Thank you Chris, That is also my understanding.
-----Original Message-----
From: [EMAIL PROTECTED]
To: [EMAIL PROTECTED]; [EMAIL PROTECTED]; [EMAIL PROTECTED]; [EMAIL PROTECTED]
Sent: Fri, 28 Jul 2006 7:00 PM
Subject: RE: Inclusion/exclusion criteria for IV to PO conversion
I have been out of homecare for a few years, but we always "mixed" IVIG and Prolastin in the home, whether we supplied it or it came from another pharmacy. Stability was the issue. These drugs had limited stability, and could not be sent out to the home the day before the infusion if they were already mixed. My understanding was that reconstitution for administration is different than compounding as far a 797 goes. Chris Cavanaugh, CRNI -----Original Message----- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED]] On Behalf Of Brenda Seaver Sent: Friday, July 28, 2006 4:49 PM To: Marilyn Hanchett; Tim Talbert; [EMAIL PROTECTED] Subject: RE: Inclusion/exclusion criteria for IV to PO conversion Marilyn, We actually only have 3 patients on service in which we have a different company dispensing Octagam for us to mix in the home. All patients that OUR pharmacy dispenses to are mixed in the hood. We have nurse only contracts for some out of state pharmacies. Drug stability issues arise in those cases. Does everyone have Prolastin mixed in the hood? Our patients receive their Med directly from the drug companies. -----Original Message----- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] Behalf Of Marilyn Hanchett Sent: Friday, July 28, 2006 4:25 PM To: Tim Talbert; [EMAIL PROTECTED] Subject: RE: Inclusion/exclusion criteria for IV to PO conversion Really? That's very interesting - and obviously very different from our Pharmacy's view of 797. Perhaps it is - in part - a philosophical issue, i.e. if we are a specialty infusion pharmacy and we have in house compounding capability, how could we clinically justify dispensing products that require compounding into any situation in which the potential for quality control is less than what we provide as part of our routine operations? In other words, if we know we can do something 100%, why would we choose to risk using a process that could easily reduce it to less than 100? Perhaps not all will agree with this, but no matter. It works for us, and works well . . And makes 797 compliance simple. Marilyn -----Original Message----- From: Tim Talbert [mailto:[EMAIL PROTECTED]] Sent: Friday, July 28, 2006 2:48 PM To: Marilyn Hanchett; [EMAIL PROTECTED] Subject: RE: Inclusion/exclusion criteria for IV to PO conversion I agree that compounding of IVIG in the home is not appropriate, however, I don't believe that 797 applies to point of use preparation. Tim >>> "Marilyn Hanchett" <[EMAIL PROTECTED]> 7/28/06 >>> RE Sharps Containers: Our nurses do not carry sharps containers. All biohazardous materials are disposed of in OSHA specific containers at the point of use & removed by an approved service/waste hauler. The RN's car is not appropriate for transporting hazardous waste. Consider: do the sharps containers the RNs now carry close tightly during transport? If not, then they are carrying containers that have the potential to leak or spill. If that happens, the company will be liable. What happens if a container fails or is damaged in an accident? Is your staff prepared to deal with a container that may be damaged/break in any way, spilling the infectious contents all over the car/street/other public location? If the RN claims that he or she is transporting the sharps container in the trunk via another closeable container, how do you know that the secondary container is sufficiently safe? You should review the OSHA regulations. Compliance Assistance is also available through your area OSHA office. RE Mixing IVIG at Home: Compounding of IV products must be done in conditions that assure their sterility. Our nurses do not mix IVIG in the home. In fact, in the seven years of this company, we have never permitted it. See USP 797. Marilyn Hanchett RN Director of Clinical Affairs IgG America ________________________________ From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED]] On Behalf Of Brenda Seaver Sent: Friday, July 28, 2006 10:30 AM To: Lynn Hadaway; Patricia Howell; [EMAIL PROTECTED]; Vascular List Serve; Venous Listserve Subject: RE: Inclusion/exclusion criteria for IV to PO conversion Hello everyone, I am sorry to tag onto your topic here, but I have had some trouble posting. I have a question to put out to those working in homecare. We are trying to evaluate the necessity of sharps containers. At the present time the nurses all carry a small box. We only dispense containers to patients receiving blood products like Prolastin, IVIG where the nurse mixes in the home. The glass bottles are disposed of in the containers. All our products except SubQ sets are safety. Are other agencies having their nurses carry sharpstainers? Would it be OK to just double bag everything? I appreciate any feedback you may have. Brenda -----Original Message----- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] Behalf Of Lynn Hadaway Sent: Friday, July 28, 2006 9:46 AM To: Patricia Howell; [EMAIL PROTECTED]; Vascular List Serve; Venous Listserve Subject: RE: