What has your organization implemented to eliminate the use of prefilled saline flushes to dilute or reconstitute medications.
ISMP newsletter update stated........

"Do NOT dilute or reconstitute IV push medications by drawing up the
contents into a commercially available, prefilled flush syringe of
0.9% sodium chloride".

Megace (megestrol) is on table 1 of "NIOSH List of Antineoplastic and Other Hazardous Drugs in Healthcare Settings, 2014".
We have patients admitted to our hospital who are taking Megace to treat anorexia. Our nurses are asking if we really need to take all the precautions (especially assigning a private room) that we take for patients on other antineoplastics.
When hospital census is high nurses often struggle to find a private room for patients on Megace.
Can you please comment on precautions you take for Megace patients?
Thank You,

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Sorry,
This post has been removed.

We are currently reviewing our policy/process for administration of naloxone injection for opioid induced toxicity.
Would you be willing to share for following information from your facility:
Do you routinely dilute naloxone prior to administration? If so, what is the final concentration?
Do you dilute naloxone for all indications including respiratory arrest? Or only when the patient exhibits symptomatic indications of toxicity such as decreased Level of Conciousness, decreased respirations, etc.

Thanks, Vic

I am observing an increase in events related to adverse reactions to inactive ingredients, (grape flavoring, red dye, aloe). Does your institution have a procedure for alerting when a patient has an allergy to an inactive ingredient and a process for screening medications that contain that ingredient?

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……