What safety strategies have people employed to prevent tubing mixup for TPN compounders? See brief description of our event below.

Has anyone successfully used the "shrink wrap"-type vial covers for any of their high-alert medications? For reference, I was looking at the product available from Healthcare Logistics: https://shop.gohcl.com/default.aspx?page=item detail&itemcode=16063

We are specifically considering them for use with our neuromuscular blocking medications, as applying labels to the vials is problematic space-wise.

My concern is that it looks like the shrink wrap could possibly cover important vial labeling information.

Hello,

We are hoping to learn from other pharmacies who compound autologous serum eye drops for ophthalmology patients. If you are currently preparing these drops following USP 797 standards, would you mind sharing your written procedure or provide an overview of your process?

Thank you,
Crystal

Crystal Holmes, PharmD
Pharmacist Practice Leader, Regulatory Compliance

It has been a while since this topic was posted here.

What safeguards is your institution employing to enhance safety when topical epinephrine is used for ENT cases?

Are you repackaging epinephrine in a pour bottle? If yes, what sterile container are you using for that repackaging?

Hi all,
we currently have ketamine on override in Automated Dispensing cabinets in ED only. We have had a request to add to ICU on override.

Wondering if other folks have ketamine on override in ICU and if so,
1- are nurses allowed to administer ketamine, and
2- do you have safeguards around the withdrawal of this med (witness, alerts, etc.?)

Alternatively if you do NOT have ketamine on override if you can share thoughts or how you handled any pushback.

Thanks in advance!
Dana Miller

I can't find a great answer to this.

What techniques do your institutions use when the OR needs to open a vial to spread the powdered contents into a bone cement? Are there any tools to ensure aseptic technique? One of the nurses mentioned hearing about a catheter, but I can't seem to find anything.

Hello,

Has anyone completed the gap analysis tool? I'm curious to know whether your institution required you to obtain IRB approval prior to completing the tool. Thanks,

Jennifer

Hi, all -

How does your organization handle IM injections with volumes that exceed maximum recommended doses? We've seen a few examples recently, such as methotrexate for ectopic pregnancy and ceftriaxone.

Our pharmacists have been separating into multiple syringes and hand-writing "1 of 2" and "2 of 2" on the individual syringes, however, a single barcode scan at med admission would technically "fulfill" the entire order so there's risk of only partial med administration.

How are other facilities labeling Hazardous medications? I have several questions.
1. Are you using a simple statement "chemotherapy - Hazardous Medication, handle with care"
2. Are you putting NIOSH category 1,2,3 with reference for PPE?
3. Are you building these messages at the primary drug level or placing information in comment sections?
4. Is this information face up on the eMAR for nursing?

If you are a Cerner facility, your input is especially welcomed.

Kind regards,

Kelly

For hospitals that utilize Catcus, Stericycle CsRx, or other diversion deterrent waste systems: