SWFI 20ml in ADCs

PLEASE NOTE:   Posts made to this forum should not be considered as the expressed opinions of, nor should be considered endorsed by, the Medication Safety Officer’s Society (MSOS) or the Institute for Safe Medication Practices (ISMP). 

Make sure your email is up-to-date
In order to continue to receive updates from MSOS, as well as forum posts and other valuable information as a member of MSOS, please be sure to update your email address with us, whenever it changes. If you need assistance doing so, please send an email to jrufo@ismp.org

5 posts / 0 new
Last post
Sarah Durham
Sarah Durham's picture
Offline
Last seen: 1 year 8 months ago
Joined: 01/15/2020 - 12:14
SWFI 20ml in ADCs

I am curious if other inpatient pharmacies stock sterile water for injection in automated dispensing cabinets to be used for reconstitution?

My preference would be that we send the proper diluent when we send the drug (as a sort of kit), or prepare in ready-to-use syringes in Pharmacy (per ISMP IV push guidelines). We used to always send the cathflo vials with a vial of SWFI on dispense. However, due to shortages in the past, sometimes SWFI had to come from distribution, so now many nursing units have it available on floor stock (not in ADC). We have no current mechanism for nurses to scan the diluent for reconstitution. Just having it in ADCs or on floor stock makes me nervous, even tho it is the 10ml or 20ml vials. Just curious what other places do or would like to do and if this makes anyone else uncomfortable or know of errors that have happened. (Or maybe I am being overly cautious with this?)

We have identified 5 main drugs that we use SWFI for reconstitution and are done as nursing prep: azathioprine, chlorothiazide, alteplase (for catheter dwell), olanzapine, and ziprasidone.

Thank you in advanced.