Pharmacy and Therapeutics Update

November 20th Meeting Agenda Items / Information

• A copy of the Pharmacy and Therapeutics (P & T) packet (agenda, information etc.) will be made available in the Medical Staff Office prior to each meeting

o Dr. Harte (Infectious Disease) has been appointed Chair of the P&T Committee

o Dr. Bartelt (CCPC) has been appointed the Vice-Chair of P&T Committee

 

• The Medication Safety Team presented the results of a “Dose Omission Error” audit from second quarter 2009

o No trends were noted but another audit with third quarter 2009 data will be conducted and presented to the committee

 

• Updated HCA Medication Diversion Prevention Policy

o A summation of information and changes will be developed and presented to impacted groups (physicians, nursing, pharmacy etc.)

 

• The following P & P were reviewed / updated and approved by the committee

o TX – M 425 Medications Acquired by Practitioners from Outside Sources

o TX – M 405 IV Medications

o EC5.4 Drug Storage & Look-Alike/Sound-Alike Safety Measures

•    Policy will be moved from Environment of Care to Medication Management

o TX 2.24 Formulary Management

 

• Review of PPI / H2 Blocker Interchange

o The decision was made that it should not be an automatic interchange as it was previously approved for

o The committee wishes to continue the process of having the Clinical Pharmacist review the patient profile and make a recommendation of changing from PPI to H2 Blocker (if appropriate) for Stress Ulcer Prophylaxis during daily ICU Rounds or through discussion with the rounding Physician (for non-ICU patients)

•  Any change from PPI to H2 Blocker would require physician approval

 

• The committee discussed and endorsed a recommendation from the Quality Management Committee to limit the dose of IV hydromorphone to 0.5 – 1 mg unless a patient meets certain criteria (non-opiate naïve, specific diagnoses, etc.)

o Clinical Pharmacists will monitor IV hydromorphone orders and discuss with ordering Physician if doses > 1 mg are appropriate in specific patients

 

• Vancomycin Residency Project

o Project is to monitor the efficacy of using a 30 mg/kg loading dose of vancomycin in all “Pharmacy to Dose” vancomycin orders (unless patient meets exclusion criteria)

• Information will be developed by Chris, the Pharmacy Resident and reviewed by Dr. Harte prior to being presented to physicians and pharmacists

 

• Various changes with the Medication Safety Committee were discussed

o Dr. Bartelt, our previous M.S. Chair has been transitioned to the P & T Committee

o The Medication Safety team will present highlights of the quarterly Medication Use Report to the P & T Committee rather than the whole report

• Gadoxetate disodium (Eovist) – a MRI Contrast Agent for use in Radiology has been approved for formulary use

 

• Medication Reconciliation changes were discussed

o Iatric Medication Reconciliation Software has been approved for use at TMCA

•  Implementation Committee is currently being formed

 

• 2010 P & T Committee meeting schedule was distributed

o Meetings are on the third Friday of odd months at 7:15 a.m. in the Physicians’ Conference Room