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The Pharmacist’s News Source
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Millions in savings reported
Targeting Drug Wastage Slashes Chemotherapy Cost New Orleans—Strategies that resulted in significant cost savings, including a novel way to extend the beyond-use dating of chemotherapy medications, the judicious use of elastomeric pumps and having pharmacists supervise IV compounding to reduce drug wastage, were presented at the sixth annual meeting of the Hematology/Oncology Pharmacy Association. Ryan A. Forrey, PharmD, assistant director in the Department of Pharmacy at the Arthur G. James Cancer Hospital, Columbus, Ohio, demonstrated how he and his team were able to use an automated compounding device to extend beyond-use dating of chemotherapy agents from single-dose vials. In doing so, they were able to decrease pharmaceutical wastage while complying with United States Pharmacopeia (USP) Chapter <797> recommendations for sterile compounding. “The ultimate goal is to save money,” Dr. Forrey said in an interview. “After USP <797> went into place, its latest revisions stated that you could only use a single-
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see COST SAVINGS, page 12
New Orleans—Boston researchers have developed a bar code–based syringe-labeling system they believe has the potential to significantly improve patient safety and workflow in the operating room. A pair of studies by the investigators revealed that the technology not only provides full compliance with requirements of both the Joint Commission and the American Society of Anesthesiologists (ASA), it also improves the efficiency of the clinicians who use the device. And it passed muster with at least one pharmacist who specializes in medication safety in the operating suite. The system, a bar code–driven method of printing full Joint Commission-compliant drug labels at the time that the OR clinician draws up the syringe, “certainly makes sense, and it’s something that we would consider for the medications that we cannot prepare in the pharmacy department beforehand,” said Meagan Rushe, PharmD, manager of the Shock Trauma and OR
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see SYRINGE LABELS, page 34
Volume me 37 • Number 6 • June 2010
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McMahon Publishing
in this issue Up Front
ASHP Late-Breaker Pharmacists boost quality of post-anesthesia care.
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Audits reveal high rate of HIV prescribing errors.
Daily Feedback Can Help Fix Drug Order-Entry Errors Multistep action plan cut medication mishaps by 72%
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Operations & Mgmt
Finance Saint Barnabas just says no to payment claims denials.
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Policy
Research Tangled bureaucracy of NCI trials may imperil innovation.
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Clinical
Hem/Onc Pharmacy Improving the costeffectiveness of antinausea medications.
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Formulary Focus
Automated Syringe Labels May Boost OR Drug Safety
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GPO-wide echinocandin switch saves $4 million.
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Pharmacy Heritage The amazing Charles Rice and Bellevue Hospital.
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Tampa, Fla.—Progress in reducing medication order-entry errors took off slowly at first at Bloomington Hospital in Bloomington, Ind., after the Pharmacy Department launched an error-avoidance initiative in February 2009. As the months went by, however, the error rate kept falling, and by the time the full impact of the pharmacy’s actions took hold, it had been cut by 72%. At less than 0.5%, the rate of order-entry errors had not been that high to begin with, according to Stephen L. Speth, RPh, MS, pharmacy manager at the 317-bed community hospital, who presented the data at the American Society of Health-System Pharmacists Summer Meeting this month. However, the high volume of orders—an average of 2,500 per day—resulted in “an unacceptable number of errors.”
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see ORDER ENTRY, page 22
Technology
unSummit 2010 Ten years of bar coding triggers turnaround at VA.
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Educational Review
Diagnosis and Treatment of Mycosis Fungoides and Sézary Syndrome See www.pharmacypracticenews.com
QI Project Shows a Less-Is-More Strategy Works in ICU Sedation
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lighter touch with sedation in critically ill patients can translate into a host of benefits, according to the results of a new quality improvement (QI) project. The effort, by a multidisciplinary team at Baltimore’s Johns Hopkins University, involved reducing the medication dosages in their medical intensive care unit (MICU). As a result of the QI program, patients experi-
enced significantly less delirium and an increased ability to be mobilized and undergo rehabilitation therapy. The improved outcomes “were certainly encouraging,” said lead author Dale M. Needham, MD, PhD, associate professor of medicine. “Another key payoff, however, was reduced length of stay [LOS], which we documented not only in the intensive care
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see ICU SEDATION, page 18
New Products American Health Packaging adds metformin, other SKUs to its growing line of unitdose medications. See page
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