Has anyone out there successfully implemented all 12 Targeted Best Practices? I would be interested in talking with you! Thanks!

Hello,

We are interested in knowing how other institutions enter their patient's home medications.  At our institution, we currently enter a dummy "POM" medication into the patient's profile.  However, this dummy record does not perform a drug interaction check for new or existing orders. We currently have Meditech version 5.6.6.  Our current process relies on a manual check which allows for POMs drug interactions to be missed.  Any feedback or suggestions on the following questions are appreaciated:

1- How does your institution enter patient's home medication?

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We did a brief article in today's ISMP newsletter related to the recent tragic error in Oregon where a neuromuscular blocker was prepared in a bag labeled fosphenytoin.

http://www.ismp.org/newsletters/acutecare/showarticle.aspx?id=97

The Strategies Worth Sharing session is scheduled for Wednesday, June 10, 2015 from 8 -10 am at the 2015 Medication Safety Collaborative. Notice that this session used to be called “Best Practices” but has been renamed to avoid confusion with the ASHP award program called Best Practices.

What is the process you use for notification of nursing that a medication has been prepared and delivered to the floor/Pyxis machine? We are not yet at BCMA so this process can't be used and we are trying to figure out a way to improve the process.

We have need to send patient specific subcutaneous IV preparations to our floors.  The nurses are asking we send the preparations with a subcutaneous needle primed and attached so they do not lose any medication in the needle (these are small doses so 0.1mL lost to the needle could easily be 25% of the dose).  Has anyone done this successfully?  I am concerned that the needles could fall off during transport. I have asked the technicians to put these preparations into separate sealed bags when delivering.  I know there has to be a better way to do this.  Suggestions?

Phenytoin and fosphenytoin are now considered "hazardous" by NIOSH on their 2014 list... It is currently stocked in ADCs in our emergency room and critical care areas. Are people removing phenytoin/fosphenytoin from ADCs and mixing all doses in a chemo hood? Is anyone making an expection in their hazardous drug handling policy for STAT meds?

Good morning

We received a query that the sender and ISMP would appreciate your input. Does your hospital IT system have the ability to notify the nurse by a visual or audio cue which medications are in the time-critical period of giving to meet CMS guidelines for drug administration?

If you don't mind what system are you using? Thanks!

Ivy Andreica, BSN, PharmD

Dear colleagues,

If you have a few minutes, would you please tell us if you are having any trouble scanning Exparel? We are curious as someone reported to us that their system is not able to scan Exparel's barcode as it contains a large amount of characters. We contacted the company but thus far no feedback. We are doing data gathering all the same.