ISMP survey on promethazine

Total : 999

About your process

Recommendation

 Value of recommendation
1=low_value...5=high_value 		Does your facility follow the recommendation?
a) Limit the concentration in stock to 25 mg/mL
1 4%
2 4%
3 10%
4 15%
5 67%
NA 5%
No 25%
Yes 69%
b) Limit the starting dose to 6.25 to 12.5 mg IV
1 6%
2 8%
3 17%
4 19%
5 51%
NA 7%
No 64%
Yes 29%
c) Dilute the drug in 10 to 20 mL of normal saline
2 5%
3 9%
4 16%
5 70%
NA 7%
No 45%
Yes 47%
d) Prepare the drug in minibags containing normal saline
1 18%
2 12%
3 22%
4 16%
5 32%
NA 8%
No 82%
Yes 10%
e) Do not allow administration via hand or wrist veins
1 12%
2 9%
3 22%
4 19%
5 39%
NA 7%
No 83%
Yes 10%
f) Give the drug through a central venous site only
1 26%
2 19%
3 23%
4 12%
5 20%
NA 8%
No 89%
Yes 4%
g) Inject the drug through a running IV line
1 3%
2 6%
3 15%
4 26%
5 50%
NA 7%
No 52%
Yes 41%
h) Inject the drug through a running IV line at the port furthest from the patient’s vein
1 5%
2 7%
3 17%
4 26%
5 44%
NA 9%
No 67%
Yes 25%
i) Administer the drug slowly over 10-15 minutes
1 7%
2 11%
3 19%
4 22%
5 41%
NA 6%
No 68%
Yes 25%
j) Require the person administering the drug to remain with the patient to assess the IV site during the entire injection/infusion
1 7%
2 8%
3 19%
4 25%
5 41%
NA 8%
No 59%
Yes 33%
k) Standing orders for promethazine IV reflect the current safety requirements
1 4%
2 5%
3 16%
4 22%
5 53%
NA 20%
No 58%
Yes 22%
l) Patients are advised to report burning or pain
1 1%
2 1%
3 8%
4 19%
5 70%
NA 6%
No 34%
Yes 59%
m) An alert appears on MARs reminding staff of safety precautions
1 3%
2 4%
3 14%
4 20%
5 60%
NA 10%
No 63%
Yes 27%
n) An alert appears on automated dispensing cabinet screens reminding staff of safety precautions
1 4%
2 3%
3 15%
4 21%
5 57%
NA 18%
No 62%
Yes 19%
o) Remove promethazine from the formulary
1 44%
2 19%
3 16%
4 5%
5 17%
NA 8%
No 90%
Yes 3%
p) Ban IV use of promethazine
1 46%
2 15%
3 14%
4 6%
5 19%
NA 8%
No 89%
Yes 3%
q) Use alternative rescue antiemetics
1 13%
2 9%
3 24%
4 20%
5 33%
NA 12%
No 50%
Yes 38%

2). At your current or past facility, have there been any cases of serious tissue damage in the past 5 years that occurred after IV administration of promethazine?
No 45%
Not sure 37%
Yes 18%

3). Do you believe FDA should withdraw approval of the IV route of administration of promethazine?
No 59%
Not sure 17%
Yes 24%

Copyright © 2008, ISMP. All rights reserved