Question for retail pharmacy members: We are discussing paperless options to deliver medication guides to the patient. Has anyone in this group switch from printing the FDA medication guide to give to patient to an alternative paperless delivery of the FDA medication guide? Thank you! Lu

Wondering how your facility prepares chemo doses that are dispensed in bags.
1) Do you start with an empty bag and add the diluent and drug to the empty bag?
2) Do you start with a commercially available bag and remove fluid from the bag? Do you remove overfill? Have you had any concerns of doses being prepared inaccurately due to varying amounts of overfill?
3) Does your process vary depending on pediatric vs adult/adult sized patients?

Has anyone been successful with curbing unintentional therapeutic duplications with PRN orders? I know this has been a long-standing issue with TJC. I perused prior discussion on this topic from 2013-2016, and hoping to see if there was something new we could learn from.

All we have had several errors secondary to missing medications and significant delays once replacements are requested. In larger facilities, would you be willing to share process metrics in terms of time required to re-dispense, verify and deliver a medication to the nurse?

Any insight would be helpful.

Thanks,

The anesthesia department at my institution is starting to explore the use of bar code scanning of medications in intra-operative areas (we use EPIC). Are there other institutions that have incorporated this into OR processes, and would you be willing to share your experience implementing this process as well as what the barcoding process actually looks like in the OR suite?

I am trying to create a MUE plan for my institution. What are some of the ways your institution identifies MUEs ?

My thought is to run routine/annual MUEs for high risk / high cost / rescue meds-

- kcentra
- vancomycin
- naloxone
- flumazenil
- dextrose
- heparin
- warfarin

and in addition, identify other high risk high cost meds - 4 per year to perform MUE

Would love some thoughts on how this is done at other institutions.

Thank you.

We did not develop specific formularies for areas such as the IV room, peds, oncology, etc when we implemented Epic many years ago (not sure it was an option) and have one main formulary. We are now identifying a need for a better option to ensure labels print in the correct area and understand there is the capability to develop separate formularies. IS is reluctant to make these due to the large amount of work.

With our next Epic upgrade our providers will now have the ability to put medication orders on hold, something they have not had before. In reviewing the recommendations from the most recent ISMP Quarterly Action Agenda we would like our pharmacists to be involved in reviewing held orders daily, especially high alert medications, and are starting to work on what that process would look like. Are there any Epic facilities that have a process or standard work for pharmacists reviewing held orders that they could share?

This has been resolved thank you!

Hi, I understand that error reporting is not punitive. However, when a pattern is identified with an individual, how do you handle team members? Do you follow an escalation process?