Our facility infrequently uses PPN for patients with post-op ileus who may require just 1-2 weeks of parenteral nutrition and otherwise don't have or need central access. Due to osmolarity we require lipids run simultaneously with the dextrose/amino acids compomnent of the PPN. We have had events where the lipids were not run concurrently. This has led to discussion of a 3-in-1 PPN formulation. Our TPN (central parenteral nutrition) would remain a 2-in-1.

Does anyone utilize a 3-in-1 PPN (peripheral) formulation at their site? Thank you kindly.

-Mack-

Our institution is re-examining pharmacy sample workflows in light of the updated USP <797> requirements. Outside of organism identification which requires microbiologist expertise, we are curious about the role of microbiology labs in pharmacy sample processing at other organizations.

Our acute care leadership has been reviewing current policies around our intrathecal injection for methotrexate. We were wondering if other sites are using filters since all components used to compound would be sterile and it would be compounded in a clean room suite. Additionally, has anyone used CSTDs for intrathecal administration or preparation of methotrexate? We haven't found any clear guidance or data on CSTD use for IT administration.

Thanks!

Hi all!

Hi all!

We are in the process of updating cleaning processes for our Alaris infusion pumps. we have run into some questions and I was hoping to get feedback from other facilities on how they are accomplishing the process:

How frequently are the BD Alaris PCU and modules being cleaned for both inpatient and outpatient infusion centers. Between every patient, daily, or weekly?

Who is responsible for cleaning process for Alaris pumps?

Are the modules disconnected from the PCU and cleaned each time?

Are IUI covers used during the cleaning process?

Hello,
We are discussing a restriction on ordering of sildenafil for pulmonary hypertension following a safety event for treatment initiated by family med (investigating if there was an actual ADR vs therapeutic disagreement).
Please share if you have restrictions or actively decided not to restrict.
Thank you!
Erin

Hello!

We have received reports of confusion from our nursing staff regarding BUD vs expiration date.

Our hospital gives a standard 24h BUD for most compounds from pharmacy as that generally falls within the USP limits. Nurses are interpreting this as an expiration date and are not comfortable infusing medications that would run past that BUD.

This also leads to confusion regarding medications where the stability dictates an expiration time that is shorter than our standard BUD. Nursing would like a one-size fits all solution but I don't know if one exists.

Hi Everyone,
What system does everyone use to categorize adverse drug events. We are currently using the CTCAE classification system and just wanted to learn best practice before building all the detail into our electronic reporting system. Thanks! angela

Are you seeing adverse effects from intrathecal dexmedetomidine?
Anesthesia started using dexmedetomidine intrathecally for OB patients and noticing side effects; specifically an increase in time of epidural duration and decrease in fetus heart rate, Is the intrathecal route being used for other indications? Have other side effects been noticed/identified?