Does anyone have mitigation strategies used to ensure that long acting injectables are prescribed appropriately at discharge after starting therapy in an inpatient psychiatry setting? We have had some near miss events in which the long acting prescription was not provided at discharge. Any advice is appreciated!

We are an Oracle Health/Cerner site.

Good afternoon,

For patients who are unable to verbally communicate pain, do you have separate prn pain medication orders that include the non-verbal pain assessment tool used? Or do you include both verbal and non-verbal pain scales in your prn pain medication orders? Would greatly appreciate it if you could share examples of your orders.
Thank you in advance for any advice or insight you can share!

Hello colleagues,

Given the Venofer shortage, hospitals in my area (northwestern Washington state) are using more Ferrlecit. I have received reports of increased infusion reactions at those sites, particularly with 250 mg doses.

Is anyone else seeing this uptick in Ferrlecit infusion reactions? If so, have you identified any trends (i.e. lot numbers, dose, concurrent diphenhydramine use, etc)?

Thank you,
Megan Fragale, PharmD, MS, BCPS
Medication Safety Officer
Skagit Regional Health
Mount Vernon, Washington

Hey all,

Looking to see what sites are doing for acetylcysteine inhalation. We have seen several near misses due to the Acetylcysteine inhalation vials looking like regular injectables. Nursing staff have also voiced concerns about tearing the cap completely off due to the risk of cutting themselves on the metal collar. I've heard that some staff utilize a syringe w/ needle to draw up the inhalation liquid to then place in the inhalation chamber.

We also utilize the Aerogen nebulizer which has a very small opening to add medication to.

Inquiring about storage of concentrated ketamine (100 mg/mL product). We currently store the 50 50mg/mL in select ADCs but are considering expanding to the 100 mg/mL product due to several events with combative and agitated patients needing high IM doses. Wondering how other sites are handling the safety implications around this.

Has anyone been able to make dedicated charts for either fetally administered meds, or meds that need to be ordered and available immediately at birth (eg, palliative birth meds)?

We're concerned with fetal vecuronium orders being placed on mom's chart, and right now have a kit that has to come up from pharmacy for palliative births. The kit is problematic because it is lots of controlled meds and isn't as secured as we would like.

Thanks!
Kara

hello!

Looking for input on handling of Botox at other institutions. Currently our hospital has Botox listed as a hazardous drug that would require double glove, chemo gown, and mask for reconstitution. I am not finding any information that justifies our current handling of this medication, but just wanted to reach out to others to see how your institutions classify/handle this drug.

Thank you for your time! I am new to this group and looking forward to collaborating in the future.

Hi! I am trying to build out amivantamab the safest and least complicated way for nurses to follow into our IV pumps at a cancer institution (Alaris and Baxter). Has anyone built this out in their institutions and how was it done?

For context, Amivantamab has 6 different doses and some of the doses like 1400 mg can be given over different rates depending on what number week of therapy it is.

Any insight would be greatly appreciated.

Thank you,

Monique Hazelcorn
Miami Cancer Institue

Over the past few years, my institution has made progress in terms of treating contrast agents like medications. Most are ordered in Epic based on an Algorithm and some are now scanned before administration.

We are considering whether RPh verification is required for these agents (or perhaps some and not others?). Please share your thoughts and experiences!

Thank you.

For those of you that dispense IDS medications, do you have a policy or procedure for when a study team wants to administer a medication that is NOT dispensed from your pharmacy? Do you treat it as a patient's own medication (PTOM)? We have not been asked to be a dispensing site for this particular study, but the study team wants to transport the medication to be administered on the inpatient side, again without pharmacy involvement. I feel it needs to be somehow profiled on the patient's chart. Thoughts/comments?