Hi there!

Just curious if anyone has any unique systems developed for management of REMS medications throughout their healthcare system?

Does your organization have a pharmacist check all non-patient specific ADC replenishments (pyxis, omnicell...etc)?

If not, do you use a tech validation or tech-check-tech program? and\or do you rely on barcode technology on dispense and fill?

We have always had a pharmacist check pyxis replenishment stock and have not (re)-evaluated in a number of years since incorporating barcode validation on dispense, and on pyxis fill.

appreciate others perspective and any value added accounts of having a pharmacist check pyxis stock.

Nick Haar

Hello,

I’m interested in seeing if any of my colleagues at other facilities have been experiencing an increase in adverse events associated with the use of IV contrast in neurointerventional endovascular procedures.

To summarize briefly, we have recently observed an increase in events where these patients have experienced symptoms of stroke, seizure and encephalopathy post neurointerventional procedures with subsequent recovery. One common feature among these patients is the unexpected presence of IV contrast in the brain post procedure.

How many out there have Metoprolol IV on their ADM override lists?

Thank you,
Jeff Ferber, PharmD

We have seen an increase in the utilization of TXA in our OB population and questions regarding compatibility of these two drugs in the same line as infusions. Trissels has no compatibility data and I have not located in any other data to support administering these drugs together in the same line.

As we continue to stress our system through high census, acuity, etc, we are looking at signals or thresholds that would serve as proxies for the overall safety of our organization. Like many of you, we track a variety of metrics and respond as necessary, but does anyone have a system in place to signal you when there is a drift towards unsafe territory? Any ideas are appreciated.

We have a situation that has recurred several times, and we struggle with it every time.
Currently, there are no insulin pumps that have settings based on U-500 insulin. Periodically, we have patients who come in with U-500 in their pump, so their pump settings do not accurately reflect the number of units they are receiving. How do we document this pump in the EMR? We try to move away from their pump to our medications, but that comes with conversion issues as well.

Hi. I've in New Zealand and have just joined the MSOS group.

As our Operations team tries to be more efficient with pharmacy preparation and decreasing TAT we are moving more and more products away from pharmacy compounding and towards ADC stock via Vial2Bag. Are any institutions providing safeguards/restrictions on high alert high risk medications being supplied in ADC's via vial2bag? For example calcium gluconate vial2bag? or bivalirudin vial2bag? Are you allowing those to be stocked in your ADCs? and if so, have you been successful in adding any safeguards to prevent errors ?

Curious if anyone has come up with a safe way to repackage topical creams/ointments? I am concerned from a human factors perspective about repackaging in slip tip oral syringes. Thanks in advance for any ideas!