HUNTSVILLE HOSPITAL PHARMACY
STERILE PRODUCTS UPDATE

January 2017

Pharmacy Sterile Products Newsletters Docushare Archive

Annual CBLs

Thanks to all for completing media fill and glove tip testing! An email will be sent when the CBLs are ready to be completed.

Robot Update

neostigmine and ketamine syringes are now being made on the robots. Berkley will be sending detailed information on how to handle ketamine since it is a controlled substance.

Pharmacy Keeper on site

PK will have personnel on site Jan 16^th – 17^th. They will be here to better understand our needs as well as troubleshoot ongoing issues. April and Travis have been working to get all the barcodes to scan properly. After their visit we will increase our use of PK verification and will need to address workflow issues. Please continue to communicate what is working well and what isn’t working well.

NERK syringes for colorectal surgery

Midnights now has a separate folder for orders that have been filled. Please consult the “midnights orders completed” folder if questions arise about which products were made or which pyxis machines they are in. PSP is typically not able to prepare NERK/Joint Cocktail for add on cases or for orders that were not received.

TPN Update

To ensure the standard neonatal and adult TPNs are accurate, a copy of the template is available next to the TPN printer. This can be used to verify the appropriate ingredients and amounts are pumped for the standard TPNs.

NERK Error

NERK is used for surgical site infiltration. At Crestwood, a NERK syringes was given IV push. Continue to label each NERK and Joint Cocktail syringe with the pink “NOT FOR IV PUSH” label.

Fluid Volume Error

A methylPREDNISolone IVBP was ordered for OPMED 1000mg mg in D5W 250 mL, but was made, checked and sent in D5W 100 mL. Don’t forget, when making and checking compounded sterile products, the fluid volume is an important piece of accuracy of the product.

Bacterial monitoring

The bi-annual bacterial monitoring will be performed this month. As always, ensure you have completed and documented your monthly cleaning assignment.

Midnight Workflow

Due to increased workload volume, a few adjustments have been made to the workflow for midnights: Vancomycin 1250 mg and 1500 mg is now being made on the robot. Many premade electrolytes have been added to pyxis machines. T1/T2 is making NERK/Joint Cocktail, heparin and vein bath for CVOR.

DRUG UPDATE

Intracardiac EPINEPHrine 18G – out of stock
cefotaxime- out of stock
raNITIdine injection - reserve for Peds
procainamide vials back in stock
Zosyn – back in stock
bupivacaine 0.5% w/ EPINEPHrine – packaging 0.5% bupivacaine vial with 1 mL EPINEPHrine amp