Hi everyone,

Wondering if anyone has successfully implemented IV incompatibility warnings/checks in Epic ? We have Medispan as our data vendor and recently learned about the IV CHEK module, we are not currently using it but looking into implementing it.

1. Have you implemented these warnings for pharmacy to check in solution compatibility? Likes and dislikes of these warnings? Alert fatigue concerns?
(We would mostly be interested in using this warning type for custom fluids and "iv builder" custom type orders.)

Easy question...
Do you require dual check verification for administration of short acting insulin (i.e. correction scale, fixed meal, insulin:carb ratio)?

Thanks!
Stacie Ethington MSN, RN
Nebraska Medicine

Our health system recently acquired a sports med/ortho clinic where they do lot of join injections. We are working on evaluating that process and improving. In current state most injections are drawn up by the MA, not labeled, and given to the provider for injection. No orders are entered but medications are scanned by MA into the proc doc note. We are an Epic facility.

Some questions I have for the joint injection process:

Good morning! We are re-evaluating the contents of our crash cart trays from a safety and efficiency standpoint and are wondering if anyone is willing to share examples of your tray maps/contents? For reference, we are a pediatric hospital and we currently stock separate "pediatric" and "adult" trays in our crash carts with slightly different contents but would like to move towards a unified standard tray. Thank you!

hello, we are in the process of standardizing the contrast doses placed by our imaging techs by protocol and would love to see what others have for comparison. thank you!

I'm looking for help with a Meds-to-Beds question:

If patient discharge gets postponed, what is done with meds-to-beds prescriptions that have already been delivered?

1) Left with patient (How do you prevent self-medicating?)
2) Stored on Nursing unit (How to you remember to give back to the patient before discharge?)
3) Sent to central pharmacy (What is the process for getting it to the patient?)

Thanks for your help with this!

We continue to have PCA pump programming errors due to lack of interoperability. We currently have only two concentrations of PCA and plainly label them in the library with concentration and "high" designation behind the high concentrations. The syringes themselves have several "high concentration" labels on them and only the standard concentrations are stored in ADCs. We also require an independent double check, but people still miss the concentration difference and pick the wrong syringe which causes a 10 fold overdose in some instances.

Greetings,

After a recent DNV visit, the auditor raised a concern (not a citation) about the use of manuka honey in our wound care clinics. At this point, we seeking clarification from DNV on their specific concerns (safety, efficacy, purity, potency). When discussed at P&T, the question of whether or not manuka honey should even be brought to committee was posed, resulting in a robust discussion of this gray area.

Issue: Patients admitted for inpatient IV chemotherapy, orders released from Beacon treatment plans; patients also require oral non-formulary chemotherapy (which is not built into Beacon treatment plans).

Concern: Oral chemotherapy could be missed; verbal orders without a double sign or verification placed by pharmacist). Pharmacists take verbal orders for oral chemotherapy because 1) oncologists reportedly do not know how to order non-formulary medications or 2) hospitalists do not know the regimen and struggle to order more complex non-formulary medications.

Our region is just starting to monitor time critical medication administration compliance. I have found that it appears no one else in our organization is monitoring this metric currently. Does anyone have a recommendation for compliance goal or what you may do at your site / health system for monitoring? I have started to look at compliance % by region and then individual sites and have clinical outcomes leaders looking into opportunities but was curious about a goal % compliant...

Thank you!