USP 800 includes medical surveillance for healthcare workers who handle hazardous drugs as a regular part of their job assignment.
1. How are institutions defining "regular" for this? Staff that handles chemo/HD how frequently?
2. What personnel/departments will you be including in this medical surveillance program? EVS?

I received a question from supply chain whether communication needs to go out to patients who received Apotex fluticasone given the voluntary recall. This is mostly coming from our retail rx, but I am curious whether anyone has criteria for sending communication out to patients. Thanks!

I'm working on removing range orders from my facility and am wondering if others have accomplished this? If so did you break orders up into two lines(morphine 2-4 mg q4hrs prn severe pain into morphine 2mg q4hrs prn moderate pain and morphine 4 mg q4hrs prn severe pain), go to 1st line pain med, 2nd line pain med, etc., strictly use mild, moderate, and severe with only one option or do something else? Thanks for your feedback.

Sincerely,
Jeff Ferber

Has anyone else done any EHR build for T-VEC?

This medication is expressed in exponents (10 to the 6th, 10 to the 8th) on the packaging. We use FDB which states the exponent using "EXP" by default. I am very concerned about potential errors.

Current proposal is eliminating the exponent and using 1 Million versus 100 Million instead. Also, plan to put 1 Million = 10^6 and 100 Million = 10^8 in the administration instructions.

Interested to hear what others have done to mitigate risk or any other creative ideas. Thanks!

We are trying to determine if JC or CMS have explicit language that prelabeling of syringes should not be done. I am not finding anything outright in the JC standards or NPSGs, but understand these organizations discourage it. We have an upcoming CMS visit and are having some back-and-forth with the anesthesia group on this one- the ASA has counter-arguments to the safety concerns that are raised. Has anyone been cited on this?

Thanks,

-Lara Ellinger

Don't miss out on this week's member briefing. Thursday, June 28, 1-2 pm. Register on home page under "Upcoming MSOS Member Briefings.

Topics:

Shedding Light on a Black Hole: Local Anesthetic Use in the Pediatric OR.
Meghan Rowcliffe PharmD, BCPS, BCPPS Medication Safety Officer, Pediatrics The Johns Hopkins Hospital

Does your organization allow tap water use for diluting medications for administration via feeding tube? Or do you require purified/sterile water for this purpose?

Hello All,
I am currently trying to justify a pharmacist position as the MSO in our institution. Does any one have job descriptions for their position that I may use to solidify my role?
Thanks so much!

Does your organization have a policy regarding the practice of pre-spiking IV bags? Are any exceptions to this policy allowed?

I'm curious what specific high alert medications that other institutes do an independent double check on? I'm also interested in finding out when they require those double checks; during rate changes, concentration changes, starts, etc. We recently put a hard stop in our system to force a check on a few of our high alert medications and we are getting pushback (and work arounds) due to workflow issues. We still have other meds that a force hasn't been instituted on but until we get workflow sorted out I am hesitant to add more.