Inclusion/exclusion criteria for IV to PO conversion I have been looking at the entire set of literature on catheter flushing for over 2 years now and have not seen many about sodium citrate, although there are a couple of articles that mention it. It is often used in combination with taurolidine in some studies. But the bottom line is it's commercial availability. Marc Stranz may have to address this for us, but I am not aware of any of the alternative flush solutions that has actually made it into a commercial product yet. Do you have a compounding pharmacy that will make it for you? Lynn At 8:11 AM -0500 7/28/06, Patricia Howell wrote: Hello everyone! I'm searching for evidence based practice research on the use of Sodium Citrate to maintain patency of PICCs versus Heparin. Has anyone completed this type of study? Our librarian hasn't been very successful with her searcher, so I'd thought perhaps your institution may have or be in the process of looking at an alternative flush solution to maintain PICC patency. We as an institution are no longer going to use Heparin flush bags for swans & art lines. Any information would be appreciated. -[EMAIL PROTECTED] <mailto:[EMAIL PROTECTED]> -Via Christi -929 N. St. Francis -Wichita, Kansas 67214 -(316) 268-5597 or (316) 689-5795 ________________________________ From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED]] On Behalf Of Rebecca Satarawala Sent: Friday, July 28, 2006 7:00 AM To: 'Lynn Hadaway'; 'Vascular List Serve'; 'Venous Listserve' Subject: RE: Inclusion/exclusion criteria for IV to PO conversion This is what one of my PharmD friends sent me (and this is what my other RPh associate was looking for): Are you referring to IV antibiotic to PO conversion? Usually this conversion is the most common conversion that demands criteria: Clinical improvement in signs and symptoms Afebrile or consistent improvement in fever over a 24 hour period WBC count normalizing Infection being treated does not require IV therapy (e.g., endocarditis, meningitis) GI absorption likely normal (absence of vomiting or abnormal GI anatomy) Ability to receive oral dosage form either orally or via tube (concomitant oral or via tube administration of other meds) The above criteria is used in the LTC setting by the consultant RPhs. Rebecca Satarawala, RN, BSN, CRNI 3445 Guilford Ave NW Canton, OH 44718 330.353.0722 mobile 330.491.1896 fax [EMAIL PROTECTED] <mailto:[EMAIL PROTECTED]> Infusion Expertise You Can Trust*. ________________________________ From: Lynn Hadaway [mailto:[EMAIL PROTECTED]] Sent: Wednesday, July 26, 2006 11:04 AM To: [EMAIL PROTECTED]; Vascular List Serve; Venous Listserve Subject: RE: Inclusion/exclusion criteria for IV to PO conversion This decision is a drug-specific thing. For instance, Vancomycin IV and Vancomycin PO are for distinctly different indications and can not be switched. I have not ever worked with any written guidelines for this conversion. It has always depended upon the medication, the patients ability to tolerate PO fluids and meds, and the physician's order. Lynn At 3:33 PM -0400 7/24/06, Rebecca Satarawala wrote: Sorry my note wasn't clear. It is for Conversion from IV meds to po meds, e.g., antibiotics. I was asked this by a pharmacist who has not had alot of experience with infusion therapy. I know the pharmacy I used to work for had inclusion/exclusion criteria, however I don't have that information anymore. Rebecca Satarawala, RN, BSN, CRNI 3445 Guilford Ave NW Canton, OH 44718 330.353.0722 mobile 330.491.1896 fax [EMAIL PROTECTED] <mailto:[EMAIL PROTECTED]> Infusion Expertise You Can Trust*. ________________________________ From: Lynn Hadaway [mailto:[EMAIL PROTECTED]] Sent: Friday, July 21, 2006 11:25 AM To: [EMAIL PROTECTED]; Venous Listserve; Vascular List Serve Subject: Re: Inclusion/exclusion criteria for IV to PO conversion Conversion of what? Fluids, meds? I am not sure what you are asking. Lynn At 9:06 AM -0400 7/21/06, Rebecca Satarawala wrote: Does anyone have any guidelines you would be willing to share for inclusion/exclusion criteria for IV to PO conversion? Marc-any thoughts?? Thanks! Rebecca Satarawala, RN, BSN, CRNI 3445 Guilford Ave NW Canton, OH 44718 330.353.0722 mobile 330.491.1896 fax [EMAIL PROTECTED] <mailto:[EMAIL PROTECTED]> Infusion Expertise You Can Trust*. -- Lynn Hadaway, M.Ed., RNC, CRNI Lynn Hadaway Associates, Inc. 126 Main Street, PO Box 10 Milner, GA 30257 http://www.hadawayassociates.com office 770-358-7861 -- Lynn Hadaway, M.Ed., RNC, CRNI Lynn Hadaway Associates, Inc. 126 Main Street, PO Box 10 Milner, GA 30257 http://www.hadawayassociates.com office 770-358-7861 Content-Type: image/jpeg; name="image003.jpg" Content-ID: <[EMAIL PROTECTED]> Content-Description: image003.jpg Content-Location: image003.jpg Content-Type: image/jpeg; name="image004.jpg" Content-ID: <[EMAIL PROTECTED]> Content-Description: image004.jpg Content-Location: image004.jpg -- Lynn Hadaway, M.Ed., RNC, CRNI Lynn Hadaway Associates, Inc. 126 Main Street, PO Box 10 Milner, GA 30257 http://www.hadawayassociates.com office 770-358-7861 Notice from St.Joseph Health System: Please note that the information contained in this message may be privileged and confidential and protected from disclosure.
