Our organization is changing oral contraceptives dispensing from inpatient pharmacy to consistently remove placebo tablets from the pack (before dispensing the entire pack as a bulk item for nurse administration).

If your organization removes placebo tablets from oral contraceptives in pharmacy:
1) How do you communicate that placebo tables are removed to the ordering provider?
2) How does the ordering provider designate hormone withdrawal (if this is desired vs. continuous hormone administration)?

Hey everyone,

Do you guys have creative ways to address allergic reactions to medications that may help prevent/or bring awareness to possible allergies to contrast? I ask because we recently had a patient with an allergy to Bactrim already listed on their chart who experienced an allergic reaction to an ultrasound enhancing agent (sulfur hexafluoride lipid-type A microspheres) for an Echocardiogram, and required treatment and ICU monitoring for a day.

Looking forward to hearing back.

Jameika Stuckey, PharmD
University of Mississippi

It has recently come to our attention that Trissel's designates Ketamine and LR as incompatible at Y-site. Our anesthesia group disputes this assertion, saying the study it is based on is flawed and ORs everywhere have been using Ketamine+LR for decades with no issues. Our nurses rely exclusively on Trissel's/Lexi to determine compatibility, so this has caused some concern.

Have any of your institutions discussed this incompatibility with anesthesia or ORs? Do you have any scenarios where you use blanket exceptions to compatibility designations in Trissels?

With increasing risk of cybersecurity attacks, wanted to see if organizations have good examples to share of downtime RX profiles they have created help optimize ability to maintain accurate, complete pharmacy profiles.

Hello,

Hello,

Hello everyone,

Was wondering how your institutions build multicomponent mixtures in your smartpumps. We have been working very diligently to improve our DERS compliance with our pumps. In working towards that 95% compliance goal, we continue to try to come up with the best way to have entries for our multicomponent mixtures. The especially challenging part is establishing the min/max parameters. Do you set those just based on one component?

Good afternoon,
We've encountered safety issues with incorrect dosing/monitoring of vancomycin and aminoglycosides in peritoneal dialysis solutions, and are exploring options to improve the safety of our process. For example, a patient receiving vancomycin daily versus intermittently based on levels. Unfamiliarity with PD dosing and infrequent use are contributing factors we've identified. How does your institution handle these orders safely to ensure accurate dosing/monitoring?
- Do you incorporate pharmacy consults? How is that operationalized?

Hi,

ISMP has repeatedly suggested that sites take action to prevent PCA by proxy. In 2016, a "Worth Repeating" article suggested "Assess the need for warning signage
Assess whether warning signs are necessary on PCA cords to alert family members and remind staff that PCA doses should be administered only by patients. If used, be sure the warning is clear and understandable to patients, family members, and staff (e.g., WARNING: BUTTON TO BE PRESSED ONLY BY THE PATIENT)."

Good afternoon,
We've encountered safety issues with incorrect dosing/monitoring of vancomycin and aminoglycosides in peritoneal dialysis solutions, and are exploring options to improve the safety of our process. For example, a patient receiving vancomycin daily versus intermittently based on levels. Unfamiliarity with PD dosing and infrequent use are contributing factors we've identified. How does your institution handle these orders safely to ensure accurate dosing/monitoring?
- Do you incorporate pharmacy consults? How is that operationalized?