Hi all -

Is anyone engaged in a community collaborative, encompassing multiple hospitals, to work on medication safety projects?

Thank you!

Elizabeth

Our institution recently went live with the Alaris PCA and end-tidal CO2 (EtCO2) modules. We opted to implement the EtCO2 pause protocol (which will automatically pause the patients PCA when the RR drops below a pre-defined value).

We started out conservatively with an 8 bpm lower limit for adults. With this value, we have seen a lot of nuisance alarms and inappropriate pauses based on the actual patient presentation.

The national shortage of parenteral opioids is well known. Looking for hospital strategies to reduce the use of parenteral opioids quickly. Especially wondering about IV to PO criteria, for example.

Can you share what your facility does for any medication errors that reach the patient regarding notification of the patient/family and if/how it is documented in the medical record.

Do you have any policies/guidelines regarding this?

Thank you.

Hello All,

Where are you disposing your controlled substance waste?
Do you discard by flushing down the toilet/ sink? squirting waste into biohazard/ sharps? or another container such as Cactus?

Has any received any citations from Joint Commission regarding disposal of controlled substance waste in sharps containers as not being considered 'secure' and the controlled substance is not considered 'non-retrievable'

Thanks,
Olga

Hello All,

Has any had issues with the Joint Commission citing hazardous waste containers as being not secure? (because someone can put their hand into the container) They do not contain controlled substances. We are in the process of switching to Steri-cycle. Also looking into where to keep the containers? Currently in locked Med room. Is anyone storing anywhere else?

Thanks,
Olga Woloszczuk

Can anyone share their policy/procedure for administering enalapril IV push? Do you allow it? What are requirements?

There is some discussion at ASHP about requiring nursing to use filters for IV push medications that they prepare on the unit. Is anyone requiring this? Is this an old policy or a new one implemented with the minibag shortage?

The Radiology Department is asking pharmacy to weigh in on a policy that requires patients to have a driver if they need pretreatment of Prednisone and Diphenhydramine (50 mg orally) prior to contrast studies in patients with contrast allergy.

This has posed a hardship for many patients. Can anyone comment on this? Do you have objective criteria for evaluating / screeing patients for risk related to sedative properties of diphenhydramine?

Thanks for your input,

We have been streamlining our hazardous and reproductive risk medication processes here, which included automated alerts into our ADCs and carousel for front-line staff.

I am reaching out to other facilities to see how they handle labeling hazardous and/or reproductive risk medications, especially for intact oral tablets. Do you label every tablet individually or do you label only its packaging/container (i.e. baggie)? Any other different approaches?

Thank you!