list is key?

Sincerely,
Allison Hanson, PharmD, BCPS
ISMP Fellow