Our organization is trying a therapeutic interchange to Levemir. We have some exception criteria to allow patients to stay on Lantus, which we are guessing will be about 30% of patients.

Currently we stock Lantus as a MDV in our ADC and send up Levemir as a patient specific medication. With the change, we are considering stocking both Levemir and Lantus as MDV in the ADC.

Do any other organizations allow this and what safety measures have you been able to implement to prevent confusion with the two brands.

Hello,
I am a Canadian pharmacist so forgive my ignorance of Joint Commission requirements.
I understand JC has requirements for policies/education around standard interpretation of orders such as HYDROmorphone 0.5-1 mg subcut q3h prn.
Would anyone be willing to share policies/educational tools or other approaches to ensure that such orders are consistently interpreted in your organization.

I am looking for some guidance on when it is ok to use a midline instead of a picc line for certain antibiotics. I have researched this topic to death and still come up with conflicting answers. I know that if the pH is <5 or >9 or >600 mOsm/L the drug should be given via picc line but some drugs in the grey area like Ampicillin (pH 8-10) or Meropenem which seems to fall in these guidelines (pH=7.3-8.3 300mOsm/L)are still listed on most "central line only" reference charts.

Nurse manager contacted me with the following question (see below). What are folks doing in their various workplace. Best regards
.....
We currently have Pitocin orders for “ 20 Units/ LR IV drip @ Wide Open (1000 ml bag x 1 bag). This poses a potential patient safety concern as there is no specific rate. This order is used in the post-partum phase (hemorrhage control/prevention). Does ISMP provide a recommended rate? Your feedback and input is appreciated.
.....

Hello all,
one of the JC standards looks for institutions to collect data on significant adverse drug reactions. We do quite a bit for med errors but could use some direction for ADR's. Can anyone share a tool they use and how you define "significant"?

Thanks!
Rachel

Does your hospital have an overarching committee that oversees smart pump technologies for multiple hospital systems.

Who are the members?
What are there responsibilities?

Could you share policies governing smart pumps?

Thank you Mark

Hello!

I am writing today to ask a question in regards to the preparation of bladder instillations (products to be administered intravesically into the bladder) in the outpatient space.

Typically these bladder instillations or bladder “cocktails” involve a combination of injectable heparin, lidocaine+sodium bicarbonate or bupivacaine, steroids and sometimes gentamicin. Typically these are administered in the office setting, however in some instances patients may be taught to administer such therapies at home as well.

Even with the lidocaine/epi shortage, our OR staff does not want to use as a MDV d/t infection risk and use in the sterile field.

Is anyone drawing up prefilled single-use syringes for OR use, and if so, what BUD are you using?

Thanks for any feedback!

1. Do you utilize an USP-NF 797/800 compliant clean room in your OR satellite pharmacy?
2. If not, do you have plans to update your OR satellite pharmacy to a USP-NF 797/800 compliant clean room?
3. If not using a USP-NF 797/800 compliant clean room, where are you mixing IV's for planned and urgent use in the OR? Any comments on stability dating are also appreciated.
Thank You,
Cathy Goetz, Medication Safety Officer
St. Luke's Hospital
Chesterfield, MO 63017

Hello All,

We are currently in the process of evaluating intrathecal medication administration in the outpatient setting, with anticipated use of barcode med administration (BCMA) and provider eMAR documentation. We would be interested to know how your institution handles intrathecal medication documentation in the outpatient setting. If there is a different process for inpatient administration, please comment as well.