Screening Test

The Agency for Healthcare Research and Quality (AHRQ) has created a new tool, Stay Healthy at Any Age: Your Checklist for Health to help patients keep track of their health and stay up-to-date on recommended screening tests. There is one checklist for men and one for women. Both include the tests recommended by the U.S. Preventive Services Task Force (USPSTF).

Read More

Drug News

The FDA has approved the following generic equivalents:

* risedronate sodium 5, 30, and 35 mg tablets - for the treatment and prevention of postmenopausal and glucocorticoid-induced osteoporosis, and for the treatment of Paget disease. This medication is generically equivalent to Actonel.
* oxcarbazepine 150, 300, and 600 mg tablets - an anticonvulsant for the treatment of partial seizures in adults and children 4 years of age and older. The medication is the generic equivalent of Trileptal. The prescribing information for the generic versions may differ from that of Trileptal, as some sections of the Trileptal label are protected by patents and/or exclusivity.

Read More

Drug Updates - Medication Errors

Unsafe medication-use practice habits place patients in danger of an infection. To protect patients, remember the following:

* Place a sterile cap on the end of a reusable I.V. administration set that has been removed from a primary administration set, saline lock, or I.V. catheter hub that will be used again.
* Properly disinfect the port when accessing needle-free valves on I.V. sets.
* Always follow aseptic technique.
* Avoid "looping" - attaching the exposed end of the I.V. tubing to a port on the same tubing.
* Prohibit unlicensed staff from connecting/disconnecting any medical tubing.
* Establish policies and assess compliance.

Read More

Drug News

* Revised labeling has been approved for the following:
carbamazepine-containing drugs (eg, Carbatrol, Epitol, Equetro, and Tegretol) - to include a recommendation that before starting drug therapy, patients of Asian ancestry get a genetic blood test that identifies a significantly increased risk of developing a rare, but serious, skin reaction. These life-threatening skin reactions include toxic epidermal necrolysis and Stevens-Johnson syndrome.

* Merck has initiated a voluntary recall of 11 lots of PedvaxHIB (Haemophilus b conjugate [meningococcal protein conjugate]) and 2 lots of Comvax (Haemophilus b conjugate (meningococcal protein conjugate]) vaccines because the sterility of these lots is uncertain.

Read More

Discharge Summaries

If you must write a narrative discharge summary, be sure to include the following information to comply with JCAHO requirements:
· patient's status at admission and discharge
· any significant information about the patient's stay, including resolved and unresolved problems
· instructions regarding medications, treatments, activity, diet, referrals, follow-up appointments, and any other special instructions.

Read More

Drug Updates - Medication Errors

When errors occur with anticoagulant use, fatal bleeding or thrombosis can occur, which is why these medications are considered "high-alert" drugs. Review the following common risks and recommended safeguards associated with heparin, low-molecular weight heparin, and warfarin.

Common risks
- Duplicate or concurrent therapy
- Accidental stoppage of therapy
- Look-alike bags, vials, or syringes
- Look-alike names
- Dosing/infusion errors
- Calculation errors
- Patient monitoring problems
- Drug and food interactions
- Adverse reactions

Recommended safeguards
- Standardization
- Simplification
- Externalize error-prone processes
- Improved access to information
- Differentiation or constraints
- Redundancies
- Patient monitoring
- Failure mode and effects analysis (FMEA)

Read More

Rapid Response Teams

Rapid response teams are composed of clinical experts who are called to the bedside to assess and manage decompensating patients before a code occurs. Members of the team include specially trained nurses, respiratory therapists, and medical personnel. Five key roles of the RRT are:

1. Assessing the patient.
2. Stabilizing the patient either to remain on the unit or for transfer to the ICU.
3. Assisting with communication with the attending physician or other consultants.
4. Educating and supporting the patient's assigned nurse.
5. Assisting with transfer.

Read More

Drug Updates - Medication Errors

Variability of dosing methods contributes to the risk of pump programming errors. Reduce the risk of IV infusion dosing errors by considering the following:

* Work with a multidisciplinary team to standardize dosing methods for certain medications.
* Use smart pumps with functional dosage error-reduction software.
* Display drug information on the drug label and medication administration record the same way it is needed to program the pump.
* Verify dosing methods and pump settings.
* Consider the possibility of an error if the appropriate physiologic response to a medication doesn't occur.

Read More

Drug Updates - Medication Errors

In 2006, an overdose of fluorouracil had fatal consequences in an oncology patient. To safeguard chemotherapy use, remember the following recommendations from the ISMP:

* Standardize labeling
* Update certification of nurses administering chemotherapeutic agents
* Safeguard pump use
* Enhance double-checks (use charts when possible)
* Use checklists to standardize sequencing and workflow
* Include the patient
* Establish overdose protocols

Read More

Drug Update

Among the new drugs recently approved by the Food and Drug Administration (FDA):

* Intelence (etravirine) tablets has been approved in combination with other anti-HIV medications, for the treatment of HIV in adults who have failed treatment with other antiretrovirals. Etravirine is a nonnucleoside reverse transcriptase inhibitor.


* Tysabri (natalizumab) has been approved for the treatment of moderate-to-severe Crohn's disease in patients with evidence of inflammation who have had an inadequate response to, or are unable to tolerate, conventional Crohn's disease therapies.

Source: Food and Drug Administration.

Read More

Drug Update

(from Drug News Weekly)

• The FDA has approved the following new indication:
  • Diovan (valsartan) - for the treatment of high blood pressure in children and adolescents 6 to 16 years of age.
• The FDA has approved Triesence (triamcinolone acetonide) 40 mg/mL injectable suspension, a synthetic corticosteroid for visualization during vitrectomy and treatment of sympathetic ophthalmia, temporal arteritis, uveitis, and ocular inflammatory conditions unresponsive to topical corticosteroids.
• Roche Pharmaceuticals has discontinued the production of Roferon-A (interferon alfa-2a, recombinant). This action is related to the product's life cycle, not to any safety or efficacy concerns.
• Manufacturers have updated the prescribing information for desmopressin acetate (DDAVP, DDAVP Nasal Spray, DDAVP Rhinal Tube, DDVP, Minirin, and Stimate Nasal Spray). Patients taking desmopressin and children treated with intranasal formulations for primary nocturnal enuresis (PNE) are at risk for developing severe hyponatremia, resulting in seizures and death. Thus, desmopressin intranasal formulations are no longer indicated for PNE treatment and should not be used in hyponatremic patients or patients with a history of hyponatremia. All formulations should be used with caution in patients at risk for water intoxication with hyponatremia.

Read More