Saturday morning coffee [May 23 2015]

“I was out on a date recently and the guy took me horseback riding. That was kind of fun, until we ran out of quarters.” – Susie Loucks

So much happens each and every week, and it’s hard to keep up sometimes. Here are some of the tabs that are open in my browser this morning along with some random thoughts….

MUG_SMC
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“Improving Safety and Efficiency in the IV Room” : thoughts on the ASHP webinar

I previously wrote about a live webinar put on by ASHP – Improving Safety and Efficiency in the IV Room: Key Features of Automated Workflow Systems – on Wednesday, May 20 2015. The webinar was made up of three separate, 20 minute presentations:

  • Medication Error Reduction Strategy Using Dispense Preparation and Dispense Check by Tom Lausten, RPh, Director of Pharmacy at Children’s Hospital of Wisconsin.
  • IV Workflow Systems: Barcode Plus Volumetric Verification by Steve Speth, RPh, Pharmacy Operations Manager at IU Bloomington.
  • Automated i.v. Workflow Systems and Technologies by Caryn Bellisle, RPh, Director of Pharmacy Regulatory Compliance at Brigham and Women’s Hospital.

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Saturday morning coffee [May 16 2015]

Repetition does not transform a lie into a truth.” — Franklin D. Roosevelt

So much happens each and every week, and it’s hard to keep up sometimes. Here are some of the tabs that are open in my browser this morning along with some random thoughts….

The mug below comes from the Starbucks Roastery & Tasting Room in Seattle, Washington. A friend of mine recently took me on a field trip to the roastery. Neat, neat place. It’s the kind of place I could spend an entire afternoon just kicking back, surfing the web, and drinking different coffees cup after cup. I highly recommend a visit if you’re in the area. A word of advice, don’t ask about “blond roast coffee”. Apparently they find it to be quite the abomination.

MUG_StarbucksRoastery
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Upcoming ASHP Webinar: Improving Safety and Efficiency in the IV Room

This caught my attention. ASHP is holding a live webinar – Improving Safety and Efficiency in the IV Room: Key Features of Automated Workflow Systems – on Wednesday, May 20 2015 at 2:00 PM ET.

According to the webinar site “Technology for IV rooms can be used to streamline work processes and support staff.  However, despite the advancements in technology there are still significant challenges in the compounding of sterile products. This webinar will take a look at IV room technologies and how it has improved IV room operations and overall safety for patients.  The speakers will also review the cost benefits, the key safety components including barcode scanning, imaging and gravimetric technology, and the best practices related to implementation and maintenance of these automated processes.

Objectives listed include:

  • Describe the most common IV Compounding Safety technologies available in workflow programs today
  • Describe and contrast the types of errors that the workflow technologies may affect
  • List key benefits of workflow systems beyond the reduction of errors
  • List and describe key considerations when choosing an IV workflow system

I look forward to attending as this is an area of great interest for me. I will be looking for depth of information presented in an unbiased manner. Not sure how deep they can go in an hour, but should be worthwhile nonetheless.

You can register for the webinar here, or by following the link above.

I’m done with #Lenovo machines

I’ve had a lot of laptops over the years. I started with a Compaq tablet PC back in the day. Great machine. Ground breaking design and functionality. Tried Toshiba a couple of times. Nice machines, but they always had terrible batter life. Had one really nice high-end business class HP. I liked that machine. I’ve had three Dell’s, all crap. And I’ve had three Lenovo machines: a T410s laptop, an x201t tablet PC, and my most recent purchase, a Yoga 2 Pro.

