ISMP Survey on Administration of IV Vincristine (All Respondants)

ISMP Survey on Administration of IV Vincristine
(All Respondants)

Total: 1047

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?	68%	28%	2%
b. Are doses of IV vincristine diluted and dispensed/ administered in a syringe?	79%	17%	2%
c. Are intrathecal medications packaged in a distinctive container not used for any other purpose to prevent confusion with IV medications, including vincristine?	81%	16%	2%
d. Do doses of IV vincristine include warning labels stating: “Fatal if given intrathecally. For IV use only.” (or similar labeling)?	80%	3%	0%
e. Are vincristine injections placed in an overwrap with a second warning label affixed?	89%	8%	1%
f. Does a pharmacist independently double-check IV vincristine doses, even if another pharmacist initially prepared the dose?	89%	7%	3%
g. Is IV vincristine delivered from the pharmacy to a location where intrathecal drugs are prohibited?	68%	28%	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)?	76%	21%	1%
i. Do two health professionals independently check IV vincristine doses before administration?	96%	1%	1%
j. Are doses of IV vincristine prohibited from being administered in the same location where intrathecal medications are given?	74%	22%	1%
k. Is IV vincristine banned from rooms where lumbar punctures are performed?	75%	22%	1%
l. Are those who prescribe, prepare, dispense, and administer chemotherapy educated about published case reports of fatal intrathecal administration of IV vincristine?	94%	1%	3%

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 78%	50 mL 11%	Other 9%
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 94%	No 4%
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 63%	No 35%	Mild:31965 Moderate:31961 Severe:31956
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:31970 Moderate:31955 Severe:31956		Yes 72%	No 26%

3. Please provide the following information about your facility:

a. Category that best describes your facility:

0 and 1=0

0 and 1=0 --

0 and 1=1

0 and 1=1 --

0 and sleep(10)#

0 or sleep(10)#

0" and "1"="0

0" and "1"="0" --

0" and "1"="1

0" and "1"="1" --

0" and sleep(10)#

0" or sleep(10)#

0¿" or sleep(10)#

0+31337

0+31337-31337

-1

General

64%

Specialty: non-oncologic

Specialty: oncology

30%

b. Category that best describes your services:

0 and 1=0

0 and 1=0 --

0 and 1=1

0 and 1=1 --

0 and sleep(10)#

0 or sleep(10)#

0" and "1"="0

0" and "1"="0" --

0" and "1"="1

0" and "1"="1" --

0" and sleep(10)#

0" or sleep(10)#

0¿" or sleep(10)#

0+31337

0+31337-31337

-1

Both

64%

Inpatients

16%

Outpatients

16%

c. Category that best describes your oncology patients:

0 and 1=0

0 and 1=0 --

0 and 1=1

0 and 1=1 --

0 and sleep(10)#

0 or sleep(10)#

0" and "1"="0

0" and "1"="0" --

0" and "1"="1

0" and "1"="1" --

0" and sleep(10)#

0" or sleep(10)#

0¿" or sleep(10)#

0+31337

0+31337-31337

-1

Adults and pediatric

24%

All adults

61%

All pediatrics

12%

ISMP Survey on Administration of IV Vincristine (General Acute Care)

ISMP Survey on Administration of IV Vincristine
(General Acute Care)

Total: 279

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?	28%	66%	6%
b. Are doses of IV vincristine diluted and dispensed/ administered in a syringe?	51%	43%	6%
c. Are intrathecal medications packaged in a distinctive container not used for any other purpose to prevent confusion with IV medications, including vincristine?	52%	43%	4%
d. Do doses of IV vincristine include warning labels stating: “Fatal if given intrathecally. For IV use only.” (or similar labeling)?	50%	6%	1%
e. Are vincristine injections placed in an overwrap with a second warning label affixed?	76%	21%	4%
f. Does a pharmacist independently double-check IV vincristine doses, even if another pharmacist initially prepared the dose?	77%	15%	8%
g. Is IV vincristine delivered from the pharmacy to a location where intrathecal drugs are prohibited?	24%	71%	6%
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)?	38%	59%	3%
i. Do two health professionals independently check IV vincristine doses before administration?	94%	4%	2%
j. Are doses of IV vincristine prohibited from being administered in the same location where intrathecal medications are given?	36%	60%	4%
k. Is IV vincristine banned from rooms where lumbar punctures are performed?	36%	62%	2%
l. Are those who prescribe, prepare, dispense, and administer chemotherapy educated about published case reports of fatal intrathecal administration of IV vincristine?	89%	3%	8%

