Strategies for heparin drug shortage, especially hospitals performing cardiac surgeries? Restrictions being considered?

Dear MSOS Members:

Maternal Child RNs have expressed their concern regarding the safety device that covers the RhoGam needle. Some of their concerns are:

- It is difficult to engage the safety shield.

- They feel the safety shield puts them at greater risk for a needle stick as the quality of the material is flimsy compared to prior versions.

- The plunger falls out of the syringe if the syringe is tipped slightly.

The ISMP list of Standard Concentrations of Neonatal Drug Infusions has 2 mg/ml and 10 mg/ml for gentamicin.

The pediatric 20 mg/ml vial states that it must be diluted prior to IV administration. All of the Fresenius Kabi vials state this as well but I'm wondering if it is really necessary to dilute the 10 mg/ml concentration (unless of course the dose is really small and then having a 2 mg/ml concentration would help with measuring smaller volume/dose)?

Lexicomp and Neofax just state that the vial concentration is 10 mg/ml.

thoughts/insight?

TIA!!

How does your organization dispense unsealed topical/bulk products such as hydrocortisone or lidocaine creams/gels/ointments?

Do you tamper-evident seal the product? Do you discard any/all returns instead of placing back into inventory?

Appreciate your feedback!

Have organizations approved and added vitamins and certain supplements to formulary? If so, have you restricted these to USP-NF certified brands when possible? Do you provide any guidance if USP is not available?
A few examples I can think of: Fish oil, melatonin, multi-vitamins...etc.

Nick Haar
Maine Medical Center

Hello!

Has anyone out there delved into the world of Ambulatory ENT practices yet?? Curious if others have evaluated these spaces from a medication delivery / device perspective for best practice / compounding / infection prevention practices, etc. (for example... powder blowers, multi-use atomizers, http://www.devilbisshealthcare.com/files/LT-577_RevL_FINAL_022715_Web.pdf)

Thanks for any insight or experiences you might be able / willing to share!
Emily

In our outpatient infusion center, we continue to have physicians that do not sign their chemotherapy orders until very close to the patient's scheduled appointment time. This creates stress for all involved, and it is not safe to try to rush the preparation or administration of chemotherapy. Do any facilities enforce a cut off time for receiving chemo orders? I would like to have a policy that says we must have signed chemotherapy orders in hand at least 24 hours prior to the patient's scheduled appointment.

We previously used Micromedex for compatibility information, but have switched to Lexicomp.

Hello!

Looking to get a little information regarding reporting structure and division of work / resources:

1) Do you have a separate medication safety team?
2) What department does your medication safety team or MSO report up through?
3) If willing - can you comment on pros/cons of your reporting structure?
4) How is work delineated between Medication Safety and Pharmacy? How do you determine initiatives owned and operationalized by the pharmacy department vs. medication safety? (i.e. how do these two teams typically divide and conquer?)

Hello!

Looking to get a little information regarding reporting structure and division of work / resources:

1) Do you have a separate medication safety team?
2) What department does your medication safety team or MSO report up through?
3) If willing - can you comment on pros/cons of your reporting structure?
4) How is work delineated between Medication Safety and Pharmacy? How do you determine initiatives owned and operationalized by the pharmacy department vs. medication safety? (i.e. how do these two teams typically divide and conquer?)