MSOS Discussion Board

Opioid Risk Assessment Tool to identify high risk patients inpatient

Alissa Carter's picture

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Our opioid stewardship team is trying to determine the best way to meet the Joint Commission Pain Management Standard for identifying high risk patient's. We would like to flag patient's who are considered high risk for opioid related harm via Epic. Has anyone successfully implemented this at your institution. How are you meeting this standard and identifying high risk patients?

Zofran with prolonged QTc

Randi Trope's picture

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In the ED Zofran is often given quickly and early (from or in triage). Do you have any systems in place to ensure that patients with congenital prolonged QTc do not get it? We are seeing that those that prescribe it in the ED are usually NP's and residents that may not realize the connection yet.

Therefore looking to see what, if any, measures you have in place to prevent it's prescribing.

Fatigue Management and alertness testing

Mary E. Burkhardt's picture

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HI All,
I really enjoyed the "Great Safety Debate" at the ASHP Annual meeting. As part of the follow up to the drug testing debate, I have begun to look at what pharmacies or hospitals have done for fatigue management/ alertness in a structured way. I had a recent discussion with a vendor that was mentioned at the debate and I think my coworkers were a bit surprised how pharmacies are staffed in the real world with call ins, doubles, 7 on 7 off midnights, etc. (often in violation of fatigue management principles).

RN flushing practices

Lara Ellinger's picture

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We discovered a concerning nursing flushing practice that is occurring in our clinical research unit. After an IV investigational medication has been administered, the nurses are drawing up 30 mL of fluid (usually 0.9% NS) and injecting it into the empty bag. They then run the 30 mL at the infusion rate the drug was run at. They do this to ensure the entire dose of investigational drug is delivered, and state this is common practice across the country. We have safety, sterility, and documentation concerns and are wondering if this is actually done elsewhere.

Thanks,

Single Dose Vials

Natalie Kuchik's picture

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We have a lot of single dose vials that we reuse during 6 hours window that is allowed per USP 797, since we serve pediatric patients, we usually do not use the whole vial per one patient.

I was wondering how other hospitals store vials in ISO 5 environment, since we might epinephrine vial and dexamethasone that look almost identical. Outside of ISO 5 environment we have more space, so we can segregate epinephrine vial away from dexamethasone. What about narcotics, since they have to be locked? How can we store open vials of narcotics safely in ISO 5 environment?

Single Dose Vials

Natalie Kuchik's picture

Forums: 

We have a lot of single dose vials that we reuse during 6 hours window that is allowed per USP 797, since we serve pediatric patients, we usually do not use the whole vial per one patient.

I was wondering how other hospitals store vials in ISO 5 environment, since we might epinephrine vial and dexamethasone that look almost identical. Outside of ISO 5 environment we have more space, so we can segregate epinephrine vial away from dexamethasone. What about narcotics, since they have to be locked? How can we store open vials of narcotics safely in ISO 5 environment?

Single Dose Vials

Natalie Kuchik's picture

Forums: 

We have a lot of single dose vials that we reuse during 6 hours window that is allowed per USP 797, since we serve pediatric patients, we usually do not use the whole vial per one patient.

I was wondering how other hospitals store vials in ISO 5 environment, since we might epinephrine vial and dexamethasone that look almost identical. Outside of ISO 5 environment we have more space, so we can segregate epinephrine vial away from dexamethasone. What about narcotics, since they have to be locked? How can we store open vials of narcotics safely in ISO 5 environment?

Transgender Patients - Legal/Preferred Naming on medication labels

Tanya John's picture

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Hi,
Our institutions were presented with a proposal for medication labels with the ability to put both the legal and preferred name on the label.

Does anyone have any experience with this topic or can share if there are any recommendations out there?

I have found the following so far:
https://www.ashp.org/-/media/assets/policy-guidelines/docs/policy-positi...

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