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 20%	50 mL 46%	Other 34%
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 95%	No 5%	Yes 79%	No 21%
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 5%	No 95%	Mild:5 Moderate:4 Severe:1
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:2 Moderate:0 Severe:0		Yes 2%	No 98%

3. Please provide the following information about your facility:

a. Category that best describes your facility:

General

100%

b. Category that best describes your services:

Both

74%

Inpatients

21%

Outpatients

c. Category that best describes your oncology patients:

Adults and pediatric

27%

All adults

67%

All pediatrics

ISMP Survey on Administraton of IV Vincristine (Specialty Facility: Non-Oncologic)

ISMP Survey on Administration of IV Vincristine
(Specialty Facility: Non-oncologic)

Total: 8

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?	13%	75%	13%
b. Are doses of IV vincristine diluted and dispensed/ administered in a syringe?	50%	38%	13%
c. Are intrathecal medications packaged in a distinctive container not used for any other purpose to prevent confusion with IV medications, including vincristine?	75%	25%	0%
d. Do doses of IV vincristine include warning labels stating: “Fatal if given intrathecally. For IV use only.” (or similar labeling)?	75%	0%	0%
e. Are vincristine injections placed in an overwrap with a second warning label affixed?	100%	0%	0%
f. Does a pharmacist independently double-check IV vincristine doses, even if another pharmacist initially prepared the dose?	88%	13%	0%
g. Is IV vincristine delivered from the pharmacy to a location where intrathecal drugs are prohibited?	38%	63%	0%
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)?	25%	63%	13%
i. Do two health professionals independently check IV vincristine doses before administration?	100%	0%	0%
j. Are doses of IV vincristine prohibited from being administered in the same location where intrathecal medications are given?	63%	38%	0%
k. Is IV vincristine banned from rooms where lumbar punctures are performed?	50%	50%	0%
l. Are those who prescribe, prepare, dispense, and administer chemotherapy educated about published case reports of fatal intrathecal administration of IV vincristine?	75%	13%	13%

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 20%	50 mL 20%	Other 60%
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 100%	No 0%	Yes 75%	No 25%
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 13%	No 88%	Mild:0 Moderate:0 Severe:0
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:0 Moderate:0 Severe:0		Yes 17%	No 83%

3. Please provide the following information about your facility:

a. Category that best describes your facility:

Specialty: non-oncologic

100%

b. Category that best describes your services:

Both

75%

Inpatients

13%

Outpatients

13%

c. Category that best describes your oncology patients:

Adults and pediatric

25%

All adults

13%

All pediatrics

63%

ISMP Administration of IV Vincristine Survey (Specialty Facility Oncologic)

ISMP Survey on Administration of IV Vincristine
(Specialty Facility: Oncologic)

Total: 130

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?	17%	80%	3%
b. Are doses of IV vincristine diluted and dispensed/ administered in a syringe?	56%	41%	3%
c. Are intrathecal medications packaged in a distinctive container not used for any other purpose to prevent confusion with IV medications, including vincristine?	63%	33%	3%
d. Do doses of IV vincristine include warning labels stating: “Fatal if given intrathecally. For IV use only.” (or similar labeling)?	62%	9%	2%
e. Are vincristine injections placed in an overwrap with a second warning label affixed?	77%	21%	2%
f. Does a pharmacist independently double-check IV vincristine doses, even if another pharmacist initially prepared the dose?	73%	21%	6%
g. Is IV vincristine delivered from the pharmacy to a location where intrathecal drugs are prohibited?	28%	68%	4%
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)?	56%	42%	2%
i. Do two health professionals independently check IV vincristine doses before administration?	94%	3%	3%
j. Are doses of IV vincristine prohibited from being administered in the same location where intrathecal medications are given?	47%	50%	3%
k. Is IV vincristine banned from rooms where lumbar punctures are performed?	52%	47%	2%
l. Are those who prescribe, prepare, dispense, and administer chemotherapy educated about published case reports of fatal intrathecal administration of IV vincristine?	93%	2%	5%

