Request for ideas on IV Products course

[Aseptic Admix]

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I am looking for ideas or suggestions from students about what they do or do not like or if they could change the experience how so, with regard to course work dealing with IV products, aseptic technique, and other related issues. Thanks

 

[WVUPharm2007]

So is this an entire COURSE on sterile preparations or is it just a lab? I would question the need for an entire course on the subject. If it's just a lecture or lab...then good, they need it.

Actually, if you folks in academia want to help, drill into their heads which drugs need dose adjustments when converted from PO. That's one (of the many) subjects I felt wasn't even covered at my school that I wish I had known more about. For any student going into residency or institutional pharmacy, I'd wager they need to know that 20mg of IV enalaprilat is bad.

Of course, they'd just forget soon after the lecture unless it is later revisited in some sort of practical experience later on...which probably won't happen...

 

[PharmDstudent]

I think students should be exposed to a variety of different products, so that they'll be familiar with more than just one type of product. There are so many ways to give IV medications that unless they work directly with IVs in a hospital or IV room, then they'll have no clue what PCN, chemo, banana bag, TPN, etc. means.


I second IV to po and vice versa conversions. I don't think we even covered anything beyond vanco!

 

[Quiksilver]

I think students should be exposed to a variety of different products, so that they'll be familiar with more than just one type of product. There are so many ways to give IV medications that unless they work directly with IVs in a hospital or IV room, then they'll have no clue what PCN, chemo, banana bag, TPN, etc. means.


I second IV to po and vice versa conversions. I don't think we even covered anything beyond vanco!

vanco iv to po?!?!?


i do think that chemo should be covered well. also using different size bags and vials if you have a course. My biggest problem from school to working in the iv room is using real drugs in vials greater then 10 mls (ie not using placebo NS 10 ml vials) and being able to get every drop out.

i also think iv to po conversions should be covered

 

[PharmDstudent]

vanco iv to po?!?!?

Right! You can't go IV to po...

Thank gawd they clued us in! 😉

 

[Farmercyst]

Our course was 6 weeks in the IV room at LA County hospital doing admixtures 2-3 days/week for 3-4 hours. We had homework assigned that essentially went over bugs vs drugs, common doses, common/serious side effects. We had quizzes most days in the IV room.
I liked becoming familiar with different bottle sizes, special mixing instructions etc. (double rinse primaxin, not injecting air into clinda, etc)
I can't say that I remember much of the course material, but I should get that again in our ID module. The hands on was great though.

 

[johnep34]

LA county seem to have got it right. The worst incidents happened in UK are:

1) Vincristine injected intrathecally instead of IV

2) Epanutin syrup to be given to elderly pt by mouth using syringe. Filled syringe handed to assistant to give, she promptly put a needle on the syringe (should have been non compatible oral syringe) and injected IV.

johnep

 

[StaviZFingerZ]

Our course was 6 weeks in the IV room at LA County hospital doing admixtures 2-3 days/week for 3-4 hours. We had homework assigned that essentially went over bugs vs drugs, common doses, common/serious side effects. We had quizzes most days in the IV room.
I liked becoming familiar with different bottle sizes, special mixing instructions etc. (double rinse primaxin, not injecting air into clinda, etc)
I can't say that I remember much of the course material, but I should get that again in our ID module. The hands on was great though.

Ahhhhh the IV rotation!!! The Slave Labor!!!! This has been a part of USC's curriculum for 238 years! We all bitched and moaned about it..especially those of us who already worked inpatient and knew how to work in IV room. But this program allowed every USC student to experience IV admixture. Every student. Looking back, this is an excellent rotation. 👍

 

[Aseptic Admix]

thanks for the info.

So is this an entire COURSE on sterile preparations or is it just a lab? I would question the need for an entire course on the subject. If it's just a lecture or lab...then good, they need it.

It is a module within a course, approx 15 hours lecture, 4 labs. Fall P2 yr. Lecture topics have included basic concepts/terms of IV therapy, types/issues associated with venous access, infusion devices, aseptic tech, 797, handling chemo/hazard material, admixture prep, common calculations, common compatibility, home infusion, med errors, text/web resources.
Labs: garbing/cleaning, basic procedures (single add/low risk), advanced procedures (multiple add/med risk), and TSB validation.

Actually, if you folks in academia want to help, drill into their heads which drugs need dose adjustments when converted from PO. That's one (of the many) subjects I felt wasn't even covered at my school that I wish I had known more about.

That is a good idea. What are more "of the many"

Of course, they'd just forget soon after the lecture unless it is later revisited in some sort of practical experience later on...which probably won't happen...

Another good point


The labs will be used to provide application of some lecture content. When I took this course it had much less (which is hard to say considering now there is not significant lab time) practical application. I had no intentions of practicing in an area with significant parenteral involvement as I anticipated a retail setting. However as many learn later you never really know where you will end up. So now, I am trying to develop a course with more practical application and content that I feel all pharmacist should have at least some vague concept. I would assume most programs have some IV product component of the curriculum, and expect most of it is limited and thought to be a waste of time by the students. I would prefer to offer a course students feel is of benefit. So all suggestions are much appreciated. Thanks again.

