1. John Karwoski, RPh, MBA President and Founder JDJ Consulting, LLC
Hot topics: the six pack regarding your medication management performance
John Karwoski, RPh, MBA
President and Founder
JDJ Consulting, LLC

2. The six pack Sound Alike Look Alike Drugs and High Alert Lists
Syringe Preparation
Labeling
Refrigerator Compliance
Emergency Medications
Testing your Staff’s Knowledge

3. Salad and high alert lists
Appropriateness of your Sound Alike Look Alike Drugs and High Alert Lists
According to Joint Commission, one of the top 10 deficiencies among surgery centers
Epinephrine MDV High Alert
Wipe each port with a new wipe, every vial, everytime!

4. Syringe & vial preparation
CMS is heavily focusing on the preparation of injectable medications
Immediate Use = must be administered within 1 hour of syringe preparation and have a physician order
Syringes prepped in the OR
Must be after the case has concluded
Must be after the room has been cleaned
Dedicated medication preparation areas for RN staff
Open vials in the OR must be treated as single patient use

5. Syringe labeling
Syringes prepared ahead of a case must be labeled with:
Drug Name
Drug Strength
Date of Preparation
Time of Preparation
Beyond Use Date and Time (BUD)
Initials of preparer
Pre-filled syringes
Labeling software or apparatuses

6. A quick note…
Compounding and preparation of a syringe containing a single sterile injectable medication are two different things
Compounding: USP <797> defines compounding as the mixing of 3 or more products from the original manufacturer packaging
Preparation of a syringe containing a single sterile injectable medication is NOT compounding but must still adhere to safe injection practices outlined by CMS, including labeling and the one hour rule

7. Refrigerators Retrievable recorder
Adhere to the expiration date on your temperature tracker
Must be recalibrated
If not recalibrated, replace
Temperatures must be recorded daily, and twice if the refrigerator contains vaccines
What if my temperature tracker is hard wired and monitored by an outside company?

8. Emergency medications
Crash Carts
The American Heart Associate publishes a recommended list of crash cart medications and supplies
Your consultant pharmacist should review your center’s list and help determine what medications and supplies are necessary
Ultimately, your medical director must determine what medications and supplies are best suited for the crash cart at your center
This list should be approved by your medical board
Reversal Agents
Track usage through incident reporting
No open vials in the OR
Critical Drug Shortage Policy

9. Testing your staff’s knowledge
Utilize a tool, such as a broad topic quiz, to analyze your staff’s areas of strengths and weaknesses
Great opportunity for process improvement projects
Develop a list of mock codes or in-services based on areas in need of improvement
Staff competencies
How do you handle in-servicing when new staff is oriented?

10. Thank you!
John Karwoski, RPh, MBA President and Founder JDJ Consulting, LLC (609)
Brittney Lodato, MPH Administrative Director JDJ Consulting, LLC (609)