Hi all,

We recently have had a spattering of reports that the spike is falling out of Fresenius Kabi heparin 25000 unit/250 mL bags. This has occurred in patient repositioning and just during transport. I was able to easily replicate this in my office.

Has anyone else experienced this issue, or have any mitigation strategies?

Thank you,

Kara Thornton

Does your organization have a policy or protocol related to management of diabetes while patients are observed in the ED? Thinking specifically of how we can mitigate risk of patients with type 1 diabetes going without basal insulin for too long if they happen to be held in the ED for a prolonged time. What about policy/protocol for checking blood glucoses at regular intervals when they have not yet been admitted?

Appreciate any insight you may have.

Sloane Hoefer, PharmD, BCPS
Nebraska Medicine

Good morning,
With the updates to ISMP best practices and high alert lists related to tranexamic acid, we are re-evaluating our dispensing practices for this medication. I have a few questions for the group:
1. How are you dispensing TXA for nebulization?
2. How are you dispensing TXA for topical use?
3. If you have any order panels or order sets that work well or safety measures you have implemented for this medications that you are willing to share, I would greatly appreciate it.

Thank you!
Jordan Anderson
Driscoll Children's Hospital

Hello,

For those involved in USP 800 program implementation/maintenance for your organization, especially larger institutions with a main cancer center and many community infusion centers:

What is your general approach to handling hazardous drug spills?

1. Do you have different processes for large centers vs. small community sites?

2. Who is involved in the hazardous drug spill response? What (if any) role do the following stakeholders play: pharmacy, nursing, chemical safety, environmental services, etc.?

We are working on updating our policy on 503B outsourcing to standardize our process. Does anyone have a policy they are willing to share? Our current policy is so vague I'd like to add a SOP to delineate the specifics. My biggest concern is the documentation piece. Do you require quarterly safety reports?

My hospital is in the process of implementing a policy that allows the use of medical cannabis on their premises for terminally ill patients with a valid Medical Marijuana
Identification Card (MMIC) or/ recommendation from an attending physician. (Ryan's Law).

One of the questions we are trying to address is the requirement of a locked container – does it need to be affixed to the wall or can it be a lock box that we can provide to the patient or caregiver? What are some ways that your hospital has implemented this requirement?

I appreciate your time and input!

Hello fellow Med Safety officers.

We recently conducted an insulin storage audit at our organization and identified some opportunities for improvement.
I am hoping to get an idea of how other hospitals are storing and dispensing insulin vials.

At your respective facilities:
1. Are insulin products dispensed as patient specific, multi-patient use or a combination of both (e.g. long acting insulins - pt specific, rapid acting insulin = multi-patient use)?

Dear all,

I wanted to learn your current processes to prevent propofol diversion (storage in the pharmacy, in patient care units, and OR). Do you have it as a controlled medication (if your state does not require it)?

Thank you,
Deepika

Has anyone successfully instituted an automatic stop time for opioids or benzodiazepines while in-patient and is willing to share their policy or procedure? Likewise, if anyone has successfully used pharmacy to minimize discharge on these classes unnecessarily, would love to hear about it as well.
Thanks all.

Hello! I am interested in learning if anyone has done work to improve safety for medication orders that are only needed during the dialysis session.

For example, what safeguards are in place to prevent an order for heparin, only needed during dialysis, from being administered outside of the dialysis "procedure".

Appreciate any thoughts or insights you may have!

Kind regards,
Jen