Applied Medication Safety

Season 2 - Anticoagulation is diving into the safety concerns of anticoagulants across a variety of healthcare environments. This episode explores the care that happens outside the acute care visit. We speak with a primary care physician about the use of anticoagulation, the safety concerns they have, and how those concerns differ from the acute care setting. This is a great follow up that rounds out the first two episodes from a physician perspective.   Visit us at our website at www.amspod.com and send us an e-mail! We'd love to hear from you about topics of interest or burning questions, especially those that fall within the season's clinical focus. If you would like to contribute and be a guest on the podcast, the website is the place to send that message.   Disclaimer: The first person narration of safety events is done to preserve the learning power of stories. The safety events discussed are fictional though the risks and safety concerns are very real. They are created from over decades from multiple home care, acute care, and long-term care institutions; and gathered from discussion with peers around the world who shared their stories to help others. In no way do these fictional safety events reflect the patient experience at my current employer. This podcast is purely a personal and private endeavor to enhance patient safety in some small way. Hosted by Michael Van Ornum RPh, RN, BCPS, CPPS with over 30 years experience in the medical field and more than 10 years with medication safety.

Season 2 - Anticoagulation is diving into the safety concerns of anticoagulants across a variety of healthcare environments. This episode continues an interview with an expert in direct oral anticoagulants, an Emergency Department physician, who shares some of his concerns along with proven tips for helping us all care safely. The conversation was compelling and rich enough that we had to break it into two episodes for our listeners, and this is the conclusion of that conversation.   Visit us at our website at www.amspod.com and send us an e-mail! We'd love to hear from you about topics of interest or burning questions, especially those that fall within the season's clinical focus. If you would like to contribute and be a guest on the podcast, the website is the place to send that message.   Disclaimer: The first person narration of safety events is done to preserve the learning power of stories. The safety events discussed are fictional though the risks and safety concerns are very real. They are created from over decades from multiple home care, acute care, and long-term care institutions; and gathered from discussion with peers around the world who shared their stories to help others. In no way do these fictional safety events reflect the patient experience at my current employer. This podcast is purely a personal and private endeavor to enhance patient safety in some small way. Hosted by Michael Van Ornum RPh, RN, BCPS, CPPS with over 30 years experience in the medical field and more than 10 years with medication safety.

Season 2 - Anticoagulation is diving into the safety concerns of anticoagulants across a variety of healthcare environments. This episode features an interview with an expert in direct oral anticoagulants, an Emergency Department physician, who shares some of his concerns along with proven tips for helping us all care safely. The conversation was compelling and rich enough that we had to break it into two episodes for our listeners.   Disclaimer: The first person narration of safety events is done to preserve the learning power of stories. The safety events discussed are fictional though the risks and safety concerns are very real. They are created from over decades from multiple home care, acute care, and long-term care institutions; and gathered from discussion with peers around the world who shared their stories to help others. In no way do these fictional safety events reflect the patient experience at my current employer. This podcast is purely a personal and private endeavor to enhance patient safety in some small way. Hosted by Michael Van Ornum RPh, RN, BCPS, CPPS with over 30 years experience in the medical field and more than 10 years with medication safety.

Controversial Conversations are podcasts exploring the sticky areas in healthcare that may often be viewed as sensitive, controversial, or polarized. We hope these conversations add information and perspective into the conversation in a way that prompts new questions and promotes a wider appreciation of the complexity in healthcare that is around us every day. Resources used include: 2016 Nicholso L, "The Immune system" https://research-information.bris.ac.uk/ws/portalfiles/portal/94167087/275.full.pdf   2020 Seneff S, Nigh G "Worse than the Disease? Reviewing Some Possible Unintended Consequences of the mRNA Vaccines Against COVID-19 https://people.csail.mit.edu/seneff/2021/SeneffNigh_mRNA_vaccines_IJVTPR.pdf   Disclaimer: The first person narration of safety events is done to preserve the learning power of stories. The safety events discussed are fictional though the risks and safety concerns are very real. They are created from over decades from multiple home care, acute care, and long-term care institutions; and gathered from discussion with peers around the world who shared their stories to help others. In no way do these fictional safety events reflect the patient experience at my current employer. This podcast is purely a personal and private endeavor to enhance patient safety in some small way. Hosted by Michael Van Ornum RPh, RN, BCPS, CPPS with over 30 years experience in the medical field and more than 10 years with medication safety.

