at 4mg/mL vancomycin appears y site compatible with zosyn-does anyone infuse both routinely as zosyn is 4 hr infusion? will this practice affect vancomycin blood level validity? promoting concurrent administration can optimize rn practice workflow as it's tough to stagger both esp if vanco also q8hrs...any thoughts appreciated.

Background: We are a large government health system that uses ScriptPro dispensing robots in our retail service lines. We are reviewing compliance with placing hazardous medications in these machines.
Questions:
(1) Do you currently place hazardous medications (e.g. phenytoin, spironolactone, fluconazole, carbamazepine, capecitabine, azathioprine, zonisamide) in your ScriptPro robots?

Hi! Wondering what your process is for dispensing of nitroglycerin from an automated dispensing cabinet. We want to avoid dispensing 1 bottle of 25 tablets, but are concerned about the removal process, including labeling, barcode scanning, light-sensitive drug, etc.

Thanks so much!

When we have TPN running at a rate that would require 2 standard TPN bags, we hang Bag 1 of 2 (Clinimix containing multivitamins and trace elements) @ 2000 today, run until complete, and then hang Bag 2 of 2 (plain Clinimix) tomorrow. How do you all deliver Bag 2 of 2, PLAIN Clinimix, if, for example, it is not due until 1400 or 1600 the next day? Do you send BOTH Bag 1 of 2 and Bag 2 of 2 together, or do you send Bag 2 of 2 with batch medications the next day?

Thanks so much!!

About a year ago when the Versed/vecuronium issue was being discussed, one of the pie-in-the-sky ideas that was batted around was a DO NOT LOAD list for our ADCs. However at that time, it would be a manual list and not something that could be hardwired into ADC "brains". Now that it has been a year-ish, has anyone found anything like this that would not be a manual process?

We use Omnicell, and have restricted the addition of medications to machines to a core team. This obviously helps, but desire to go a bit further than human vigilance on this if possible.

Thoughts?

ISMP received a report recently about confusion between Activase (alteplase 50 mg and 100 mg) and Cathflo Activase (alteplase 2 mg). We previously published recommendations (in 2008) to: communicate the purpose of the drug, communicate complete orders (i.e., dose, route, administration directions), use disease-specific ordersets in non-emergent situations, and avoid the abbreviation “tPA”.

Just curious, but what additional strategies is your institution using to avoid medication errors with these two products?

Thanks!

Mike

Hello!

As you are likely aware, there have been safety concerns reported with the packaging of Recothrom [as it comes in a box containing supplies for medication preparation including a 5-mL sterile empty syringe (luer-tip)]. (reference links below)

Wondering if you might be able to speak to the process around dispensing, preparation and use of recombinant topical thrombin (Recothrom) in your organizations.

Hello!

As you are likely aware, there have been safety concerns reported with the packaging of Recothrom [as it comes in a box containing supplies for medication preparation including a 5-mL sterile empty syringe (luer-tip)]. (reference links below)

Wondering if you might be able to speak to the process around dispensing, preparation and use of recombinant topical thrombin (Recothrom) in your organizations.

Does your facility carry both preservative-free and preservative-containing vitamin K injection for neonates, and what is your rationale for what you carry? ​If your facility carries only preservative-containing neonatal vitamin K, and family refuses, what is the procedure for handling the situation? Does your facility have a protocol/procedure in place for accepting labeled, unaltered Vitamin K injection for single use that the family has brought in from an outpatient pharmacy?

Thank you!

Our Med Management Committee would like our inpatient pharmacy to standardize use of auxiliary labels and develop a SOP for use. Wondering if anyone would be willing to share a list of which auxiliary labels you use and/or SOP/info on who is responsible for labeling, when in process they're put on, are they put on the patient label or the actual bottle, who approves the use of new labels, how to ensure and monitor for consistent use, etc. Thanks! Joanie