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 20%	50 mL 36%	Other 44%
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 98%	No 2%	Yes 89%	No 11%
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 5%	No 95%	Mild:3 Moderate:3 Severe:1
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:14 Moderate:1 Severe:2		Yes 9%	No 91%

3. Please provide the following information about your facility:

a. Category that best describes your facility:

Specialty: oncology

100%

b. Category that best describes your services:

Both

51%

Inpatients

Outpatients

41%

c. Category that best describes your oncology patients:

Adults and pediatric

19%

All adults

60%

All pediatrics

22%

ISMP Survey on Administration of IV Vincristine (Setting: Inpatients)

ISMP Survey on Administration of IV Vincristine
(Setting: Inpatients)

Total: 70

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?	39%	60%	1%
b. Are doses of IV vincristine diluted and dispensed/ administered in a syringe?	57%	39%	4%
c. Are intrathecal medications packaged in a distinctive container not used for any other purpose to prevent confusion with IV medications, including vincristine?	51%	43%	6%
d. Do doses of IV vincristine include warning labels stating: “Fatal if given intrathecally. For IV use only.” (or similar labeling)?	50%	3%	0%
e. Are vincristine injections placed in an overwrap with a second warning label affixed?	79%	19%	3%
f. Does a pharmacist independently double-check IV vincristine doses, even if another pharmacist initially prepared the dose?	87%	10%	3%
g. Is IV vincristine delivered from the pharmacy to a location where intrathecal drugs are prohibited?	20%	79%	1%
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)?	38%	61%	2%
i. Do two health professionals independently check IV vincristine doses before administration?	96%	4%	0%
j. Are doses of IV vincristine prohibited from being administered in the same location where intrathecal medications are given?	35%	63%	1%
k. Is IV vincristine banned from rooms where lumbar punctures are performed?	25%	74%	1%
l. Are those who prescribe, prepare, dispense, and administer chemotherapy educated about published case reports of fatal intrathecal administration of IV vincristine?	91%	1%	7%

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 23%	50 mL 55%	Other 23%
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 96%	No 4%	Yes 91%	No 9%
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 3%	No 97%	Mild:0 Moderate:0 Severe:0
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:0 Moderate:0 Severe:0		Yes 2%	No 98%

3. Please provide the following information about your facility:

a. Category that best describes your facility:

General

83%

Specialty: non-oncologic

Specialty: oncology

16%

b. Category that best describes your services:

Inpatients

100%

c. Category that best describes your oncology patients:

Adults and pediatric

26%

All adults

66%

All pediatrics

ISMP Survey on Administration of IV Vincristine (Setting: Outpatients)

ISMP Survey on Administration of IV Vincristine
(Setting: Outpatients)

Total: 70

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?	12%	88%	0%
b. Are doses of IV vincristine diluted and dispensed/ administered in a syringe?	55%	43%	1%
c. Are intrathecal medications packaged in a distinctive container not used for any other purpose to prevent confusion with IV medications, including vincristine?	60%	40%	0%
d. Do doses of IV vincristine include warning labels stating: “Fatal if given intrathecally. For IV use only.” (or similar labeling)?	56%	12%	3%
e. Are vincristine injections placed in an overwrap with a second warning label affixed?	67%	30%	3%
f. Does a pharmacist independently double-check IV vincristine doses, even if another pharmacist initially prepared the dose?	77%	18%	5%
g. Is IV vincristine delivered from the pharmacy to a location where intrathecal drugs are prohibited?	32%	65%	3%
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)?	49%	49%	2%
i. Do two health professionals independently check IV vincristine doses before administration?	93%	3%	4%
j. Are doses of IV vincristine prohibited from being administered in the same location where intrathecal medications are given?	44%	53%	3%
k. Is IV vincristine banned from rooms where lumbar punctures are performed?	54%	44%	2%
l. Are those who prescribe, prepare, dispense, and administer chemotherapy educated about published case reports of fatal intrathecal administration of IV vincristine?	96%	1%	3%