Controversial Conversations are podcasts exploring the sticky areas in healthcare that may often be viewed as sensitive, controversial, or polarized. We hope these conversations add information and perspective into the conversation in a way that prompts new questions and promotes a wider appreciation of the complexity in healthcare that is around us every day. Resources used include: 2016 Nicholso L, "The Immune system" https://research-information.bris.ac.uk/ws/portalfiles/portal/94167087/275.full.pdf   2020 Seneff S, Nigh G "Worse than the Disease? Reviewing Some Possible Unintended Consequences of the mRNA Vaccines Against COVID-19 https://people.csail.mit.edu/seneff/2021/SeneffNigh_mRNA_vaccines_IJVTPR.pdf   Disclaimer: The first person narration of safety events is done to preserve the learning power of stories. The safety events discussed are fictional though the risks and safety concerns are very real. They are created from over decades from multiple home care, acute care, and long-term care institutions; and gathered from discussion with peers around the world who shared their stories to help others. In no way do these fictional safety events reflect the patient experience at my current employer. This podcast is purely a personal and private endeavor to enhance patient safety in some small way. Hosted by Michael Van Ornum RPh, RN, BCPS, CPPS with over 30 years experience in the medical field and more than 10 years with medication safety.

Controversial Conversations are podcasts exploring the sticky areas in healthcare that may often be viewed as sensitive, controversial, or polarized. We hope these conversations add information and perspective into the conversation in a way that prompts new questions and promotes a wider appreciation of the complexity in healthcare that is around us every day. At the end of nearly every episode of Season 1: Opiate Safety, guests provided their thoughts for improving healthcare. In this episode, we've sought out balancing perspectives to answer the same question, and discover where the true direction of patient care may lie. Christian Heinz, co-host from the Making the Argument podcast (https://podcast.nickforva.com/), joins to provide a perspective grounded in history and familiarity with the Virginia legislative process to broaden our questions and ways we think of common issues. Resources referenced in this podcast episode include: Emergency Medical Treatment and Labor Act (EMTALA): https://www.cms.gov/files/document/qso-22-22-hospitals.pdf CMS Stats for Coverage and Payments: https://data.cms.gov/sites/default/files/2023-03/CMSFastFactsMar2023.pdf  Government Healthcare Values: https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/Value-Based-Programs/CMS-Quality-Strategy  COVID-19 Vaccination among Healthcare Personnel (HCP) measure: https://www.cms.gov/newsroom/fact-sheets/fy-2024-hospital-inpatient-prospective-payment-system-ipps-and-long-term-care-hospital-prospective List of Largest Private Insurers: https://www.forbes.com/advisor/health-insurance/largest-health-insurance-companies/    Disclaimer: The first person narration of safety events is done to preserve the learning power of stories. The safety events discussed are fictional though the risks and safety concerns are very real. They are created from over decades from multiple home care, acute care, and long-term care institutions; and gathered from discussion with peers around the world who shared their stories to help others. In no way do these fictional safety events reflect the patient experience at my current employer. This podcast is purely a personal and private endeavor to enhance patient safety in some small way. Hosted by Michael Van Ornum RPh, RN, BCPS, CPPS with over 30 years experience in the medical field and more than 10 years with medication safety.

The finale to our focus on opiate safety concludes in this episode. This is a summary of the lessons learned, a few new observations, and preparations for the next season. Disclaimer: The first person narration of safety events is done to preserve the learning power of stories. The safety events discussed are fictional though the risks and safety concerns are very real. They are created from over decades from multiple home care, acute care, and long-term care institutions; and gathered from discussion with peers around the world who shared their stories to help others. In no way do these fictional safety events reflect the patient experience at my current employer. This podcast is purely a personal and private endeavor to enhance patient safety in some small way. Hosted by Michael Van Ornum RPh, RN, BCPS, CPPS with over 30 years experience in the medical field and more than 10 years with medication safety.

This episode features a review of a paper by Sidney Dekker featuring the attributes of complex systems, as opposed to simple or complicated systems. We use many stories and examples from healthcare that illustrate these attributes of complexity and, more importantly, the best way to resolve the challenges in a way that helps us care safely. Source Reference: Dekker S, Cilliers P, Hofmeyr J-H "The Complexity of failure: Implications of complexity theory for safety investigations" Safety Science 49 (2011) 939–945 doi:10.1016/j.ssci.2011.01.008 Disclaimer: The first person narration of safety events is done to preserve the learning power of stories. The safety events discussed are fictional though the risks and safety concerns are very real. They are created from over decades from multiple home care, acute care, and long-term care institutions; and gathered from discussion with peers around the world who shared their stories to help others. In no way do these fictional safety events reflect the patient experience at my current employer. This podcast is purely a personal and private endeavor to enhance patient safety in some small way. Hosted by Michael Van Ornum RPh, RN, BCPS, CPPS with over 30 years experience in the medical field and more than 10 years with medication safety.

