During a review of our medication use process, I was struck by an apparent inconsistency that appears endemic among hospital pharmacists and was wondering if others had noted and/or were concerned. Every order in the hospital undergoes an independent review except those generated by pharmacists. When pharmacists perform dosing consults, they routinely enter and verify their own orders.

Does any of your institution consider the use of DSMO as a antidote for extravasation?
If you use DSMO which presentation do your institution use?
The only presentation we have available is RIMSO-50 for irrigation. I'm understanding from what I'm reading that it can be used. But I'm not totally sure about this.

Thanks,

Brenda Santiago, BSPharm, R.Ph., CPPS
Medication Safety Specialist
HIMA San Pablo
Caguas, PR

How does your facility classify use of propellant sprays, such as Hurricaine spray? Are they single-patient vs. multi-patient use? CDC recommendations specifically focus on manipulation of multi-dose injectables in close proximity to the patient, but what about other formulations that could be considered prone to contamination?

Hello,
I am at a lost as to what to do next. I desperately need your expertise…. We have had probably 5-6 incidents of inadvertent free flow of IV fluids over last year. Staff open the door and forget to clamp tubing first. I have tip sheets posted, I bring it up every other week in nursing orientation and again at 60 day orientation. I give examples of the events in our system of the error. What else can I do? I am at a lost as to why staff open the door before clamping. I cannot comprehend this as a seasoned nurse……

Hello,

Does anyone use methadone IV in the hospital? We currently have it as non-formulary but we are thinking of adding to our "do not order" list. Does anyone do this, use restrictions or have a policy for it's use? Thanks! ---Jeff

We apologize about the recent inappropriate posting of an advertisement for naltrexone.  We have removed the ad and plan to use this case to evaluate how to better improve our filtering system to prevent such future posts.  We regret any inconvenience this may have occurred. 

Hello,
Is anyone using ofloxacin and ciprofloxacin ophthalmic drops in the ears? We use them in the ears, but I heard that the dose conversion may not be 1:1. I have not found anything specific to tell me that though.

Thank you
Marilyn Hargett MSN, RN

Hello,

I have been asked to give a medication safety presentation to our family practice medical residents. It has been left open for me to choose what will be covered. I am wondering if anyone has presented on medication safety for medical residents and what topics were covered. Were there any topics the residents were particularly interested in? I'm excited to have the opportunity to develop this lecture but just want to make sure I keep them engaged.

Thanks!
Amanda

Everyone,

I an interested in learning how your organization approaches REMS Alerts for the clinician/prescriber to acknowledge to order these agents.

We have an alerts built in our CPOE system to inform prescriber what actions they need to complete to order REMS agents.

Example: REMS Alert

FDA REMS DRUG - By ordering this medication I acknowledge that I have completed the FDA REMS certification requirements and I am an authorized prescriber.