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  • 1.  Availability of Nalozone (Narcan) in Ambulatory Clinics

    Posted 02-21-2024 11:07

    I have looked at past posts and there has been discussion of Clinics having Naloxone (Narcan) availability in their clinics. Most have referred to carrying injectable with separate atomizer for nasal administration versus the nasal spray. 

    I was looking for current information on the following:

    • Do you keep Narcan in your clinics?
    • Do you have it available in all clinics?
    • If you do, are you keeping the nasal spray since it is now more broadly available or the injectable?
    • What quantity do you keep in the clinics? (We recently had an episode and it required 3 nasal sprays before the person revived.)
    • Do you have a policy that you would be willing to share.

    Thank you in advance for your assistance.



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    Ceresa Ward, MSN, RN
    Director of Nursing, Ambulatory Patient Care Services
    University of Missouri Health Care
    Columbia, MO 65212
    573-884-7957
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  • 2.  RE: Availability of Nalozone (Narcan) in Ambulatory Clinics

    Posted 02-22-2024 06:37
    • Do you keep Narcan in your clinics? We are in process of adding Narcan with an atomizer for nasal instillation to all of our clinics.
    • Do you have it available in all clinics?
    • If you do, are you keeping the nasal spray since it is now more broadly available or the injectable? The nasal spray is quicker and easier to administer than the injectable. To my understanding it also is absorbed and acts faster than IM delivery.
    • What quantity do you keep in the clinics? (We recently had an episode and it required 3 nasal sprays before the person revived.) Per the DNP who did her work in Substance Use Disorders, 3 doses is a minimum to have on hand. I'm advocating for 4 at this time with my system pharmacists.

    Also, the Red Box program is installing a vending machine for the community to have access to internasal Narcan in one of our clinics. Per regulations, these doses can only be used for the community and should not be accessed by the clinic staff in the event of an emergency.

    Regards,

    Leslie

    Leslie Hazle, MSN, RN, CPHQ (she/her)

    Director, Patient Safety & Clinical Risk

    McLaren Medical Group - Our Guiding Principle is to provide healthcare as we expect for our own family.

    G-3235 Beecher Rd.

    Flint, MI 48532

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  • 3.  RE: Availability of Nalozone (Narcan) in Ambulatory Clinics

    Posted 02-22-2024 07:28


    I work in a family practice and we are required to have Narcan nasal spray as part of our emergency drug supply. We have 3 kits which contain two each of the spray applicators. 

    We have never had to use them, but it's good to know that they are available in such an emergency. 

    Of course we keep track of the expiration dates and replace them when necessary, as we do with all the emergency medications.





  • 4.  RE: Availability of Nalozone (Narcan) in Ambulatory Clinics

    Posted 02-22-2024 08:41

    Hi Ceresa,

    We just added Narcan 4mg nasal spray to each of our clinic emergency boxes at the end of 4th quarter 2023.  At this time, we are just keeping one dose in each of the boxes, which we can use for both our pediatric and adult patients.  We have emergency boxes in each of our pediatric, internal medicine and specialty clinics, with the exception of our outpatient psychiatry clinics.  Our next step is to add Narcan 4mg nasal spray availability to our outpatient psychiatry clinics also, even though they don't have dedicated emergency equipment.  We don't have a policy specific to Narcan administration. 

    Thank you, 

    Jamie White MSN, RN

    Director, Primary Care Clinics

    Boys Town National Research Hospital 

    Boys Town, NE 68010



    ------------------------------
    Jamie White
    Director, Primary Care Clinics
    Boys Town National Research Hosp
    Omaha NE
    (531)355-6993
    ------------------------------



  • 5.  RE: Availability of Nalozone (Narcan) in Ambulatory Clinics

    Posted 02-22-2024 11:57
    • Do you keep Narcan in your clinics? Yes (we keep it in our med cart)
    • Do you have it available in all clinics? Yes
    • If you do, are you keeping the nasal spray since it is now more broadly available or the injectable? Nasal spray
    • What quantity do you keep in the clinics? (We recently had an episode and it required 3 nasal sprays before the person revived.)  We keep 2 single dose nasal 4mg devices
    • Do you have a policy that you would be willing to share. I shared our Nurse Initiated Protocol with you via email. Part of that protocol is to call 911. 
    I read that some clinics have a protocol that also allows medical assistants to administer the Narcan. I hope this helps. 
    Sharon

    Sharon Watts, MN, RN
    RN Supervisor, Ambulatory Virtual Teams
    Virginia Mason Franciscan HealthTM 
    Seattle, WA 


    Caution: This email is both proprietary and confidential, and not intended for transmission to (or receipt by) any unauthorized person(s). If you believe that you have received this email in error, do not read any attachments. Instead, kindly reply to the sender stating that you have received the message in error. Then destroy it and any attachments. Thank you.





  • 6.  RE: Availability of Nalozone (Narcan) in Ambulatory Clinics

    Posted 02-22-2024 21:18

    Hi. We are an FQHC in Oregon and keep at least 2 boxes (4 doses) in our emergency carts and more in our med storage area.  We have used it more and more often recently in our parking lots and in our waiting rooms.  We have an emergency protocol which allows anyone with BLS training to administer.  Last year we had our BLS trainers increase the amount of time in a class dedicated to how to use Narcan. 

    Last year we received access from the state to free Narcan that we can dispense to pts. To make it easier Oregon relaxed the med labeling requirements for Narcan.  



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    Rebekah Sherman
    Director of Nursing
    La Clinica de Valle
    Medford OR
    (541)221-3040
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  • 7.  RE: Availability of Nalozone (Narcan) in Ambulatory Clinics

    Posted 02-23-2024 10:57

    We require that all patients on Opioids have a Narcan nasal or inj as well



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    Robyn Nickels CRH RN
    Nurse Manager
    Veteran Administration
    Newtown CT
    (530)227-6735
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