This episode is almost a two-for-one special as our guest is not only an oncology pharmacist but also spent more than a decade working as a respiratory therapist. He brings together a wide range of experience and shares his insights.  Disclaimer: The first person narration of safety events is done to preserve the learning power of stories. The safety events discussed are fictional though the risks and safety concerns are very real. They are created from over decades from multiple home care, acute care, and long-term care institutions; and gathered from discussion with peers around the world who shared their stories to help others. In no way do these fictional safety events reflect the patient experience at my current employer. This podcast is purely a personal and private endeavor to enhance patient safety in some small way. Hosted by Michael Van Ornum RPh, RN, BCPS, CPPS with over 30 years experience in the medical field and more than 10 years with medication safety.

One of the superstars of safety joins us - Todd Conklin! Author of multiple books including "Pre-Accident Investigations: Better Questions", and co-author with Sidney Dekker, "Do Safety Differently". His approach as a specialist outside of healthcare brings challenging questions. This episode also published on Todd's podcast - well worth listening to - "Pre Accident Investigations" Disclaimer: The first person narration of safety events is done to preserve the learning power of stories. The safety events discussed are fictional though the risks and safety concerns are very real. They are created from over decades from multiple home care, acute care, and long-term care institutions; and gathered from discussion with peers around the world who shared their stories to help others. In no way do these fictional safety events reflect the patient experience at my current employer. This podcast is purely a personal and private endeavor to enhance patient safety in some small way. Hosted by Michael Van Ornum RPh, RN, BCPS, CPPS with over 30 years experience in the medical field and more than 10 years with medication safety.

This is our second interview with a Medication Safety pharmacist, and she doesn't sugarcoat any of the challenges we face in healthcare! It's a shorter episode, but packed with raw and relevant experience.  Disclaimer: The first person narration of safety events is done to preserve the learning power of stories. The safety events discussed are fictional though the risks and safety concerns are very real. They are created from over decades from multiple home care, acute care, and long-term care institutions; and gathered from discussion with peers around the world who shared their stories to help others. In no way do these fictional safety events reflect the patient experience at my current employer. This podcast is purely a personal and private endeavor to enhance patient safety in some small way. Hosted by Michael Van Ornum RPh, RN, BCPS, CPPS with over 30 years experience in the medical field and more than 10 years with medication safety.

Back to the general med/surg floors for this episode. A second hospitalist - a physician specializing in acute care for inpatients was kind enough to share his insights.  Disclaimer: The first person narration of safety events is done to preserve the learning power of stories. The safety events discussed are fictional though the risks and safety concerns are very real. They are created from over decades from multiple home care, acute care, and long-term care institutions; and gathered from discussion with peers around the world who shared their stories to help others. In no way do these fictional safety events reflect the patient experience at my current employer. This podcast is purely a personal and private endeavor to enhance patient safety in some small way. Hosted by Michael Van Ornum RPh, RN, BCPS, CPPS with over 30 years experience in the medical field and more than 10 years with medication safety.

We speak with a diversion expert about the intersection of opiate safety and diversion and the patients, staff, and institutions at the center. Terri Vidals hosts her own podcast "Drug Diversion Insights" and can be reached through her company's website at www.rxpert.solutions. This episode also appears on her podcast. Disclaimer: The first person narration of safety events is done to preserve the learning power of stories. The safety events discussed are fictional though the risks and safety concerns are very real. They are created from over decades from multiple home care, acute care, and long-term care institutions; and gathered from discussion with peers around the world who shared their stories to help others. In no way do these fictional safety events reflect the patient experience at my current employer. This podcast is purely a personal and private endeavor to enhance patient safety in some small way. Hosted by Michael Van Ornum RPh, RN, BCPS, CPPS with over 30 years experience in the medical field and more than 10 years with medication safety.

This episode features a discussion with a pharmacy student who speaks about her experience in healthcare from two cultures. Her perspective as a first generation immigrant from an Asian country provides the foundation for many questions as it relates to opiate safety. The contrast between Eastern and Western medicine is never quite so apparent as when we are discussing how pain management concepts cross the cultural divide. Disclaimer: The first person narration of safety events is done to preserve the learning power of stories. The safety events discussed are fictional though the risks and safety concerns are very real. They are created from over decades from multiple home care, acute care, and long-term care institutions; and gathered from discussion with peers around the world who shared their stories to help others. In no way do these fictional safety events reflect the patient experience at my current employer. This podcast is purely a personal and private endeavor to enhance patient safety in some small way. Hosted by Michael Van Ornum RPh, RN, BCPS, CPPS with over 30 years experience in the medical field and more than 10 years with medication safety.

