We are a small critical access hospital that does not have on site pharmacy services 24:7. We follow the TJC standard "to a tee" and do not stock concentrated electrolytes outside of the pharmacy, including potassium phosphate. We are routinely called in from home to mix potassium phosphate (or sodium phosphate) infusions. Something I read recently made me think... can't we safety store this concentrated electrolyte outside of the pharmacy in a secured location in the form of a kit with clear instructions for use? Does anyone else do this? Does anyone hardwire a process where the on-call pharmacist is notified (or the remote pharmacy service) of when this is needed to go through some sort of safety checklist with the person who is mixing/administering to mitigate any risk? I am wondering what TJC would say. They would probably like to see a Safety Risk Assessment which we could do. I don't like to reinvent wheels which is why I am reaching out here. Thanks, all!

Rachel Durham PharmD RPh