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 23%	50 mL 27%	Other 50%
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 98%	No 2%	Yes 100%	No 0%
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 6%	No 94%	Mild:5 Moderate:0 Severe:1
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:0 Moderate:0 Severe:0		Yes 7%	No 93%

3. Please provide the following information about your facility:

a. Category that best describes your facility:

General

22%

Specialty: non-oncologic

Specialty: oncology

77%

b. Category that best describes your services:

Outpatients

100%

c. Category that best describes your oncology patients:

Adults and pediatric

10%

All adults

77%

All pediatrics

13%

ISMP Survey on Administration of IV Vincristine

ISMP Survey on Administration of IV Vincristine
(Patient Population: All Pediatrics)

Total: 278

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?	24%	68%	7%
b. Are doses of IV vincristine diluted and dispensed/ administered in a syringe?	51%	43%	6%
c. Are intrathecal medications packaged in a distinctive container not used for any other purpose to prevent confusion with IV medications, including vincristine?	56%	39%	4%
d. Do doses of IV vincristine include warning labels stating: “Fatal if given intrathecally. For IV use only.” (or similar labeling)?	55%	6%	1%
e. Are vincristine injections placed in an overwrap with a second warning label affixed?	79%	18%	3%
f. Does a pharmacist independently double-check IV vincristine doses, even if another pharmacist initially prepared the dose?	73%	18%	9%
g. Is IV vincristine delivered from the pharmacy to a location where intrathecal drugs are prohibited?	24%	69%	7%
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)?	44%	53%	4%
i. Do two health professionals independently check IV vincristine doses before administration?	94%	3%	3%
j. Are doses of IV vincristine prohibited from being administered in the same location where intrathecal medications are given?	40%	56%	4%
k. Is IV vincristine banned from rooms where lumbar punctures are performed?	42%	56%	2%
l. Are those who prescribe, prepare, dispense, and administer chemotherapy educated about published case reports of fatal intrathecal administration of IV vincristine?	89%	3%	8%

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 18%	50 mL 43%	Other 39%
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 95%	No 5%	Yes 76%	No 24%
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 5%	No 95%	Mild:6 Moderate:7 Severe:1
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:16 Moderate:1 Severe:2		Yes 5%	No 95%

3. Please provide the following information about your facility:

a. Category that best describes your facility:

General

74%

Specialty: non-oncologic

Specialty: oncology

24%

b. Category that best describes your services:

Both

100%

c. Category that best describes your oncology patients:

Adults and pediatric

28%

All adults

59%

All pediatrics

13%

ISMP Survey on Administration of IV Vincristine (Patient Population: All Adults)

ISMP Survey on Administration of IV Vincristine
(patient Population: All Adults)

Total: 264

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?	25%	68%	7%
b. Are doses of IV vincristine diluted and dispensed/ administered in a syringe?	53%	42%	5%
c. Are intrathecal medications packaged in a distinctive container not used for any other purpose to prevent confusion with IV medications, including vincristine?	52%	43%	5%
d. Do doses of IV vincristine include warning labels stating: “Fatal if given intrathecally. For IV use only.” (or similar labeling)?	50%	8%	2%
e. Are vincristine injections placed in an overwrap with a second warning label affixed?	73%	23%	4%
f. Does a pharmacist independently double-check IV vincristine doses, even if another pharmacist initially prepared the dose?	76%	16%	7%
g. Is IV vincristine delivered from the pharmacy to a location where intrathecal drugs are prohibited?	24%	71%	5%
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)?	41%	58%	2%
i. Do two health professionals independently check IV vincristine doses before administration?	93%	4%	3%
j. Are doses of IV vincristine prohibited from being administered in the same location where intrathecal medications are given?	36%	61%	3%
k. Is IV vincristine banned from rooms where lumbar punctures are performed?	36%	64%	1%
l. Are those who prescribe, prepare, dispense, and administer chemotherapy educated about published case reports of fatal intrathecal administration of IV vincristine?	91%	3%	7%

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 14%	50 mL 48%	Other 38%
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 95%	No 5%	Yes 76%	No 24%
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 3%	No 97%	Mild:1 Moderate:2 Severe:1
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:2 Moderate:0 Severe:0		Yes 3%	No 97%

3. Please provide the following information about your facility:

a. Category that best describes your facility:

