Hi Everyone, Happy Friday!
For over 20 years we have allowed lidocaine 1% and lidocaine 2% (with and without epi) to be stocked in our ADC's and removed without orders. Nobody knows the history of why/how this started but we would like to start requiring orders for these medications.

This will be a BIG change for our institution and there are so many different types of lidocaine that I am not sure where to start.

Dear Colleagues,

I am writing to inquire about your current processes for administering Nitrous Oxide in L&D. I would appreciate insight into the following:

- Do nurses document the usage of Nitrous Oxide on the MAR? (Is it self-administration? Do nurses document the usage?) Any issues with BCMA scanning, or is it on the exclusion list?
- If this is not documented on the MAR, what processes have you implemented to minimize potential drug interactions or the concurrent administration of opioids?

Hello everyone,

My hospital system is looking to implement Vial2Bag adapter assembly on nursing units. We are curious to gather insight from other hospital systems that currently have this in place.

Some key points that we are interested in knowing:
-What the transition and implementation process looked like at your institution
-Safeguards that were put into place to ensure appropriate distribution, administration, and storage
-Any challenges encountered and strategies used to mitigate risk or improve safety

Hi everyone,
Our hospitals recently switched to BBraun large volume pumps from an ancient Baxter fleet. As those who use them know, to program a rate you click left for each place value and then up or down to reach the desired value. So for 20, you would click left twice and up twice to get 2-0.

Hi, I need tips for navigating the ECRI website for ISMP content efficiently.

I know there is an ISMP website here: https://home.ecri.org/pages/ismp. When I log in on that website, it takes me to a seemingly less sophisticated ECRI website that is not broken down into sections like newsletters, guidelines, etc.

Any tips?

Hello All,

My facility is currently evaluating options for IV WFMS and we are mostly set on Assure-Trak through Wolters Kluwer. At the stage that we are now, we are comparing volumetric vs gravimetric analysis. I had a few questions for anyone using gravimetric analysis, but especially those using Assure-Trak.

1. Do you have the ability to apply gravimetric analysis to certain IV products but leave others as volumetric, or is it all or nothing?

2. What barriers did you encounter when implementing gravimetric analysis?

Hello,
we had an error where the RN administered 6 bags of 20 meq KCL in succession because they thought it was a 10 meq bags.

i am curious if any hospital has had any operational or IT rule processes to prevent confusion on 20 meq and 10 meq bags or detect unusual number of 20 meq KCL bags administered so closely.

Hi there! I am looking to get info from another HRO that was successful in removal of injectable Phenergan from formulary. Our Anesthesia providers informed us they are participating in MIPS metric, targeting reduction in PONV and are now thinking they will need a 3 injectable agents for N/V and are wanting inj Phenergan back!!!! How did you guys navigate thru this? Any changes to gas administrations or such, or anything else you guys to assist them in wanting to achieve there metrics but also not allow inj Phenergan back?

Hello!
My site is updating our hyperkalemia order set to help reduce hypoglycemia rates with IV insulin (regular). Our current order set doesn't have accuchecks built in, but it is recommended to monitor glucose every hour up to 6 hours. However, this is a sticking point with our ED nurses.

Does anyone monitor glucose Q1H for 4-6 hours, especially in the ED? How has it impacted workflow and throughput for admissions?

Thank you!
-Annie

My Health System is a Cerner/Oracle site and we've been made aware that a few of our Multum-provided synonyms for medications (particularly Brand name Zofran and Ancef) are being obsoleted. The IT team and I are wondering if there are recommendations/best practices on whether to follow the Cerner recommendation to remove these from the ordering system. Not doing so can cause a multitude of downstream effects, particularly with e-prescribing and when performing discharge medication reconciliation.