LenovoYoga2Pro

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ASHP updates chemotherapy guidelines

ASHP Guidelines for Chemotherapy

It seems as though everyone has chemotherapy on the brain. The National Institute for Occupational Safety and Health (NIOSH) is in the process of updating their Alert on Preventing Occupational Exposures to Antineoplastic and Other Hazardous Drugs in Health Care Settings. NIOSH already released a new list of hazardous drugs late last year. The U.S. Pharmacopeial Convention (USP) is busy finalizing General Chapter <800> Hazardous Drugs – Handling in Healthcare Settings. And now, ASHP has published updated chemotherapy guidelines.(1)
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More thoughts on USP <797> and pharmacy IV rooms [comment from reader]

A friend and colleague, Ray Vrabel, left a comment on my post from April 20th. I thought what Ray had to say was too good not to post. He raises some good points, which are worth more discussion.

Ray is a sharp guy, and he and I have had some good conversations over the past couple of years. He’s passionate about patient safety and pharmacy practice. While I don’t always agree with everything that Ray has to say, I definitely appreciate his thoughts and opinions.

Make sure to read more of Ray’s thoughts here.

Jerry,

Your post has got me wondering about a number of things: Area 51, The Kennedy Assassination, Obama’s birth certificate, and now USP797.

You raise the question which I have always wondered about: What was the problem that USP797 was attempting to solve? Was there documentation of significant problems associated with pharmacy-prepared IV admixtures by pharmacies who were following the ASHP Guidelines in place before USP797? Did anyone conduct a multi-hospital study to determine if hospitals following pre-USP797 ASHP Guidelines had any clinical problems associated with pharmacy IV admixtures? In other words, what is the science that drove the USP797 standards?

We have effectively turned our pharmacy IV Rooms into GMP-like sterile manufacturing facilities. So now, if properly followed, we have hospital pharmacies preparing a very high quality product from a sterility standpoint. That’s a good thing, but we also have a number of unintended consequences:

(1) Most IV admixtures are now prepared by pharmacy technicians, but they are no longer being directly supervised by pharmacists because of the onerous garbing requirements, making it inconvenient for the pharmacist to move into and out of the IV room.

(2) While there is now a requirement that every pharmacy must follow UPS797 standards, we do not have a technician licensure/certification requirement for all technicians in all states.

(3) While USP797 has required the use of all types of environmental, operational, and testing products, there is no requirement for pharmacies to use barcode checking of the IV admixture ingredients (i.e., Label, bag, and additives). Why do we have excellent sterility requirements with no requirement for accuracy of IV additive preparation?

What’s wrong with this picture? We now have sterile IV admixtures, but we don’t have any standards to make sure that the IV admixture is made correctly (i.e., correct ingredients). I feel that barcode scanning during medication preparation (BCMP) should be the minimum standard for ALL IV admixtures in ALL pharmacies. For more on this, please see my LinkedIn post: https://www.linkedin.com/pulse/why-hospital-gift-shops-more-important-than-pharmacy-iv-vrabel.

Three CE Opportunities for Sterile Compounding and the IV room

There’s little doubt in my mind that everyone’s eyes are on pharmacy IV rooms these days. Case in point, I’ve received several continuing education (CE) opportunities via email recently that are aimed squarely at the IV room and sterile compounding.

  • Achieving and Marinating Excellence in Sterile Compounding: Innovative Techniques to Ensures Competency (link)
  • IV Integration and a Culture of Safety: Reducing Complexity and Its Consequences (link)
  • Understanding the New Federal Framework for Oversight of Sterile Compounding (link)

So if you’re in the market for a little free CE – and let’s face it, who isn’t – and want some great information on a timely subject, then simply click on the links above. Enjoy!

What practice area benefits most from increased sterile compounding regulation?

I recently sat through a webinar that was recorded during a live symposium at ASHP Midyear in Anaheim on December 8, 2014. The symposium was entitled “Understanding the New Federal Framework for Oversight of Sterile Compounding” (1) and consisted of three separate presentations, one of which was given by Eric Kastango. (2)
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Do patients in the U.S. really own their healthcare data?

Yesterday I was reading through my Twitter stream when I came across a brief exchange between Eric Topol (@EricTopol)  and Farzad Mostashari (@Farzad_MD). Both are big names in the digital healthcare space.


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