Looking for any advice/tips for handling of compounded levodopa/carbidopa oral suspension (already have the recipe) in terms of orderability for the ambulatory setting. It appears that our system is set up to handle levodopa/carbidopa in terms of "tablets" so dose checking and ordering for fractions of the tablet size become problematic.

Hello,

I was curious is others would be willing to share their process for physician ordering of parenteral chemotherapy and pharmacist order entry/verification, particularly if your EMR is Cerner.

Our process is currently to have orders entered electronically by the provider as a communication order (free text) and the pharmacists transcribes each order, a second pharmacist completes an independent double check prior to compounding. We are currently assessing this practice.

Thank you for your help!

Hello,

I wanted to reach out to see what your IM max volumes are at your institution. We have adjusted to 5mL for deep IM. However, we have seen where some institutions allow for 10 mL and even up to 30 mL (e.g. Fosphenytoin IM).

We are working to standardize administration and develop a tip sheet regarding IM Magnesium Sulfate. We are trying to decide if it should be 5 or 10 mL as that would determine the number of injections received by the patient (4 vs 2 respectively). Also considering adding Lidocaine to reduce pain as well.

Would love to hear back.

Hello,

Wanted to see if anyone was willing to share the following information. If you would prefer not to share publicly, please just shoot me a message. We are in the market and trying to receive lessons learned from others.

What automated compounding device (ACD) does your institution use to compound parenteral nutrition? Also, do you have any safety concerns to report with you current compounder? If so, what are they?

Thanks
Jameika Stuckey,PharmD
University of Mississippi Medical Center

Good afternoon -

Reaching out to the group regarding approaches to EMR guidance on use of peripheral vasopressors. We have some CDS alerts in place currently but have a lot of room for improvement and am investigating alternative strategies.

Appreciate any info offered.

Thanks,

Amaris

Looking for ideas of the metrics that others are using for their Medication Safety Pharmacist/Officer position for their pharmacy scorecard. I am interested in those gpals/metrics that are measurable. Appreciate any feedback!

Heather

Good afternoon -

Reaching out to the group regarding approaches to EMR guidance on use of peripheral vasopressors. We have some CDS alerts in place currently but have a lot of room for improvement and am investigating alternative strategies.

Appreciate any info offered.

Thanks,

Amaris

ISMP suggested I reach out to this message board
Has any one done any work or had experiences with regard to best practice for warfarin directions for ambulatory prescriptions and therefore the Medicine bottle label? I would appreciate a discussion.
We are in conflict on how to reduce the risk for error and I have been looking for a standard to help us to come to a consensus.
Example: I prefer, and historically the practice has been to quote a range of tablets in the prescription directions with added instructions, example as follows:

Any organizations have any form of decision support within their EHR systems to assist nursing with IV drug compatibility? For example, embedded hyperlinks to Trissels in MAR, active alerting when two incompatible medications are "linked" to infuse through the same lumen, etc...

There's some interest from our nursing team in exploring but struggling to determine what might actually be feasible.

Appreciate your insight!

We have seen events with cyclic TPN where the rate or VTBI of a TPN titration is manually misprogrammed. We use Epic-Alaris pump integration and have TPN built as a fluid on the Alaris pump. Has anyone figured out a way to use pump integration to send the titrations rates and VTBI to the pumps so that nurses do not have to manipulate the programming? Have any organizations created reminders within the MAR to alert staff when the next titration is due? Appreciate any suggestions!