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Medication safety pearls from ASHP MCM: optimizing IV workflow, avoiding ped errors, and more ......................... 30
Demand for Drugs ‘Unpre
Who says DOACs don’t require routine patient monitoring? .................... 35
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POLICY
How to get the 20% add-on DRG payment for COVID-19 ..................
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OPERATIONS & MGMT
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he danger that there won’t be enough h medications to facilitate mechaniical ventilation in COVID-19 patients remains a concern as the infectionss continue to surge in hotspots around d the nation, according to a Vizientt analysis of 13 critical sedatives, opioidss and paralytic drugs. Even if the much-awaited “flattening of the curve” happens with COVID-19 cases, experts noted, the potential for a pandemic resurgence this Fall should keep ventilator drug supply chain planning a priority in the coming months. Erin Fox, PharmD, BCPS, the senior director of Drug Information and Support Services at the University of Utah Health, in Salt Lake City, said, “Hospitals are facing two to 10 times their normal ventilated population. This means that you need two to 10 times the amount of medications.
Parenteral nutrition:
Steering Clear Of Trouble From Hospital to Home
TECHNOLOGY
Telepharmacy and COVID-19: Taking the first steps to ramp up offerings ............................
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CORPORATE SPOTLIGHT
American Regent See page 26.
Shortages of sedatives, opioiids and NMBAs likely to worsen
CLINICAL
A repository program repurposes costly cancer meds ...................
Volume 47 • Number 5 • May 2020
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ransitioning a patient from the hospital to the home setting on parenteral nutrition (PN) can introduce a number of potential hazards. But several steps, from ensuring a safe home PN setup to identifying the appropriate PN formulation, can go a long way in protecting patients during this crucial handoff, according to a presentation at the ASPEN20 Virtual Conference. “It’s a team effort to get these patients on parenteral nutrition Continued on page 48
That is not so easy in these days of allocations and limits placed on the amounts of controlled substances you can order.” Vizient normally tracks about 200 acute and chronic “workhorse medications” used in hospitals, said Dan Kistner,
PharmD, the group senior vice president of pharmacy solutions at Vizient Inc. “About 69 drugs have our special attention because of the unusually high demand we’re seeing across the country,” he said. Continued on page 8
Preventing Medication Errors At Small and Rural Hospitals A
lmost right away, the nurse realized she had made a serious mistake. While administering medications during a shift in 2015, she gave one hospitalized patient a basal/prandial dose of insulin and then placed the pen on the top of the medication cart instead of in the patient’s medication drawer. She got distracted handling another task, then moved on to the next patient. Following the correct procedures before administering, she scanned the second patient’s wristband and the barcode on the insulin pen, and the correct dose appeared on the patient’s medication administration record (MAR). But then after administering the dose, when she opened
Special Focus:
COVID-19 Pandemic More coverage starting on page 6.
the second patient’s medication drawer, she saw their insulin pen and realized she’d used the first patient’s pen by mistake. The nurse immediately reported what had happened, and no harm came to either patient. But because insulin is a high-alert medication, the outcomes could have been much worse. Medication errors can happen at any hospital. But this one occurred at Deborah Heart and Lung Center, an 89-bed rural facility in Browns Mills, N.J. The hospital had safety checks in place in the patient’s MAR and the electronic health record (EHR), but one additional piece was missing: a patient-specific Continued on page 44