General

70%

Specialty: non-oncologic

Specialty: oncology

29%

b. Category that best describes your services:

Both

62%

Inpatients

17%

Outpatients

20%

c. Category that best describes your oncology patients:

All adults

100%

ISMP Survey on Administration of IV Vincristine (All Pediatrics)

ISMP Survey on Administration of IV Vincristine
(Patient Population: All Pediatrics)

Total: 50

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?	10%	88%	2%
b. Are doses of IV vincristine diluted and dispensed/ administered in a syringe?	58%	42%	0%
c. Are intrathecal medications packaged in a distinctive container not used for any other purpose to prevent confusion with IV medications, including vincristine?	65%	33%	2%
d. Do doses of IV vincristine include warning labels stating: “Fatal if given intrathecally. For IV use only.” (or similar labeling)?	62%	2%	0%
e. Are vincristine injections placed in an overwrap with a second warning label affixed?	92%	8%	0%
f. Does a pharmacist independently double-check IV vincristine doses, even if another pharmacist initially prepared the dose?	77%	19%	4%
g. Is IV vincristine delivered from the pharmacy to a location where intrathecal drugs are prohibited?	20%	78%	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)?	53%	45%	2%
i. Do two health professionals independently check IV vincristine doses before administration?	100%	0%	0%
j. Are doses of IV vincristine prohibited from being administered in the same location where intrathecal medications are given?	68%	28%	4%
k. Is IV vincristine banned from rooms where lumbar punctures are performed?	76%	24%	0%
l. Are those who prescribe, prepare, dispense, and administer chemotherapy educated about published case reports of fatal intrathecal administration of IV vincristine?	98%	0%	2%

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 21%	50 mL 14%	Other 64%
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 98%	No 3%	Yes 92%	No 8%
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 18%	No 82%	Mild:9 Moderate:2 Severe:1
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:13 Moderate:0 Severe:0		Yes 16%	No 84%

3. Please provide the following information about your facility:

a. Category that best describes your facility:

General

33%

Specialty: non-oncologic

10%

Specialty: oncology

57%

b. Category that best describes your services:

Both

70%

Inpatients

12%

Outpatients

18%

c. Category that best describes your oncology patients:

All pediatrics

100%

ISMP Survey on Administration of IV Vincristine (Patient Population: Adults and Pediatrics)

ISMP Survey on Administration of IV Vincristine
(Patient Population: Adults and Pediatrics)

Total: 102

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?	29%	69%	2%
b. Are doses of IV vincristine diluted and dispensed/ administered in a syringe?	49%	44%	7%
c. Are intrathecal medications packaged in a distinctive container not used for any other purpose to prevent confusion with IV medications, including vincristine?	62%	35%	3%
d. Do doses of IV vincristine include warning labels stating: “Fatal if given intrathecally. For IV use only.” (or similar labeling)?	62%	5%	0%
e. Are vincristine injections placed in an overwrap with a second warning label affixed?	78%	19%	3%
f. Does a pharmacist independently double-check IV vincristine doses, even if another pharmacist initially prepared the dose?	75%	18%	7%
g. Is IV vincristine delivered from the pharmacy to a location where intrathecal drugs are prohibited?	30%	63%	7%
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)?	46%	47%	7%
i. Do two health professionals independently check IV vincristine doses before administration?	93%	4%	3%
j. Are doses of IV vincristine prohibited from being administered in the same location where intrathecal medications are given?	36%	59%	5%
k. Is IV vincristine banned from rooms where lumbar punctures are performed?	37%	57%	6%
l. Are those who prescribe, prepare, dispense, and administer chemotherapy educated about published case reports of fatal intrathecal administration of IV vincristine?	85%	3%	12%

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 33%	50 mL 38%	Other 29%
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 98%	No 3%	Yes 91%	No 9%
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 5%	No 95%	Mild:1 Moderate:3 Severe:0
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:1 Moderate:1 Severe:2		Yes 6%	No 94%

3. Please provide the following information about your facility:

a. Category that best describes your facility:

General

75%

Specialty: non-oncologic

Specialty: oncology

24%

b. Category that best describes your services:

Both

75%

Inpatients

18%

Outpatients

c. Category that best describes your oncology patients:

Adults and pediatric

100%