ISMP Survey on Administration of IV Vincristine (All Respondants)

ISMP Survey on Administration of IV Vincristine
(All Respondants)

Total: 422

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%	71%	5%
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?	56%	40%	4%
d. Do doses of IV vincristine include warning labels stating: “Fatal if given intrathecally. For IV use only.” (or similar labeling)?	54%	6%	1%
e. Are vincristine injections placed in an overwrap with a second warning label affixed?	77%	20%	3%
f. Does a pharmacist independently double-check IV vincristine doses, even if another pharmacist initially prepared the dose?	76%	17%	7%
g. Is IV vincristine delivered from the pharmacy to a location where intrathecal drugs are prohibited?	25%	70%	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)?	43%	54%	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?	39%	57%	4%
k. Is IV vincristine banned from rooms where lumbar punctures are performed?	41%	57%	2%
l. Are those who prescribe, prepare, dispense, and administer chemotherapy educated about published case reports of fatal intrathecal administration of IV vincristine?	90%	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 19%	50 mL 44%	Other 37%
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 81%	No 19%
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:11 Moderate:7 Severe:2
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 3%	No 97%

3. Please provide the following information about your facility:

a. Category that best describes your facility:

General

67%

Specialty: non-oncologic

Specialty: oncology

31%

b. Category that best describes your services:

Both

67%

Inpatients

17%

Outpatients

17%

c. Category that best describes your oncology patients:

Adults and pediatric

24%

All adults

64%

All pediatrics

12%

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

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

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?	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%	44%	5%
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?	23%	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

20%

Outpatients

c. Category that best describes your oncology patients:

Adults and pediatric

28%

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: 7

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?	0%	86%	14%
b. Are doses of IV vincristine diluted and dispensed/ administered in a syringe?	43%	43%	14%
c. Are intrathecal medications packaged in a distinctive container not used for any other purpose to prevent confusion with IV medications, including vincristine?	71%	29%	0%
d. Do doses of IV vincristine include warning labels stating: “Fatal if given intrathecally. For IV use only.” (or similar labeling)?	71%	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?	86%	14%	0%
g. Is IV vincristine delivered from the pharmacy to a location where intrathecal drugs are prohibited?	29%	71%	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)?	14%	71%	14%
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?	57%	43%	0%
k. Is IV vincristine banned from rooms where lumbar punctures are performed?	43%	57%	0%
l. Are those who prescribe, prepare, dispense, and administer chemotherapy educated about published case reports of fatal intrathecal administration of IV vincristine?	71%	14%	14%

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 0%	50 mL 25%	Other 75%
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 67%	No 33%
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 0%	No 100%	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 0%	No 100%

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

86%

Inpatients

14%

c. Category that best describes your oncology patients:

Adults and pediatric

29%

All adults

14%

All pediatrics

57%

ISMP Administration of IV Vincristine Survey (Specialty Facility Oncologic)

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

Total: 129

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?	16%	81%	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%	34%	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%	22%	6%
g. Is IV vincristine delivered from the pharmacy to a location where intrathecal drugs are prohibited?	28%	69%	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?	46%	50%	3%
k. Is IV vincristine banned from rooms where lumbar punctures are performed?	51%	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 18%	50 mL 37%	Other 45%
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 4%	No 96%	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 7%	No 93%

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

50%

Inpatients

Outpatients

41%

c. Category that best describes your oncology patients:

Adults and pediatric

18%

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: 69

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?	38%	61%	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)?	49%	3%	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?	87%	10%	3%
g. Is IV vincristine delivered from the pharmacy to a location where intrathecal drugs are prohibited?	19%	80%	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)?	37%	62%	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?	34%	64%	1%
k. Is IV vincristine banned from rooms where lumbar punctures are performed?	24%	75%	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 21%	50 mL 56%	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 2%	No 98%	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 0%	No 100%

3. Please provide the following information about your facility:

a. Category that best describes your facility:

General

82%

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

65%

All pediatrics

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

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

Total: 69

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%	90%	0%
b. Are doses of IV vincristine diluted and dispensed/ administered in a syringe?	54%	44%	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)?	55%	12%	3%
e. Are vincristine injections placed in an overwrap with a second warning label affixed?	66%	31%	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?	31%	66%	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)?	48%	50%	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?	43%	54%	3%
k. Is IV vincristine banned from rooms where lumbar punctures are performed?	53%	45%	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 20%	50 mL 28%	Other 52%
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 5%	No 95%	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 4%	No 96%

3. Please provide the following information about your facility:

a. Category that best describes your facility:

General

22%

Specialty: oncology

78%

b. Category that best describes your services:

Outpatients

100%

c. Category that best describes your oncology patients:

Adults and pediatric

10%

All adults

78%

All pediatrics

12%

ISMP Survey on Administration of IV Vincristine

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

Total: 277

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%	69%	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%	40%	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?	78%	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)?	43%	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?	39%	56%	5%
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 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 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 4%	No 96%

3. Please provide the following information about your facility:

a. Category that best describes your facility:

General

74%

Specialty: non-oncologic

Specialty: oncology

23%

b. Category that best describes your services:

Both

100%

c. Category that best describes your oncology patients:

Adults and pediatric

28%

All adults

60%

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: 263

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?	35%	61%	3%
k. Is IV vincristine banned from rooms where lumbar punctures are performed?	35%	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 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 2%	No 98%	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 2%	No 98%

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

21%

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: 49

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?	8%	90%	2%
b. Are doses of IV vincristine diluted and dispensed/ administered in a syringe?	57%	43%	0%
c. Are intrathecal medications packaged in a distinctive container not used for any other purpose to prevent confusion with IV medications, including vincristine?	64%	34%	2%
d. Do doses of IV vincristine include warning labels stating: “Fatal if given intrathecally. For IV use only.” (or similar labeling)?	61%	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?	19%	79%	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)?	52%	46%	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?	67%	29%	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 15%	50 mL 15%	Other 69%
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 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 16%	No 84%	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 11%	No 89%

3. Please provide the following information about your facility:

a. Category that best describes your facility:

General

33%

Specialty: non-oncologic

Specialty: oncology

58%

b. Category that best describes your services:

Both

71%

Inpatients

12%

Outpatients

16%

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: 101

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%	45%	7%
c. Are intrathecal medications packaged in a distinctive container not used for any other purpose to prevent confusion with IV medications, including vincristine?	61%	36%	3%
d. Do doses of IV vincristine include warning labels stating: “Fatal if given intrathecally. For IV use only.” (or similar labeling)?	61%	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?	29%	64%	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)?	45%	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?	35%	60%	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 32%	50 mL 38%	Other 30%
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 3%	Yes 90%	No 10%
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 4%	No 96%	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 4%	No 96%

3. Please provide the following information about your facility:

a. Category that best describes your facility:

General

75%

Specialty: non-oncologic

Specialty: oncology

23%

b. Category that best describes your services:

Both

75%

Inpatients

18%

Outpatients

c. Category that best describes your oncology patients:

Adults and pediatric

100%