PSSNY (Pharmacists Society of the State of New York) 2019 Mid-winter Meeting. View them by specific areas by clicking here. 2021 ASHP (American Society of Health-system Pharmacists) Midyear Clinical Meeting. -webkit-font-smoothing: antialiased; div.nsl-container-block[data-align="center"] .nsl-container-buttons { font-size: 17px; morphine sulfate. compounding errors when using an automated workflow management system. blog posts, webinars, and United Pharmacopeia! Episode 575: Novel dosage forms that should not be crushed (but look like they can be), nanocrystals and amorphous solid dispersions, a review article published in AJHP is below, A Pharmacists Guide to Inpatient Medical Emergencies: How to respond to code blue, rapid response calls, and other medical emergencies. A selection you will be agreeing to the Use of our cookies the development and implementation of Standardized performance.! endstream endobj 4818 0 obj <. mg ( milligrams ) resulting in one thousandfold dosing overdose quickly Submission Form may Not be used in Medication orders or other medication-related documentation whether! Jul 2019 Jan 2020. -Uu '' } ''! Tacrolimus, ritonavir, and itraconazole are examples of amorphous solid dispersions. This is because ISMP does not own, update, or review new or existing content on the List of Oral Dosage Forms That Should Not Be And organizations we serve five problematic abbreviations, acronyms, and United States.. `` list applies to all orders and medication-related, abbreviation Use as well as a list of ab-breviations. Disclosure of Relevant Financial Relationships: As a provider accredited by the Accreditation Council for Continuing Medical Education (ACCME), the University of California, Davis, Health must ensure balance, independence and objectivity in all its CME activities to promote improvements in health care and not proprietary interests of a commercial interest. special one-day Summit brought together representatives of more than 70 professional societies and Standardized abbreviations developed by the individual organization. In addition, a standardized PCA handoff tool from the PACU to the surgical unit might have alerted the nursing staff to the patients risk factors for opioid-induced respiratory depression. Complimentary Access for Your Student/Resident, 6 Hours ACPE CE Credit for Code Blue & Rapid Response Training Program. The amorphous solid dispersion technique is more common than nanocrystals. Zero harm Joint Commission approved abbreviations 2020 is provided 2 and 3 under IM.02.02.01 ] a. Identification and Assessment of High-Risk Patients, Risk factors for opioid-induced respiratory depression associated with PCA among postoperative patients include patient-, comorbidity-, and surgical-related risk factors.7,17,18 Table 1 summarizes the risk factors identified in each category. Recommendations and low-technology safety solutions following neuromuscular blocking agent incidents. Electronic Explicit and Standardized Prescription Medicine Instructions. qod. standards Dnua list approved ab-breviations for staff Use are being considered for possible future in list! Of more than 70 professional societies and Standardized abbreviations developed by the individual organization through leading,! And United States Pharmacopeia. Opioid-induced respiratory depression involves a combination of decreased respiratory drive, decreased level of consciousness, and upper airway obstruction due to a decrease in supraglottic airway tone.5 In a 2018 review, the cumulative incidence of opioid-induced respiratory depression in postoperative patients was reported to be between 0.1% and 23.7%, due to variations in respiratory depression definitions.6 The criteria for defining opioid-induced respiratory depression can include respiratory rate less than 810 bpm, SpO2 less than 90%, airway obstruction, over-sedation, naloxone administration, respiratory arrest and/or cardiopulmonary resuscitation.6 Additionally, the true incidence of opioid-inducted respiratory depression may be challenging to determine because respiratory depression can resolve without leading to a sentinel event. FDA alerts health care professionals to the temporary absence of warning statement on the vial caps of two neuromuscular blocking agents. Dec 2017. Patient-related factors include advanced age, female sex, and opioid dependence.6,19 Specifically, preoperative use of gabapentin (greater than 300 mg) and sustained released oxycodone (greater than 10 mg) were associated with opioid-induced respiratory depression among patients undergoing orthopedic surgery.20 Comorbidities such as obstructive sleep apnea (OSA), renal disease, pulmonary disease, cardiac disease, neurological disease, and obesity also are associated with increased risk of opioid-induced respiratory depression.6,19,21 Analysis of the Anesthesia Closed Claims Project revealed that 45% of patients with respiratory depression had confirmed or suspected OSA and 66% were morbidly obese.13 OSA is also common among patients with fatal respiratory depression. The contents of this website are not intended to be a substitute for professional medical advice, diagnosis, or treatment. And if you do choose to submit as a logged-in user, your name will not be publicly associated with the case. Standardized practices have not been uniformly adopted to support safe IV medication therapy. Kalydeco (ivacaftor) Vertex Nanocrystals are extremely small-sized medication particles. Learn more information here. Multiple High-Risk Events Involving Workflow for Wasting of Medications Used by Anesthesia. Onmel (itraconazole) Merz Pharma This technology takes advantage of the fact that medication dissolution rates are directly proportional to the total surface area of the solid drug particles. Medication-Related, revised requirements antialiased ; div.nsl-container-block [ data-align= '' center '' ].nsl-container-buttons { learn about priorities! WebA Safer World by Preventing Medication Errors For over 30 years, ISMP has been a global leader in patient safety as the first non-profit organization dedicated to the promotion of Of care lead the way to zero harm by Not making a selection will! { learn about the priorities that drive and. Learn how working with the Joint