Hello All
Wondering if anyone allows for medications to be pre-checked in order sets? Does anyone have any guidance on this issue? ISMP's guidelines for standard order sets doesn't address this matter. Thanks
Niloofar

Hello All,

As a part of TJC 2018 revisions hospitals must have a policy that describes the types of medicaiton overrides that are reviewed for appropriateness. Would you please share how your organizaions are handling the following.

• What types of medication overrides are hospitals choosing to review?
• If you do not review non-profile ADC overrides, why not?
• What are you looking for to determine in an override is compliant?
• What steps does your practice take to address non-compliance?

Thank you,
Ashley Warnock

Hello,

Could you please share how your organization handles the storage of controlled substances once they have been removed from automated dispensing cabinets by nurses?
-Is there a defined time that the nurse must administer, return, or waste the controlled substance after removing it from the automated dispensing cabinet?
-Can controlled substances be stored in the drawers of Computers on Wheels?

Thank you.

Is anyone aware of regulations to document lot# for medications derived from pooled human blood, such as IVIG, albumin, or KCentra? It seems like something that should be documented but I cannot find any regulation on this.

Hello,

Could you please share how your organization handles:

A. Patient’s Own Medications (brought to the hospital because they are ordered for administration and not available through pharmacy)
• How are medications stored in association with an automated dispensing cabinet?
• How do they appear on the medication administration record (eMAR)?
• Do you relabel these products?
• How do you handle barcode scanning for administration of these medications?

How does your hospital dispense cyclosporine oral solution (Sandimmune or Neoral)? We have PVC-free oral syringes to draw up doses but do you drawn up doses ahead of time i.e the night before or do you dispense doses on demand? The manufacturer recommends only using the syringe provided which does not come with a cap and instructs patients to draw up the dose immediately before use. However this is catered to home use and is not practical for a hospital that needs to dispense to multiple patients from one bottle.

We recently had a request for rocuronium to be used in the Allergy clinic for patient sensitivity testing. As I found out, there is primary literature that speaks to allergy testing of NMBs when a patient has anaphylaxis to one of these agents since there is cross-reactivity. I prefer to have pharmacy own this process, to minimize the risk of a NMB used in clinic setting, but would like to hear how others are handling this type of request.

At my organization, patients often transfer directly to the ICU from OR or a procedural area, bypassing the PACU. If your organization does this also:

--What scale, if any, is nursing using to assess the patient's sedation level (Aldrete, MOASS, etc.)?
--Do you know of "recovery" standards that exist to guide practice?

Thank you!

Would you be able to share how you dispense sumatriptan injection to reduce risk of IV administration?
Do you use auto-injector? ready-to-use needle attached product?
If you use vials, how to dispense?
Thank you very much!
Susan

Hello,

When referring to the high alert drug list, certain classes of medications are included in addition to individuals agents.
With respect to the classes, IV moderate sedation agents, do folks include IV phenobarbital in this group? With it is not a sedative per se, it has significant sedative properties and could be very harmful when used in error.
Just wondering how folks move from classes to considering how individual drugs may or may not fit into a classification. As you might imagine, referring to a class/classification can lead to differing interpretations.