Jerry Fahrni

Category: Pharmacy Practice

  • Aethon launches TraySafe at #ASHPSM15 in Denver

    I’ve been at the ASHP Summer Meeting in Denver this week roaming the exhibit hall looking for interesting new products. One product that caught my attention was TraySafe by Aethon.

    TraySafe is a medication tray management system. There are several such systems currently on the market, but what makes TraySafe different is its approach to the replenishment process. The system utilizes a combination of photo recognition and barcode scanning to analyze tray content and notify the user of items that are missing, in the wrong location, or about to expire.

    TraySafe1
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  • Pharmacy – entrenched in outdated dogma

    Dogma: belief or set of beliefs that is accepted by the members of a group without being questioned or doubted (Merriam-Webster)

    I have opinions, lots of opinions. And like most, I believe my opinions are valid; it’s human nature. It’s not uncommon for me to find people within a group that agree and disagree with my opinions. However, once in a while I come across an entire group of people that stand in disagreement with my thoughts. That’s not crazy to imagine, but when that happens I’m forced to re-evaluate. Let’s face it, if everyone thinks I’m wrong, it’s possible that I am.

    Such is the case with my thoughts on the use of technology and personnel in the i.v. room, which are on record at this site and are quite transparent. In a nutshell I believe that:
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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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  • 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.

  • ASHP updates chemotherapy guidelines [UPDATED]

    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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  • 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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  • Managing medication trays in acute care pharmacy

    Medication trays – a.k.a. med trays, code trays/kits/boxes/bags, transport trays/kits/boxes/bags, intubation kits, C-section trays, anesthesia trays, and so on ad infinitum – are common in acute care pharmacies.  I’ve seen them in every variation you can imagine in every pharmacy I’ve ever been in.

    Depending on the situation, med trays can contain a large number of injectable medications. For example: code trays may contain several different neuromuscular blockers like vecuronium, rocuronium, succinylcholine; pressors like epinephrine, norepinephrine, phenylephrine;  other code drugs like atropine, vasopressin; reversal agents like naloxone and neostigmine; antibiotics, etc, while a C-section tray may contain local anesthetics in various shapes and sizes (lidocaine with or without EPI, SDV or MDV, bupivacaine of various concentrations, etc). The list goes on. It’s pretty crazy.

    Anesthesia_Tray
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  • Drug shortages, whose to blame?

    Medscape: “One cause of these shortages, pharmaceutical companies charge, is the amount of time it takes the DEA to approve controlled substance quotas. The DEA has created these quotas for each class of controlled substances and for each manufacturer of drugs containing these agents to prevent their diversion to illegal uses.”

    The drug shortage problem is nothing new. It has become an everyday reality of pharmacy practice. ASHP has established a dedicated website for the problem, and the FDA has gone as far as to create a mobile app to help people track shortage information.

    For most people the idea of a drug shortage seems silly, i.e. just make more. The problem is more complicated than that, however. The causes of drug shortages are multifaceted.
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  • Applications to assist with Antimicrobial Stewardship

    A couple of days ago I wrote about The California Antimicrobial Stewardship Program Initiative, and how it’s an opportunity for pharmacists to get out and stretch their clinical legs.

    Antimicrobial stewardship requires a lot of real-time surveillance and monitoring of patients, labs and cultures, medication use, and so on. There are basically two ways to accomplish this. One is tedious and inefficient, while the other is smart and efficient.

    The tedious, inefficient method is the one used by many healthcare facilities. Pharmacies in these facilities simply throw pharmacists at the problem by having them look at a bunch of patients manually every day in search of anomalies. It’s very time consuming. It’s like looking for a crooked needle in a needle stack.

    The smart, efficient method involves the use of clinical decision support systems. These systems are connected to several data feeds from other systems throughout the hospital, such as ADT, pharmacy, lab, and so on. The data is aggregated and analyzed against a set of rules designed to find patients with potential problems. These patients are tagged and referred to a pharmacist for follow up, i.e. the pharmacists are only presented with the crooked needles. It’s a much better way to go about things.

    There are several systems on the market designed to perform real-time surveillance and clinical decision support. The list below includes many, but is certainly not exhaustive.