Our system has converted vincristine to IVPB to prevent mishaps with inadvertent intrathecal administration. However, we are now faced with other low volume pediatric IV chemo regimens. Our peds group would like these delivered in IV syringes rather than IVPB to decrease volumes lost in IVPB tubing. These regimens are different than vincristine type regimens (IE no IT meds accompanying), but I don’t want to overlook something. How are others handling low volume chemo agents? Do I need to worry about inadvertent intrathecal administrations with other non-vincristine-based regimens?

We have a shortage of NS vials used by nursing for reconstitution. They want to use flush NS syringes which is concerning if medication were to be drawn back up into the flush syringe. Though, we are also simultaneously experiencing a shortage of 50mL and 100mL NS mini-bags so it is tough to recommend that due to shortage and waste issues.

Good Afternoon,

Has your institution developed a policy on biosimilars? Are you willing to share that policy?

Thank you!

Good Morning,

In our institution we record and report adverse drug reactions that happen in our infusion center dependent on severity. I was wondering if any of you have decided which ADRs to record for checkpoint inhibitors? Do you record it based on the severity of the grading system toxicity? thank you

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?

Hello,
Can you share what your institution is doing in light if the SWFI shortage?
Thank you!

Has anyone had reports of inflammatory reactions at the site of injection with Hemabate? We've had three in the last few months. Could it be related to the temperature of Hemabate at the time of injection? Thanks

Hello all,

I help oversee 23 different hospitals associated with our hospital organization. We recently standardized our meds in our crash carts across all our sites, however one thing that was overlooked were RSI kits/meds.

Some sites have RSI kits in a separate drawer in their crash cart (not the same as the code meds), others have them stored in their ADC. We are leaning towards no RSI kits/meds in the crash cart due to some recurrent errors (administering RSI meds inappropriately) but also struggle with some sites not having enough space to store an RSI kit separately.

Hello,
How is your organization addressing Med Rec in the outpatient setting? Our providers are concerned with completing an accurate Med Rec, as well as, the Regulatory and Legal implications if incorrect/or missing a medication.

Could you let me know how your organization views and completes the Outpatient Med Rec?

We are in the process of evaluating our medication administration guidelines that were historically developed for the inpatient setting and how they are applied to the ambulatory infusion setting.

For example, in the infusion center patients may receive alteplase lock flushes (Cathflo), but not alteplase infusions or bolus doses. Does your institution have drug specific guidelines for the ambulatory infusion setting or a policy/guideline with guiding principles for what can be administered in the infusion room setting that you would be willing to share?