Hi Everyone,

Does anyone have a definition of what a "not an opioid naive pediatric patient" is? We have a definition for an adult pt such as having been on morphine sulfate, hydromorphone but I was wondering if anyone has one for a pediatric patient and what doses of opioids will qualify the patient to be not an opioid naive pt.

Hello all,

Trying to get a feel for current practice.

1) Do you allow use of lidocaine as a diluent for intramuscular injections (ceftriaxone most commonly)
2) Do you have any weight or age restrictions for this use?

Thanks,

Zach Hodges, PharmD, BCCCP
Medication Safety Officer
Tucson Medical Center

HI All-Just sending a f/u email on this topic..

How do you draw up a patient-specific dose of an inhaled med? It is my understanding that the product needs to remain sterile, therefore doses should be drawn up in an ISO Class 5 environment into a sterile syringe. I cannot find any "sterile" oral syringes, however...

1. Are you drawing up inhaled meds in your IV room hood?

2. Do you dispense them in an IV syringe or an oral syringe?

3. If you do use oral syringes, are you using a STERILE oral syringe? If so, what manufacturer are you using?

As a health system we are working on the USP 800 guidelines/Hazardous drug list.

I was curious what other institutions are requiring on the nursing end for the IV drugs in table 2 and 3 of the hazardous drug list. Some of the ones that are concerning to me are Dilantin, Valproic Acid, Zometa, Pamidronate.
1. Are you requiring nurses to handle these as chemo agents as the NIOSH would suggest? chemo gloves, gown, and CTSD for administration ?
2. If not what requirements do you have in place ?

Any help is greatly appreciated.
Nancy

As a health system we are working on the USP 800 guidelines/Hazardous drug list.

I was curious what other institutions are requiring on the nursing end for the IV drugs in table 2 and 3 of the hazardous drug list. Some of the ones that are concerning to me are Dilantin, Valproic Acid, Zometa, Pamidronate.
1. Are you requiring nurses to handle these as chemo agents as the NIOSH would suggest? chemo gloves, gown, and CTSD for administration ?
2. If not what requirements do you have in place ?

Any help is greatly appreciated.
Nancy

In light of the USP 800 deadline, I have a few questions about gloves.

1) Is your institution keeping both chemocertified and regular gloves?
2) Is your institution planning to use chemocertified gloves for ALL medications?
3) If yes to #2, how will you differentiate disposal of non hazardous drug-contaminated gloves vs. HD contaminated gloves?

Thank you,
Daniel

Can anyone give me your thoughts about having ambulatory surgery outpatient fluid orders auto-verify? Any regulatory concerns? Any safety concerns?

Hello All,

What hang time does your policy allow for IV bags with or without drug additives (i.e. how long can the IV be infusing without the need to change the bag)? Our policy currently states 24 hours, but we are considering moving to 96 hours. For instance, consider a premix bag of dopamine running at low rate. How frequently does the bag need to be changed?

Thank you,
Daniel

Hi all -

Does anyone have a standard around reporting of extravasation events, such as how they're coded (i.e. treatment related, med error, ADR, etc) and if there's a certain volume cut-off for reporting said events?

Thanks,
Elizabeth

Looking for your experience and practice. with spreading use of automation dispensing cabinet which required mostly to have the medication in unit dose format.
1. How do you provide nebulizer medications as Colistin neb., Sodium chloride 3% neb. as patient specified unit dose
2. Is it required aseptic technique
3. If you use syringe; what type?

Nissreen