Hi, all -

How does your organization handle IM injections with volumes that exceed maximum recommended doses? We've seen a few examples recently, such as methotrexate for ectopic pregnancy and ceftriaxone.

Our pharmacists have been separating into multiple syringes and hand-writing "1 of 2" and "2 of 2" on the individual syringes, however, a single barcode scan at med admission would technically "fulfill" the entire order so there's risk of only partial med administration.

How are other facilities labeling Hazardous medications? I have several questions.
1. Are you using a simple statement "chemotherapy - Hazardous Medication, handle with care"
2. Are you putting NIOSH category 1,2,3 with reference for PPE?
3. Are you building these messages at the primary drug level or placing information in comment sections?
4. Is this information face up on the eMAR for nursing?

If you are a Cerner facility, your input is especially welcomed.

Kind regards,

Kelly

For hospitals that utilize Catcus, Stericycle CsRx, or other diversion deterrent waste systems:

Dear Med Safety Officers,

Does your site allow self-administration of medications for which the package insert has language about administration by healthcare provider/professional if the patient or their partner or neighbor is purportedly a healthcare professional?

For example, this has come up for Vivitrol (naltrexone) injection at my site.

Hi all -

If you've been successful in addressing this ISMP TBP, would you be able to tell me what strategies you found effective?

- Weigh each patient as soon as possible on admission and during each appropriate outpatient or emergency department encounter.
- Avoid use of a stated, estimated, or historical weight.
- Measure and document patient weights in metric units only.

Thanks!

Elizabeth

What is current practice in your organization for flow rate of carrier solutions? I cannot find literature to support what best practice is. I am thinking of infusions like PCAs, insulin, inotropes, etc. that are running a low rate and need a carrier. Thanks!

Hi all -

I'm looking for data on how many organizations have a medication safety team vs. one person covering the entire hospital/organization. If you have more than one person, could you let me know the following:

- the name of your organization and size
- city and state of your organization
- how many people are on your team and credentials (i.e. pharmacist vs. nurse vs. whatever else)

Thank you very much! I'm happy to provide the collated information to anyone who's interested.

Thanks,
Elizabeth

Does anyone have a recent, comprehensive list of the types of agents that require specialized tubing that they can share (ie: low-sorbing 0.2 micron for amiodarone infusions)? Thanks!

Good morning,

We have reviewed the updated Guidelines for the Safe use of Automated Dispensing Cabinets from the ISMP. One of the changes is recommending the nurse remove one medications for one patient at a time. We are transitioning from a process were we allowed nurses remove multiple patient's medications and store them in individual locking drawers (WOWs) to the one at a time process.

I wanted to poll this group specifically on what protections you have around IV bags and syringes that are NOT FOR IV USE. Examples would intra-articular injections and epidurals. Specifically: