A successful procedural sedation program requires a robust institutional policy backed by a solid educational program and an administrative structure. Given the nature of the services provided, combined with the growth in complexity of both patients and procedures, sedation presents a potential liability for both the provider and the institution. A sedation program is built with a multidisciplinary team of experts representing all stakeholders: healthcare providers, risk and quality improvement managers, and facility administration. An institutional procedural sedation policy should be based on nationally and state recognized practice requirements and guidelines. Clinical care must be supported with a robust risk and quality structure built within the program to ensure best practice at the point of care.

No abstract

This article describes how a hospital pharmacy department provided total parenteral nutrition (TPN) fora known latex-allergic patient to safely meet the patient's nutritional needs and maintain proper aseptic technique during the compounding process. After numerous attempts to feed the patient enterally failed, total parenteral nutrition was recommended. It was decided that preparation and administration of parenteral nutrition for this patient should follow the recently initiated Pharmacy policy for the preparation of sterile products for latex-allergic patients as closely as possible. After reviewing the compounding process, it was determined that a base solution of protein and dextrose could be safely prepared by making sure that the products we used did not contain latex and that the process did not involve puncturing of latex-containing ports or stoppers. All other ingredients would be added manually. Prior to discharge, enteral feeding was reintroduced and the TPN solution was discontinued.

No abstract