ISMP Survey on Administration of IV Vincristine
(
All Respondants)

Total: 1067

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? 67% 29% 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? 69% 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)? 77% 20% 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? 75% 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
10%
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:31982
Moderate:
31978
Severe:
31973 

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:31987
Moderate:
31972
Severe:
31973
Yes 73% No
25%
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%

Copyright © 2014, ISMP. All rights reserved

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%

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
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:

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 5%
c. Category that best describes your oncology patients:
Adults and pediatric 27%
All adults 67%
All pediatrics 6%

Copyright © 2014, ISMP. All rights reserved

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%

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
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:

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%

Copyright © 2014, ISMP. All rights reserved

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%

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
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:

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 8%
Outpatients 41%
c. Category that best describes your oncology patients:
Adults and pediatric 19%
All adults 60%
All pediatrics 22%

Copyright © 2014, ISMP. All rights reserved

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%

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
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:

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 1%
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 9%

Copyright © 2014, ISMP. All rights reserved

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%

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
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:

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 1%
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%

Copyright © 2014, ISMP. All rights reserved

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%

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
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:

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 2%
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%

Copyright © 2014, ISMP. All rights reserved

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%

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
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:

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 0%
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%

Copyright © 2014, ISMP. All rights reserved

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%

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
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:

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%

Copyright © 2014, ISMP. All rights reserved

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%

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
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:

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 2%
Specialty: oncology 24%
b. Category that best describes your services:
Both 75%
Inpatients 18%
Outpatients 7%
c. Category that best describes your oncology patients:
Adults and pediatric 100%

Copyright © 2014, ISMP. All rights reserved