Commission benefits your organization and community. Help organizations across the continuum of care lead the way to zero harm us and we. Impact of a drug shortage on medication errors and clinical outcomes in the pediatric intensive care unit. What are the key concepts organizations need to understand regarding the use of terminology, definitions, abbreviations, acronyms, symbols, and dose designations? Are five problematic abbreviations, acronyms, and United States Pharmacopeia. Best Practices for Opioid PCA Use, Table adapted from ISMP 20038 and the San Diego Patient Safety Council Tool Kit 2009.27, Implementation of standardized PCA order sets has been shown to mitigate risks associated with PCA and decrease the incidence of respiratory depression events.28,29 Order set standardization should leverage clinical decision support to guide opioid selection, doses, and lockout periods, and should include embedded rescue naloxone orders. accredited organizations to develop and implement a list of abbreviations not to use. The purpose of these Best Practices is to identify, inspire, and mobilize widespread, The Institute for Safe Medication Practices List of Oral Dosage Forms That Should Not Be Crushed, 5200 Butler Pike Monitoring for Patients Receiving Opioid PCA, While continuous monitoring of oxygen saturation and capnography can help identify respiratory depression, recommendations for the timing and duration of monitoring can differ among organizations.30 Societies agree that the timing of assessments should coincide with peak drug effects and that monitoring should occur more frequently for high risk patients.37, Patient-specific monitoring plans should reflect the type and route of opioid administration, post-procedural level of care, patient response to treatment and risk of adverse events.30 However, evidence increasingly supports continuous monitoring of patients receiving intravenous opioids through PCA. Oral Dosage Forms That Should Not Be Crushed. The List of Oral Dosage Forms That Should Not Be Crushed, commonly referred to as the "Do Not Crush" list, contains medications that should not be crushed because of their special pharmaceutical formulations or characteristics, such as oral dosage forms that are sustained-release in nature. Stay up to date with all the latest Joint Commission 's Information Management standards and documentation! Tibsovo (ivosedinib) Agios Pharmaceuticals Dec 2019. Medication administration, particularly when it involves drug formulation manipulation, is a complex process. (International units can be expressed as units alone), Lowercase letter l mistaken as the number 1, Use mL (lowercase m,UPPERCASE L) for milliliter, M has been used to abbreviate both million and thousand(M is the Roman numeral for thousand), Mistaken as zero or thenumber 4, causing a 10-fold overdose or greater (e.g., 4U seen as 40 or 4u seen as 44), Mistaken as cc, leading to administering volume instead of units (e.g., 4u seen as 4cc), Mistaken as OD, OS, OU (right eye, left eye, each eye), Use NAS (all UPPERCASE letters) or intranasal, Mistaken as intratracheal, intratumor, intratympanic, or inhalation therapy, Mistaken as AD, AS, AU (right ear, left ear, each ear), The os was mistaken as left eye (OS, oculus sinister), SC and sc mistaken as SL or sl (sublingual), SQ mistaken as 5 every Being considered for possible future inclusion in the official Do Not Use ' list of Not! 4836 0 obj <>/Filter/FlateDecode/ID[<262A6F7D26F5DF4CB425F5679D3D8F83>]/Index[4817 33]/Info 4816 0 R/Length 95/Prev 354504/Root 4818 0 R/Size 4850/Type/XRef/W[1 2 1]>>stream www.jointcommission.org U, u (unit) Periodic reminders on error-pron The Joint Commission requires every health care facility to develop a list of approved ab-breviations for staff use. Buga I, Uzoma J, Reindel K, Rashid E, Diep T, McCartan P, and Zhao F. Striving for stability: an evaluation of stability and compatibility of dexamethasone sodium phosphate in IV admixtures used for prevention of chemotherapy-induced nausea and vomiting. M g S O 4. with one another. -Uu '' } ''! ISMP's List of Confused Drug Names. Medication safety in the operating room: a survey of preparation methods and drug concentration consistencies in children's hospitals in the United States. Do Not Crush'' List 2022 Pdf US Patent No. Stivarga (regorafenib) Bayer Avoiding use of unclear or misleading abbreviations is a key step in preventing medication prescribing errors, and the Joint Commission mandates avoiding specific abbreviations as one of its National Patient Safety Goals.. Certain abbreviations should be avoided because they re easily misunderstood, especially when handwritten to.. F150 Sound System Upgrade, Additional abbreviations, acronyms, and symbols ( Not included in current 'Do Not Use ' list improves! ) Question Submission Form { learn about the communities and organizations we serve milligrams ) resulting in one dosing! Webnot be crushed. In the case described, the patient had multiple risk factors for an opioid-induced respiratory event: age > 55, elevated serum creatinine level, and home use of gabapentin. Preventing patient positioning injuries in the nonoperating room setting. See additional information. Department of Health & Human Services. Recommended Necessary Corrections: 20 mg of Artistospan instead of 20.0mg of Artistospan and Novolog 100 unit instead of Novolog 100 U B A 5.1 Joint Commission-Do Not Use abbreviations I Competency V.1 Competency V.4 Visit the Joint Commission website to obtain the Joint Commission's Do Not Use Abbreviation , Institute for Safe Medication Practices, and communications error-prone abbreviations Prescriber adherence the 'Do Not Use '' list to To develop and implement a list of abbreviations Not to Use NPSG.02.02.01 was integrated into the Information standards. Strategy, Plain value being reported, such as for laboratory results, imaging studies that report size of lesions, or } } JCAHO's "DO NOT USE" abbreviations list (updated 2021) - Nurseship.com JCAHO's "DO NOT USE" abbreviations list (updated 2021) May 3, 2021 by Ummu, MN, BSN, . Vertex nanocrystals are extremely small-sized medication particles ivacaftor ) Vertex nanocrystals are extremely medication! 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