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Medication Management

How should medications on the sterile field be labeled?   

Does a medication that is immediately administered to a patient (eg, pain medication) require labeling?  

Has propofol been classified as a controlled substance?  

Who should fill pain pumps, the pharmacist or scrub personnel at the sterile field?     


How should medications on the sterile field be labeled?

Answer:

The medication label should state (at a minimum) the following, in accordance with the health care organization's policy:
• medication name,
• strength, and
• concentration.

Resources 

  1. Recommended practices for medication safety. In: Perioperative Standards and Recommended Practices. Denver, CO: AORN, Inc; 2013:255-294.  
  2. 2013 National Patient Safety Goals. The Joint Commission. http://www.jointcommission.org/patientsafety/nationalpatientsafetygoals/. Accessed December 7, 2012.  

Updated January 28, 2013  

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Does a medication that is immediately administered to a patient (eg, pain medication) require labeling?

Answer:

No. An immediately administered medication that is prepared or obtained, taken directly to a patient, and administered to a patient without any break in the process by the same person does not require labeling.

Resources 

  1. Recommended practices for medication safety. In: Perioperative Standards and Recommended Practices. Denver, CO: AORN, Inc; 2013:255-294.  
  2. 2013 National Patient Safety Goals. The Joint Commission. http://www.jointcommission.org/patientsafety/nationalpatientsafetygoals/. Accessed December 7, 2012. 

Updated January 28, 2013  

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Has propofol been classified as a controlled substance?

Answer:

Presently, propofol has not been classified as a controlled substance despite concerns regarding drug diversion and supply shortages. The American Society of Anesthesiologists (ASA) sent a letter to the Drug Enforcement Agency (DEA) in December 2010 supporting the scheduling of propofol as schedule IV. As of December 2012, propofol is not scheduled under the Controlled Substances Act, although it is listed as "Drugs and Chemicals of Concern".

Resources 

  1. ASA submits letter to DEA supporting the scheduling of Propofol. American Society of Anesthesiologists (ASA). December 23, 2010. http://www.asahq.org/For-Members/Advocacy/Washington-Alerts/ASA-Submits-to-DEA-Supporting-the-Scheduling-of-Propofol.aspx. Accessed December 7, 2012.   
  2. Drugs and Chemicals of Concern: Propofol (Diprivan). Drug Enforcement Agency (DEA). January 2010. http://www.deadiversion.usdoj.gov/drugs_concern/propofol.htm. Accessed December 7, 2012. 

Updated January 28, 2013 

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Who should fill pain pumps, the pharmacist or scrub personnel at the sterile field?

Answer:

Pain pump reservoirs should be filled by a pharmacist with exception of urgent situations.Personnel filling a pain pump with medication should follow the manufacturer’s instructions for use, local, state, and federal regulations, and United States Pharmacopeia (USP) chapter <797>. The reservior should be filled in a sterile environment such as under a laminar airflow hood.

Resource

 
Van Wicklin, SA. Filling pain pump reservoirs. [Clinical Issues]. AORN Journal.2012;96(5):547-549. 
 

Updated January 28, 2013

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