 

[WVUPharm2007]

What are more "of the many".[/COLOR]

Not much concerning sterile prep, which is the subject at hand.

My criticisms on pharmacy education as a whole could fill volumes...

 

[Praziquantel86]

I think a section on bulk manufacturing would also be useful (i.e., drawing up multiple syringes, splitting multidose antibiotic vials). This may be more along the lines of a tech job, but the pharmacist still needs to know how to it.

Also, a section on admixing for hyperals could be helpful. Putting dozens of additives to multiple additives in many bags can get confusing.

 

[WVUPharm2007]

Actually, I take that back.

Make sure they know the lingo.
I.E. What does D5 1/2NSS w/20 mean? (Where I work, we abbreviate it even more when talking to each other..."Hey Paula, get me a d-half-twenty")

Consider introducing them to the weird stuff.
I.E. Putting cordarone into glass bottles or the fancy special-polymer bags

Review administration lingo.
I.E. What is IV Push vs infusion.

Review what drugs can be pushed and what can't.

I.E. Concentrated KCL vs. Zofran

Or which is both...
I.E. IV Mag...push if torsades is suspected in cardio arrest...otherwise infuse due to risk of acute hypotension

Review which are given IV vs. sq
I.E. Regular insulin vs the other insulins
And how about you do something they never do in school...push critical thought. Give bonus points to the student that tells you why pushing Novolog isn't a bright idea (transient hypokalemia)...and you can even dovetail that into a clinical nugget about giving insulin for hyperkalemia...

Anyway...a kid coming fresh into the world of institutional pharmacy knows none of this stuff...yet it is literally ESSENTIAL information for a staff pharmacist. And I really wish I had none more about it coming out of school...and really, it made me disappointed at how useless I was for a little while until I had it all down enough to practice without someone over my shoulder...which was only like 3 months...but still...

Maybe I'll think of more...

 

[StaviZFingerZ]

You've become such a dork since you got licensed. I want old Mikey back...

Actually, I take that back.

Make sure they know the lingo.
I.E. What does D5 1/2NSS w/20 mean?

Consider introducing them to the weird stuff.
I.E. Putting cordarone into glass bottles or the fancy special-polymer bags

Review administration lingo.
I.E. What is IV Push vs infusion.

Review what drugs can be pushed and what can't.

I.E. Concentrated KCL vs. Zofran

Or which is both...
I.E. IV Mag...push if torsades is suspected in cardio arrest...otherwise infuse due to risk of acute hypotension

Review which are given IV vs. sq
I.E. Regular insulin vs the other insulins
And how about you do something they never do in school...push critical thought. Give bonus points to the student that tells you why pushing Novolog isn't a bright idea (transient hypokalemia)...and you can even dovetail that into a clinical nugget about giving insulin for hyperkalemia...

Anyway...a kid coming fresh into the world of institutional pharmacy knows none of this stuff...yet it is literally ESSENTIAL information for a staff pharmacist. And I really wish I had none more about it coming out of school...and really, it made me disappointed at how useless I was for a little while until I had it all down enough to practice without someone over my shoulder...which was only like 3 months...but still...

Maybe I'll think of more...

 

[WVUPharm2007]

You've become such a dork since you got licensed. I want old Mikey back...

The directionless drifter that was just depressed and pissed because he was stuck in school...? I miss him, too. Unfortunately, there is less stuff to be pissed off about. I need to draw some more cartoons.

 

[Omegadramon]

Actually, I take that back.

Make sure they know the lingo.
I.E. What does D5 1/2NSS w/20 mean? (Where I work, we abbreviate it even more when talking to each other..."Hey Paula, get me a d-half-twenty")

Consider introducing them to the weird stuff.
I.E. Putting cordarone into glass bottles or the fancy special-polymer bags

Review administration lingo.
I.E. What is IV Push vs infusion.

Review what drugs can be pushed and what can't.

I.E. Concentrated KCL vs. Zofran

Or which is both...
I.E. IV Mag...push if torsades is suspected in cardio arrest...otherwise infuse due to risk of acute hypotension

Review which are given IV vs. sq
I.E. Regular insulin vs the other insulins
And how about you do something they never do in school...push critical thought. Give bonus points to the student that tells you why pushing Novolog isn't a bright idea (transient hypokalemia)...and you can even dovetail that into a clinical nugget about giving insulin for hyperkalemia...

Anyway...a kid coming fresh into the world of institutional pharmacy knows none of this stuff...yet it is literally ESSENTIAL information for a staff pharmacist. And I really wish I had none more about it coming out of school...and really, it made me disappointed at how useless I was for a little while until I had it all down enough to practice without someone over my shoulder...which was only like 3 months...but still...

Maybe I'll think of more...

Excellent ideas.

 

[Pianopooh]

Teach students how to properly use filtration needles, what order to filter things, what can/cannot/should not be used with filtration needles.

What SWFI is, calculating percent errors when comparing ratios W/V, how to recognize when drugs should not be used (e.g. pink EPI, precipitates, etc), common diluents (bacteriostatic inj, etc), what items shouldn't be used in certain populations (newborns and benzyl OH)