OSF Saint Francis Medical Center, Peoria, Illinois

...an educational memo from your Pharmacy and Therapeutics Committee

September, 2002

Fenofibrate (Tricor®), which is not on the OSF Saint Francis Formulary, is a fibric acid derivative and has become one of the more commonly prescribed agents for the treatment of hypertriglyceridemia. A survey of local pharmacies showed that patients will pay $52-58 more per month for Tricor 160mg taken daily compared to the approved Formulary drug gemfibrosil 600mg taken twice daily. In addition, 6 case reports and an investigative study (Pharmacotherapy 2001;21:1145 and Lancet 2001;358:39) have implicated fenofibrate with reduced renal function. Gemfibrosil has not been shown to affect renal function. Physicians are asked to consider these factors when choosing between these agents.

Beginning January 1, 2003, JCAHO surveyors will assess an organization’s implementation of the 6 National Patient Safety Goals. The Goals are summarized below:

Improve Accuracy of Patient Information: Use 2 patient identifiers (neither can be room number) whenever taking blood samples or administering medications or blood products.

Improve Effectiveness of Communication: Implement a process for taking verbal or telephone orders that requires verification ‘read back’ by the person receiving the order. Standardize abbreviations, acronyms and symbols.

Improve Safety of High-Alert Drugs: Remove concentrated electrolytes from patient care units and standardize available drug concentrations.

Eliminate Wrong-Site, Wrong-Patient, Wrong-Procedure Surgery: Create a preoperative verification process to confirm that appropriate documents (medical records, imaging studies) are available. Implement a process to mark the surgical site and involve the patient in the marking process.

Improve the Safety of Infusion Pumps: Ensure free-flow protection on all intravenous infusion pumps.

Improve Effectiveness of Clinical Alarm Systems: Implement regular preventive maintenance and testing of alarm systems.

The Pharmacy and Therapeutics Committee voted to remove isotretinoin from the Formulary. The decision was based on new FDA requirements, restrictions to prescribing, potential confusion with another trans-retinoic acid product tretinoin (Vesanoid®) and the low usage within the hospital

Medication orders must list each individual drug with doses, routes of administration and frequency. This is a Joint Commission regulation and hospital policy. Orders such as "Resume home medications’ cannot be accepted as a valid medication order.