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The Pharmacist’s News Source
pharmacypracticenews.com
Volume 38 • Number 7 • July 2011
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Printer-friendly versions available online
ISMP pushes for more flexibility
CMS 30-Minute Rule On Drug Administration Seen as Risk to Patients
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he Centers for Medicare & Medicaid Services’ (CMS) rule requiring that medications be given within 30 minutes before or after their scheduled time has prompted many health-system nurses to adopt rushed and risky workaround practices that increase the potential for serious errors, according to the Institute for Safe Medication Practices (ISMP). ISMP and other groups, including the American Society of Health-System Pharmacists (ASHP) and the American Pharmacists Association (APhA), have asked CMS to implement a more flexible approach to administration timeliness, one that retains the 30-minute rule for time-critical medications but allows others a wider dosing latitude. At least one hospital already has taken the more flexible approach to drug administration, despite the risk for being
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in this issue Up Front
Capsules Video-based learning may be best tool for teaching pharmacy technicians.
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Clinical ASHP Summer Meeting: Initiatives reduce ‘alert fatigue’ during drug order verification.
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Pain Medicine New clues emerge for understanding opioid abuse.
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Operations & Mgmt
Leadership Building the next generation of pharmacy leaders.
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see 30-MINUTE RULE, page 6
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Technology
Each Member of BCMA Team Should Be a Key Player in Patient Safety Louisville, Ky.—The most important factor in implementing a successful bar code medication administration (BCMA) program is ensuring that all players in the process feel that they are accountable to one another. Moreover, that sense of shared responsibility can’t only be present in the rank-and-file staff tasked with implementing BCMA. “It has to be present all the way up to the top at the executive level,” said Karla M. Miller, PharmD, BCPP, director of pharmacy at the Hospital Corporation of America (HCA), in Nashville, Tenn. For BCMA to work, a multidisciplinary team that works well together is essential, Dr. Miller said at the 2011 unSummit for Bedside Barcoding meeting. All members must feel a sense of responsibility not only for
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see ACCOUNTABILITY, page 50
Bar Coding VA initiative slashes BCMA scanning errors.
FDA, Joint Commission poised to issue new guidances following ISMP Alert
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Medication Safety
More mentoring nuggets from Ernie Anderson Jr.
A Call to Action on Sterile Compounding Gains Traction
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hree months ago, the Institute for Safe Medication Practices (ISMP) called on regulatory agencies to increase oversight of compounding pharmacies in the wake of nine deaths in Alabama linked to contaminated admixtures. It now appears that at least two of those agencies—the FDA and the United States Ph ar mac opeia (US P)— are beginning to respond, according to interviews with several top officials. The deaths have been attributed to an outbreak of Serratia marcescens in outsourced total parenteral nutrition solutions shipped by a single compounding pharmacy. In the ISMP’s Medication Safety Alert! on the outbreak, the group recognized the importance and practicality of contracting with compounding pharmacies.
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Educational Review
Pharmaceutical Issues in Patients Receiving Enteral Nutrition insert after page
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REPORT Flebogamma® DIF: A Highly Purified Intravenous Immunoglobulin See insert after page 28.
see TPN POLICY, page 8
After Heart Transplant, Hospital Admissions Often Are Drug-Related San Diego—Drug-related problems were determined to be the primary cause of hospital admissions in 40% of heart transplant patients treated at a Missouri center, according to a study presented at th e annual meeting of the International Society for Heart and Lung Transplantation. More than half of the drug problems were deemed to be preventable,
reported co-investigator Kristin Repp, PharmD, clinical pharmacy coordinator at Saint Luke’s Northland Hospital, in Kansas City. Drug-related problems in the 300 patients studied were classified by type, pharmacologic class and impact on hospital length of stay (LOS). The researchers used the Adverse Drug Reaction Scale (Naranjo algorithm) to rank the reactions according
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see TRANSPLANT, page 44
New Product CareFusion announces the launch of their Pyxis EcoStation™ system. See page 53.
Products for pharmacy automation, medication management, and more. See insert after page 20.