During the midyear, there was a presentation on alarms in infusion pumps. Someone asked what is considered a safe amount of air. 7 Years ago, I took a pump through FDA clearance, and this very question was posed. I didn't have time to write and send the letter to the editor fast enough...Anyway, if interested, below is the possible rationale based on clinical evidence, which might explain why the regulatory bodies continue to have a conservative approach.

Hello,

We recently implemented BD Alaris pumps with Anesthesia Mode disabled. As we explore the possibility of enabling Anesthesia Mode, we would appreciate learning from the experience of other organizations. Specifically, we are interested in understanding 1) Whether any medication errors or safety concerns have occurred related to use of Anesthesia Mode 2) What safeguards, workflows, or best practices sites have implemented to help mitigate risk, particularly given the absence of hard limits when programming in this mode.

I would like to submit a presentation for the MSOS briefing. Can someone help me with that?

Hello,

I wanted to reach out regarding an infection prevention concern that came up during a recent mock survey at one of our hospitals. We were cited in the ED for not adhering to CDC guidelines, which state that if a multi-dose vial enters an immediate patient treatment area, it should be dedicated for single-patient use only.

Interested to see how folks at other institutions approach medication documentation if there's a need to back chart >48hours after.

We use EPIC and current state system build is after 48 hours the eMAR cannot be edited or back charted on, regardless if the patient is discharged or not. If additional eMAR documentation is required after this period, Nursing staff must present to the Health Information Department/Medical Records Department and place a progress note.

Hi,
Looking for guidance for everyday practices and for policy wording on how you are handling light sensitive medication vials that are ADD-eased. Are you putting them in Amber bags or bins? Do you state that the BUD of 30 days allowed for small volume ADD-ease is not long enough for stability to be impacted by exposure to light?

Please advise

We have found that a large percentage of epidurals in L&D are "overridden" prior to pharmacy verification. We use a standard formula (but use different rates/PCEA parameters so cant use a standing order), so I don't have huge safety concerns other than the missing allergy check since anesthesia programs the pump but would like to reduce these overrides if possible. Anesthesia says they don't have time to see the patient/put in orders/wait for pharmacy verification prior to placement.

At anyone's health system, do you have an ambulatory pharmacist or any pharmacy presence in your orthopedic/sports medicine clinic? If so, I would love to learn more about their role.

Thanks!!

We recently received some feedback from a provider on our pediatric weight-based medication code sheets and how we have multiple epinephrine formulations and dosing listed in sequence which may be unsafe and lead to errors. I attached a snapshot.

We have been brainstorming ways of making this safer including categorizing medications by indication or moving the epinephrine drip and epinephrine ET dosing to the bottom but have gotten mixed feedback on this from nursing and pharmacists.