Hoping others could share the communication strategies that are used when a drug shortage impacts medication availability in an emergency kit.

We utilize email and other alerts, but these have not been effective in getting information to the "end user" level, most times the first time a resident/RN gets notification is when the code cart is opened and there is not a needed medication. Recently vasopressin was an issue...

Appreciate any information you can share.

I just wanted to ask how many of you have reviewed the ISMP new IV Push guidelines for adults and have implemented them into a policy and mandated education on these?

Sue Dill Calloway

Our Healthcare system is looking at our current contract for IV fluids (BBraun) and we are considering changing to Baxter. There has been so much press about recalls, leakage, particulates, etc. I am wondering what other sites are using and their experience with shortages, leakage, breakage, etc.

Any feedback would be appreciated so that we can make the best decision for our patients.

Natalie

Good morning,

Our facility is a primary stroke center receiving stroke patients in the ER. We currently prepare and dispense 23.4% NaCl in pharmacy and deliver to the ER when a stroke patient arrives. The ER physicians are requesting storage of 23.4% NaCl in the ER Acudose. If your facility is a primary stroke center, are you storing this in the Acudose? What safety precautions do you have in place? Any advice on your safety measures is appreciated.

For those health systems using closed-system transfer devices (CSTDs), how do you prepare products requiring a small volume (less than 1 mL) of drug? We are evaluating our current processes for preparing tacrolimus. Also, how do you handle products only available in ampules given exposure occurs when opening the ampule?

I would appreciate your response. I will collate the results and send to those who are interested.

Thank you!

Do you send insulin drips via pneumatic tube system or is it on your "Do Not Tube List"?

Thanks.
dpatrick

How does your institution manage problems with therapeutic duplication of pain meds etc.?

Does you hospital have a policy which list medications ( particularly high risk meds) which should never be given peripherally? If not is this information inside another policy or guideline which is accessible to nursing?

Thanks.
dpatrick

Has anyone taken steps to increase medication safety with dabigatran, rivaroxaban and apixaban? If so, what was done? Has anyone resticted usage to order sets only? If so, were any barriers discovered. Have other methods beeen attempted?

Thanks, Vic
Victor DeLapp, PharmD, BCPS
Medication Safety Specialist

For those organizations using pharmacists for discharge medication reconciliation and/or counseling, can you answer the below questions? We are trying to expand our program.

1. Are pharmacists involved in all discharges?
2. If not all discharges, what criteria are you using? High alert meds? diagnosis with high readmission rates?
3. what metrics are you tracking?

thanks
Sean