ISMP Survey on Administration of IV Vincristine
(
All Respondants)

Total: 1318

1. Please tell us whether these error-reduction strategies are employed when dispensing and/or administering IV vincristine.

Error-Reduction Strategies Yes No Sometimes
a. Are doses of IV vincristine diluted and dispensed/administered in a minibag? 61% 30% 8%
b. Are doses of IV vincristine diluted and dispensed/ administered in a syringe? 71% 20% 8%
c. Are intrathecal medications packaged in a distinctive container not used for any other purpose to prevent confusion with IV medications, including vincristine? 72% 20% 7%
d. Do doses of IV vincristine include warning labels stating: “Fatal if given intrathecally. For IV use only.” (or similar labeling)? 71% 11% 0%
e. Are vincristine injections placed in an overwrap with a second warning label affixed? 91% 6% 1%
f. Does a pharmacist independently double-check IV vincristine doses, even if another pharmacist initially prepared the dose? 91% 5% 2%
g. Is IV vincristine delivered from the pharmacy to a location where intrathecal drugs are prohibited? 75% 22% 2%
h. If a patient is receiving IV vincristine and an intrathecal medication, does the organization have a process to verify that the intrathecal injection has been completed before dispensing IV vincristine (or vice versa)? 81% 16% 1%
i. Do two health professionals independently check IV vincristine doses before administration? 97% 1% 1%
j. Are doses of IV vincristine prohibited from being administered in the same location where intrathecal medications are given? 80% 18% 1%
k. Is IV vincristine banned from rooms where lumbar punctures are performed? 80% 18% 1%
l. Are those who prescribe, prepare, dispense, and administer chemotherapy educated about published case reports of fatal intrathecal administration of IV vincristine? 95% 1% 2%

2. Please answer the following questions by placing checkmarks in the appropriate column. Use column A if referring to your experiences with administering undiluted IV vincristine from a syringe. Use column B if referring to your experiences with administering diluted IV vincristine via a bag or syringe. Do not use column B if you have no experience with administering diluted IV vincristine.

Questions
Column A: Undiluted Column B: Diluted
a. What is the typical volume of solution administered for each dose of IV vincristine in your facility?   25 mL
83%
50 mL
8%
Other

7%
b. During administration of IV vincristine, does a trained licensed practitioner remain at the bedside to continually monitor the patient and assess IV patency and signs of extravasation? Yes
97%
No
1%
Yes
95%
No
3%

c. Are you aware of any extravasations that have occurred within the past 2 years related to administration of undiluted IV vincristine?
If yes, how many were mild, moderate, or severe?

Yes
71%
No
28%
Mild:32232
Moderate:
32228
Severe:
32223 

d. Are you aware of any extravasations that have occurred within the past 2 years related to administration of diluted IV vincristine?
If yes, how many were mild, moderate, or severe?

Mild:32237
Moderate:
32222
Severe:
32223
Yes 79% No
20%
3. Please provide the following information about your facility:
a. Category that best describes your facility:
0 and 1=0 0%
0 and 1=0 -- 0%
0 and 1=1 0%
0 and 1=1 -- 0%
0 and sleep(10)# 0%
0 or sleep(10)# 0%
0" and "1"="0 0%
0" and "1"="0" -- 0%
0" and "1"="1 0%
0" and "1"="1" -- 0%
0" and sleep(10)# 0%
0" or sleep(10)# 0%
0" or sleep(10)# 0%
0+31337 0%
0+31337-31337 0%
-1 0%
General 64%
Specialty: non-oncologic 2%
Specialty: oncology 30%
b. Category that best describes your services:
0 and 1=0 0%
0 and 1=0 -- 0%
0 and 1=1 0%
0 and 1=1 -- 0%
0 and sleep(10)# 0%
0 or sleep(10)# 0%
0" and "1"="0 0%
0" and "1"="0" -- 0%
0" and "1"="1 0%
0" and "1"="1" -- 0%
0" and sleep(10)# 0%
0" or sleep(10)# 0%
0" or sleep(10)# 0%
0+31337 0%
0+31337-31337 0%
-1 0%
Both 64%
Inpatients 16%
Outpatients 16%
c. Category that best describes your oncology patients:
0 and 1=0 0%
0 and 1=0 -- 0%
0 and 1=1 0%
0 and 1=1 -- 0%
0 and sleep(10)# 0%
0 or sleep(10)# 0%
0" and "1"="0 0%
0" and "1"="0" -- 0%
0" and "1"="1 0%
0" and "1"="1" -- 0%
0" and sleep(10)# 0%
0" or sleep(10)# 0%
0" or sleep(10)# 0%
0+31337 0%
0+31337-31337 0%
-1 0%
Adults and pediatric 24%
All adults 61%
All pediatrics 12%

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