What is the return to pharmacy/ADC process look like at your institution? Do you have internal and/or external return bins for your ADCs whereby users/nurses return any unused medications to the return bin? Do you allow/expect returns to be done back to the ADC pockets by nursing? Do you have the same return process for controlled substances and non controlled substances?

Our organization is looking to move all doses of cefazolin, ceftriaxone, and cefepime to IVP. While this may work from a clinical and financial perspective, I'm concerned about the risks associated with moving from commercially-available products to pharmacy-compounded syringes (risk of error, contamination, expired product management, etc.).

Has any other large hospital or health system moved forward with this conversion and have some "lessons learned" to share with us? Thank you in advance!

We have come across several items in pharmacy (such as Eucerin cream, vitamin E, Lubriderm, etc) that do not have BUDs or expiration dates. We have contacted the manufacturers for information on several of the items we identified, but I'm sure there are more.

Have you identified a list of items in pharmacy that do not have BUDs or expiration dates? How do you keep track of them? Any policy on addressing such items?

Thank you!

Do any of your organizations currently treat propofol as a controlled substance? If so, speak to how it is handled both inside the pharmacy and outside the department (in the ADCs).
If you do not, please discuss what processes you utilize to decrease potential diversion.

Does anyone have any exact verbiage to use to inform staff that they are handling hazardous medications? we are wondering if anyone has already had employees sign an attestation that they know they are handling HDs. If anyone can share how they informed staff and if they have documents that they had staff sign.

1. Does your facility permit intravenous lidocaine for pain management?
2. How is it dosed/provided?
3. What kind of monitoring is required?
4. Does it have any formulary restrictions?

Some prescribers have expressed interest in intravenous lidocaine as an opioid alternative in some emergency department patients and some inpatients. Although this has been evaluated in some clinical trials, this indication is currently not listed as a use in our primary drug information/formulary reference.

Hi there, does anyone use a standard template for investigating/following up on potentially preventable events, and/or is anyone willing to share your ideas? We're thinking about using a template that we would email to individual pharmacy staff members if they may be familiar with a reported event. In-person communication is preferred but we can't always to that. Maybe something like this:

Hello,

What does your institution's policy specify with regards to what is reviewed during a nursing independent double check? The 5 rights, 7 rights, or more? Does the 2nd nurse checking the primary nurse's medication check fewer "rights," such as indication?

Thanks!

Hi.

Our nursing staff especially in NICU is experiencing issues with administration of SMOF lipids. It looks like every time they have to pause SMOF infusion to administer intermittent medication, they have issues restarting the infusion. They have to troubleshoot and even sometimes disconnect the lines.
Does anyone experiencing the same issues?

Thank you

Any novel ideas beyond segregating storage, tallmanning, different syringe sizes, and barcode scanning? I am part of recently merged health care organization. Half used to color code ceFAZolin 1 and 3 gram and cefTRIAXone 1 and 2 gram syringes, the other used white labels.

I tend to be in the white label camp along w/ISMP to force people to read/not foster reliance on color, but also see the value that colors help you see if one syringe is misstocked in the wrong bin and you can match syringes to color coded bins in addition to barcoding.