MSOS Members:

As we prepare for the ISMP Targeted Medication Safety Best Practices for 2022-23, please be sure to complete the current ISMP Targeted Medication Safety Best Practices Survey so we can get a sense of the current level of implementation of the 2020-2021 practices for hospitals.

We would very much appreciate your participation in this survey by July 30, 2021.

As most MSOS members are aware, we recently launched the ISMP Medication Safety Self Assessment® for Perioperative Settings. The FDA-funded project can help hospitals, ambulatory surgery centers, and other surgery settings evaluate their current medication safety systems and practices, document regulatory compliance, and compare their results to those of demographically similar organizations.

We recently had an event at one of our physician offices in which they wanted a patient to receive IV dexamethasone orally. The staff member inadvertently administered it IM. I know EDs and Urgent Cares routinely use the IV product orally due to volume concerns. Does anyone use the IV formulation orally in the office setting and if yes, what safety steps do you have in place to avoid wrong route administration errors?

We are seeing more providers wanting to titrate paralytic agents to "ventilator synchrony", although our current titration goal parameter is TOF.

If your policy/practice allows it, could you share how you objectively define ventilator synchrony at your institution?

Where does that definition live, in policy, or is part of every medication order (e.g. default order comments)? If you are willing to share your policy or screen shots, that would be very helpful!

Thank you.
Daniel

Hello,

I was wondering if someone had a presentation or even tips on presenting the topic of adverse drug events, adverse drug reactions to general practice residents? This Monday I will be teaching and training our general practice resident to the subject of Adverse Drug Reactions. I will show them the process of capturing, reocording, and reporting this in our institution but would love any additional information on this. Any shares would be greatly appreciated.

Good morning,
Does anyone have policies or procedures guiding decisions for meds allowed to be autoverified? Appreciate any information you may have

- Which areas do you allow autoverification?
- Do you have a restricted med list and what criteria do you use?

Thank you!

What are others doing to get phenobarbital loading doses to the bedside STAT?

We are facing the challenge of RNs needing 10+ vials of phenobarbital to get a loading dose into patients and weighting the risk/benefit of compounding at the bedside versus in the IV room. With the guidelines specifying a maximum # of components per preparation we are running into the challenge of immediate use compounding at the bedside versus creating a faster STAT turn around time through the central pharmacy...

thanks Jess

Jessica Rogers, PharmD, BCPS

Does your site require a "Chemo Competent RN" to administer non-hazardous monoclonal antibodies for non-oncologic indications (i.e. rituximab)? We currently do, but this practice is being questioned due to causing delays in patient care.

I'm not finding a reference/consensus statement published anywhere, but the few orders I have found refer to required RN training in monoclonal antibody administration.

Any feedback would be greatly appreciated! Thank you.

Good morning,

If your organization has converted to ENFit:
1. Is your outpatient pharmacy supplying any ENFit disposables (syringes, adapters, bottle transfer lids, etc.)?
2. If so, are these items being charged to the patient or are the items provided as part of the prescription?
3. At discharge from inpatient, are any supplies provided?

My organization converted in October 2020 and as more facilities in our region convert, the need for certain disposables has changed as patients become more saavy with the connections. I appreciate your input.

A recent question was asked:

Which infused medications(FDA approved medications and not investigational) require patient consent?

What regulation(s) require the consent? I understand this may be federal, state or locally driven but I am having a difficult time finding the federal regs. Is there a source that defines the medication classes that require the consent?