Good morning,

Our facility is a primary stroke center receiving stroke patients in the ER. We currently prepare and dispense 23.4% NaCl in pharmacy and deliver to the ER when a stroke patient arrives. The ER physicians are requesting storage of 23.4% NaCl in the ER Acudose. If your facility is a primary stroke center, are you storing this in the Acudose? What safety precautions do you have in place? Any advice on your safety measures is appreciated.

For those health systems using closed-system transfer devices (CSTDs), how do you prepare products requiring a small volume (less than 1 mL) of drug? We are evaluating our current processes for preparing tacrolimus. Also, how do you handle products only available in ampules given exposure occurs when opening the ampule?

I would appreciate your response. I will collate the results and send to those who are interested.

Thank you!

Do you send insulin drips via pneumatic tube system or is it on your "Do Not Tube List"?

Thanks.
dpatrick

How does your institution manage problems with therapeutic duplication of pain meds etc.?

Does you hospital have a policy which list medications ( particularly high risk meds) which should never be given peripherally? If not is this information inside another policy or guideline which is accessible to nursing?

Thanks.
dpatrick

Has anyone taken steps to increase medication safety with dabigatran, rivaroxaban and apixaban? If so, what was done? Has anyone resticted usage to order sets only? If so, were any barriers discovered. Have other methods beeen attempted?

Thanks, Vic
Victor DeLapp, PharmD, BCPS
Medication Safety Specialist

For those organizations using pharmacists for discharge medication reconciliation and/or counseling, can you answer the below questions? We are trying to expand our program.

1. Are pharmacists involved in all discharges?
2. If not all discharges, what criteria are you using? High alert meds? diagnosis with high readmission rates?
3. what metrics are you tracking?

thanks
Sean

Does anyone have a standard that limits haloperidol administration to IM route only?
Do you allow IV route under certain conditions?
Thank you!
Susan

This may seem like a silly post for pharmacy....

Does anyone have any instructions on directing nurses on how to administer Infusions? How are they directed to administer primary versus secondary infusions.

The issue is coming up with use of Alaris pumps and guardrails to prevent alarming...then with timing of chemo/investigational meds. In order to time the infusion properly, how do you get the drug through the line when administered as a secondary...keeping in mind that the line has to be cleared of the saline or dextrose. How is the pump programmed?

Hello,

I am wondering if anyone uses a web based or other type of software to manage unit inspection documentation. Please share what advantages and/or disadvantages of the product. Thank you! ---Jeff