We continue our conversations in the Intensive Care Unit with a pharmacist who has an impressive clinical knowledge base and deep understanding of medication therapy. Disclaimer: The first person narration of safety events is done to preserve the learning power of stories. The safety events discussed are fictional though the risks and safety concerns are very real. They are created from over decades from multiple home care, acute care, and long-term care institutions; and gathered from discussion with peers around the world who shared their stories to help others. In no way do these fictional safety events reflect the patient experience at my current employer. This podcast is purely a personal and private endeavor to enhance patient safety in some small way. Hosted by Michael Van Ornum RPh, RN, BCPS, CPPS with over 30 years experience in the medical field and more than 10 years with medication safety.

We move from the general floors to the Intensive Care Unit where pain management takes a hard turn. Opiates are used as part of sedation protocols for ventilated patients, making the risks and concerns of oversedation very different than our discussions so far. This nurse shares great insights into the unique challenges of continuous opiate infusions. Disclaimer: The first person narration of safety events is done to preserve the learning power of stories. The safety events discussed are fictional though the risks and safety concerns are very real. They are created from over decades from multiple home care, acute care, and long-term care institutions; and gathered from discussion with peers around the world who shared their stories to help others. In no way do these fictional safety events reflect the patient experience at my current employer. This podcast is purely a personal and private endeavor to enhance patient safety in some small way. Hosted by Michael Van Ornum RPh, RN, BCPS, CPPS with over 30 years experience in the medical field and more than 10 years with medication safety.

In this episode, we hear firsthand from a medication safety specialist about the process of submitting and interpreting safety events, and all the things that keep a safety specialist awake at night. Disclaimer: The first person narration of safety events is done to preserve the learning power of stories. The safety events discussed are fictional though the risks and safety concerns are very real. They are created from over decades from multiple home care, acute care, and long-term care institutions; and gathered from discussion with peers around the world who shared their stories to help others. In no way do these fictional safety events reflect the patient experience at my current employer. This podcast is purely a personal and private endeavor to enhance patient safety in some small way. Hosted by Michael Van Ornum RPh, RN, BCPS, CPPS with over 30 years experience in the medical field and more than 10 years with medication safety.

Up to this point, safety has focused on avoiding excessive sedation effects of opiates - but what about palliative care where the purpose of therapy is the comfort of the patient. In this episode, we begin to explore the role of opiates and common misconceptions about palliative care. Patient care concerns created a shorter interview than usual. Disclaimer: The first person narration of safety events is done to preserve the learning power of stories. The safety events discussed are fictional though the risks and safety concerns are very real. They are created from over decades from multiple home care, acute care, and long-term care institutions; and gathered from discussion with peers around the world who shared their stories to help others. In no way do these fictional safety events reflect the patient experience at my current employer. This podcast is purely a personal and private endeavor to enhance patient safety in some small way. Hosted by Michael Van Ornum RPh, RN, BCPS, CPPS with over 30 years experience in the medical field and more than 10 years with medication safety.

Now we move onto the general floors where we have a wonderful opportunity to speak with a hospitalist - a physician specializing in acute care for inpatients. Disclaimer: The first person narration of safety events is done to preserve the learning power of stories. The safety events discussed are fictional though the risks and safety concerns are very real. They are created from over decades from multiple home care, acute care, and long-term care institutions; and gathered from discussion with peers around the world who shared their stories to help others. In no way do these fictional safety events reflect the patient experience at my current employer. This podcast is purely a personal and private endeavor to enhance patient safety in some small way. Hosted by Michael Van Ornum RPh, RN, BCPS, CPPS with over 30 years experience in the medical field and more than 10 years with medication safety.

Taking a break from interviews, we talk about safety concerns in the procedural and operative areas through the lens of priming and drifting. One of the most famous legal events - the Vanderbilt wrong drug event - is discussed in this context. Disclaimer: The first person narration of safety events is done to preserve the learning power of stories. The safety events discussed are fictional though the risks and safety concerns are very real. They are created from over decades from multiple home care, acute care, and long-term care institutions; and gathered from discussion with peers around the world who shared their stories to help others. In no way do these fictional safety events reflect the patient experience at my current employer. This podcast is purely a personal and private endeavor to enhance patient safety in some small way. Hosted by Michael Van Ornum RPh, RN, BCPS, CPPS with over 30 years experience in the medical field and more than 10 years with medication safety.