Hello!

Our institution has started a discussion around what PPE and preparation precautions should be in place for monoclonal antibodies (in both the inpatient and ambulatory setting). We recognize that the only monoclonal antibodies that fall on the NIOSH hazardous drug list include those that are conjugated to an antineoplastic (eg, gemtuzumab)... whereas other commonly used mAbs (eg, infliximab, omalizumab-outpatient) are not present in the list. (I did attach two articles that leaned towards treating these agents as hazardous medications.)

Hello,

We're trying to develop a good process for handling patients who are struggling with an opiate addiction and are on oral or injectable naloxone or Suboxone therapy. Specifically, how do we identify these patients? How do we treat them where they are under our care? How do we avoid discharging them on opiates?

Have any of you addressed this issue? Can you share your processes?

Thank you,
Dan

We have had many patients who are on warfarin being prescribed Toradol 1X for pain and also routine NSAID dosing. Providers state this should be our policy on this situation:

Dear Colleagues,

Hope you are doing great
As you all know, every healthcare organization has it's own KPI ( key performance indicator ) for medication error rate followup which aim to control medication errors among the hospital and help to prevent recurrence of incidents, my inquiries about if you have formula or equation to determine the internal target of medication error rate that you will achieve it quarterly or monthly ( regarding the international target is it 2% - 14% ). Any participation will be highly appreciable. Thanks

If anyone is willing to share your organizations standardized order set and/or policy for antimicrobial prophylaxis in Surgery. I would be very grateful. Thank you. ...

Brenda Santiago, BSPharm, RPh, CPPS
Quality and Medication Safety Specialist
HIMA San Pablo Hospital
Caguas, PR

How does your organization address the use of multi-dose vials in patient rooms that are in isolation status?

Most inpatient care areas in my organization have medication storage just outside of the patient rooms (in a locked medication drawer). The question has come up for patients that are in isolation, what is the most appropriate way to store MDVs like insulin? We use BCMA and would typically prep the insulin at the bedside and return it to the drawer to be used solely for that patient. But if the patient is in isolation, that complicates things (risk of contamination).

Hello,
Wondering if anyone would be willing to share their charter if your organization has one.

Also available for direct email and phone conversations if you like.

dpatrick@childrensnational.org

Thanks.
DiANthia

1. How are implanted Intrathecal pumps documented at your institution?
2. Are medication orders entered on the MAR for these infusions?
3. How are drug combinations orders handled such as clonidine/HYDROmorphone or morphine/bupivacaine; i.e., are these combinations setup in the hospital formulary for CPOE, ordersets, etc?
4. Is a Pain Management Consult required.
5. If not, who reads the pump programming?
6. Do you have a policy governing IT pump use in the hospital?
7. Are you willing to share policies and/or ordersets?

Thanks, Vic

Does your outpatient pharmacy deliver discharge medications to the patient’s bedside?

If yes, where are they stored if the patient is not ready for discharge?

Thank you,
Ann Jankiewicz, PharmD, BCPS, FASHP
Rush University Medical Center
Chicago, IL

Do you allow nurses to administer ketamine IV push for indications other than sedation (i.e. status epilepticus)?

Thanks,

Cortney Swiggart pharmD
Med Safety Officer