I am wondering what other hospitals have put in place to reduce wrong route administration errors with orders to administer atropine eye drops orally to reduce secretions. Is anyone placing in a different container?

Appreciate any insight you can provide. Thanks!
Jen

My name is Barbra Fobi an ISMP fellow. I am currently working on the question “what is the safest way to express doses less than 1 mg (e.g. 0.057 mg or 57 mcg)?” In addition, is there a safer dose expression when crossing a metric threshold (i.e. 1000 mcg or 1 mg)?” Presently, ISMP’s Draft Guidelines for Safe Communication of Electronic Medication Information #9 addresses trailing zeros, leading zeros (e.g. 0.3 instead of .3) and commas but not these specific concerns.

I'm looking for some feedback on how other institutions are dispensing pharmacy-compounded syringes for inhalation. Some examples we're dispensing here are: amikacin, albuterol, amphotericin B, polymyxin B, and colistimethate.

What syringes are you dispensing in? (IV vs. oral)

Do inhalation syringes (other than the 60 mL Aerogen syringe) exist? Specifically, smaller volumes?

Any other additional preparation steps to ensure proper administration route (labeling, bagging, etc)?

Thanks!

If you use bottled sterile-water-for-irrigation for reconstitution of oral powders, when do you discard the bottle after opening? Single use? 24 hours?

Thank you for any info you can provide!

Very respectfully,
Jane Mauro

Does anyone have a hospital policy on self-administration of medications or administration by family members that they could share? We've had patients and family members wanting to administer medications and I am looking to address this in policy.

Thank you,
Madiha

HI All,

I have been to Susan Scott's presentation on Second Victim support. I attended with a pharmacist colleague who is a second victim. Right now, I am at ASHP in the peer support program right now.

My colleague and I spoke about having a support page for pharmacist second victims, so I created a SECRET group on Facebook. You can't see it. I have to INVITE them. If someone who is a second victim would like to join the group, have them contact me through FB.

If you have worked in this space and want to share the moderator role with me, reach out to me.

Is anyone willing to share their experience with various technology to automate/track your medication carts/kits, especially as regards accuracy and safety? I am especially interested in pro's and con's for the type of replenishment system that electronically scans/evaluates a whole tray at a time and e-validates placement, exp dates, correct med, etc.

Hello! We are a pediatric hospital within a larger adult hospital and use Omnicell as our automated dispensing cabinet. We've found that liquid controlled substances are particularly difficult for tracking patient-specific doses from the Omnicell, and the system seems to want a "stock dose" to be dispensed; however, since we strive to dispense other liquids as patient-specific, I'm worried that this introduces a risk for errors in administration. Does anyone have recommendations for how they are handling patient specific liquid doses from the controlled substance Omnicell? Thanks!

It is my understanding that phenylephrine is becoming standard for maternal BP maintenance during C-section and the literature out there is mcg/min dosing only. Of course deciding what weight to use in this population is complicated also. We have for a while been on only mcg/kg/min dosing for all pressors and are being asked to revisit that decision in light of this. Wondering if other facilities have had this same situation arise recently and what decision you ultimately went with.

Thanks!
Jen

Hello,
Does anyone have a policy on using your negative pressure sterile hood to mix all medication in the pharmacy?

We do not have a clean room. We have a negative pressure hood vented to the outside. We mix MTX in a syringe for IM injection once a week only. We do the steps after each syringe to Deactivate, Decontaminate, Clean and Disinfect. Do we need to have a separate sterile hood to mix all other IVs since we use this hood for MTX?

Thank you in advance for any information you can provide.
Jan