I am having a tough time wrapping my head around why we have to give opened Pharmacy Bulk Packages (PBP) a BUD of 4 hours, but we can continue using single dose vials for 6 hours (or 12 hours, if you follow the revised 2019 version of USP 797). Both products are preservative-free. Both products are only accessed within ISO Class 5 air (e.g., LAFW). In the case of calcium gluconate 10%, the ingredients of the SDV (10mL) and the Pharmacy Bulk Package (100mL) are IDENTICAL. Can someone please help me understand why we have to use shorter dating on a PBP in our cleanroom?

Re: ISMP recommendation for 5 character medication search. For those who have implemented this, how do your systems handle searches <5 characters? (e.g. APAP, ASA, etc.)

Our healthcare system uses EPIC. When translating prescription sigs from English to another language, if the sig typed does not exactly match the sig built for the translation, it will automatically revert the printed label instructions back to English. Example: “Take one tablet by mouth ONCE” will translate in Spanish. If I typed “Take one tablet by mouth ONCE before MRI” it reverts back to English if the “before MRI” is not built out.

We are helping out our adult hospital, making some of their batches. One of the batches is making their Norepinephrine drips (8 mG/250 NS, 16mg / 250 NS and 32 mg/500 NS) The only stability they were able to provide us with is 24 hours RT. I tried to contact manufacturer to no avail. Can you please share your referenced stability data beyond 24 hours please?
Thank you much!!

I’m wondering what other sites are doing re:Pyxis (or other ADC) in their COVID areas (ER, ICU, Medical unit)? Are you allowing them to be stored within COVID areas, or are they kept outside. The scenario I’m especially wondering about is a COVID unit where the whole ICU unit has been designated a closed negative pressure unit. Does anyone have, or are you preparing for, that type of scenario?

Hello,

We have been able to procure bulk sized 2.5 gallon hand sanitizer preparations. Are there any storage recommendations we should be aware of when implementing these? Have any others utilized these bulk containers at their organizations?

Thanks in advance for any responses/insight!

Would anyone be willing to share their org's medication standard admin times? In particular your BID and TID schedules. Thanks!

John Dempsey, PharmD, MHA
Medication Safety Pharmacist
Harborview Medical Center
Seattle, WA
Box 359885
Phone 206-744-6043

Hey all,
Wondering if anyone is using or considering use of MRidium (MRI compatible) pumps with remotes in covid19 patients. We are exploring the idea in our icu to minimize PPE use and exposure without extended tubing. Any successes or issues encountered?

We also realized in our exploration that the tubing is only approved for use for 6 hours. Have anyone addressed that issue, if you are using?

Thanks!
Allison

Allison Pollock, PharmD
UCSF Medical Center
Medication Safety Specialist

we are considering Andexxa for formulary addition with restrictions. what are your experiences with Andexxa, do you have both Kcentra as well and how does your institution select qualified patients? adverse events? cost containment? thanks in advance for any insights.

How do you help to ensure that certain medications do not find their way into your ADCs? How often do you monitor?

Example: I do monitor for fentaNYL patches in our EDs and procedural areas. This works well, and only a small group of technicians add medications to the machines. One that we have had difficulty slipping through the cracks is haloperidol decanoate making it's way onto a psychiatric unit as stock rather than being sent patient-specific each time.