We are in the process of revising our surgical prophylaxis guidelines and are struggling with management of patients receiving current scheduled therapy (e.g. extended infusion pip/tazo, scheduled vanco) especially when administration times fall outside of the recommended window. There are no clear guidelines from our review.

How has your organization addressed this component?

I'd be happy to compile a response summary.

We've also capped the maximum number of intra-operative re-doses at three.

Thanks!

Andrea

We operate an outpatient pharmacy at a rural hospital and are completing ISMP's Community/Ambulatory Self Assessment. We are assessing questions # 48 and #49 which state:

48. The pharmacy has a formal policy to assess and clarify any unusual doses or uses of medications before dispensing.

49. Pharmacists have a written policy to follow, to easily and effectively resolve conflicts when prescribers do not agree with their expressed concerns about the safety of an order.

Hello,

I'm interested in obtaining information about other hospitals that use neostigmine subcutaneously for the indication of acute colonic pseudo--obstruction.

What administration instructions/monitoring parameters are utilized at your facility.

Thank you,

Matthew Beaulac, PharmD, MS

Our health system is looking to assess the frequency of patient cafe area ADM controlled substance inventories.
Could you please respond to how your institution conducts the following:
1. How often do you physically inventory your patient care area ADM’s controlled substances?
2. Do you inventory all controlled substances in the ADM or only those not accessed since the last physical inventory?

I will share results after a week of responses.

Thanks in advance.

Does anyone have specific guidance related to administration of IV Medications in the ambulatory setting? I have sent the ISMP Gap Analysis Tool for Safe IV Push Medication Practices to the Nursing Leader who requested this guidance. I believe this largely comes down to monitoring requirements- which we have for inpatient administration. The actual process for medication injection should not differ. I did tell them I would check to see if others had specific information about this subject. Thanks very much!

As we move closer to hurricane season, and issues with really bad storms, does anyone have a written SOP and/or Policy on Pharmacy's role in emergency evacuation for the hospital?
We've had a few close calls over the last few years with storms that turned at the last minute and went elsewhere, but now we're getting serious about how Pharmacy will help the organization, and what it's role will be in medication management if the hospital had to be evacuated.

Thanks.

Feel free to email me directly if that's better for you.

In addition to the ISMP recommendations to consistently utilize metric system for all scales and weight recordings in the EHR, does your facility have additional approaches to validate accurate weights prior to administration of medications in the pediatric population (emergency department care)? Do you have different approaches for high risk medications?

Hello MSOS. I'm Allison, one of the international fellows with the Institute for Safe Medication Practices (ISMP). I am interested in hearing from pharmacists in hospitals regarding the handling of the Diastat AcuDial rectal diazepam system. When dispensing the AcuDial syringe from pharmacy, when are your pharmacists dialing and locking the dose? Are the pharmacists dialing and locking the dose prior to delivery to an automated dispensing cabinet? Or are the pharmacists dialing and locking the dose prior to hand delivery to the nurse?

Good morning - We are trying to find way to provide information on the MME based dosing conversions to fentanyl patches at the time of ordering. We are an Epic institution, appreciate if anyone is able to offer creative ways to display this information.

Greetings-
Our organization has recently partnered with several new outpatient oncology infusion centers, and our team is starting to evaluate their medication use processes.

We have reviewed the ISMP Self-Assessment tools, but wanted to know what other organizations have used as an assessment tool when evaluating their outpatient oncology infusion centers and care areas.

Thank You!

Trey Jenkins PharmD., BCPS
Medication Safety Officer
WellStar Health System