We are implementing EndoTool for the first time on a select nursing unit at our hospital. For those who use EndoTool (or similar third party applications), did you create a formal protocol or policy that was reviewed and approved by your P&T Committee/Medical Executive Committee? In reviewing their training material, it appears that several criteria are set by the "Medical Director" and not by the ordering provider.

Bonus points for anyone willing to share their protocol and/or policy with me (email: eaucoin@uabmc.edu).

Morphine and hydromorphone are sometimes ordered as needed for "breakthrough pain". We realized that we don't have a set definition for "breakthrough pain", and its interpretation can vary, which is not in compliance with TJC MM 04.01.01, "Medication orders are clear and accurate".

Hello - we have been working on our Sample Medication policy and associated documentation. Through this we discovered one item that we thought was a medication, is considered a device by the FDA.

1. Do you have a separate policy for sample devices? Or is it included in your sample medication policy?
2. Are sample devices allowed at your institution?
3. What group approves the use of sample devices, if any?

If you have a policy I would be interested to see it.

Thanks!

We got a notice yesterday that fluorescein strips manufactured by Vistamerica were recalled. This comes a week after there was a notice about BioGlo strips. Both seem to be made through “Wizcure Pharmaa” since they both state the manufacturer is, “voluntarily recalling Fluorescein item/lot due to the Wizsure Pharmaa recall due to the product manufactured was not in conformance with current good manufacturing practices.” We pulled back all of our stock but there are no alternatives that I know of. Is anyone else affected and do you have a plan you could share?

Hello!

Curious if those organizations that are live with smart pump interoperability have any sort of interoperability or smart pump stand-alone policy that they would be willing to share...?

...Or if you pursued a different route and have embedded across policies... if there are foundational policy statements that you included regarding practice? (e.g., nursing, when required vs. exceptions, flushing, when manual programming, scanning, infusion verify frequency, transfer, pumps that aren't interoperable, etc.)

Thanks in advance!
Emily

We had three ampicillin reactions reported within two weeks.

NDCs:
0781-9273-80 (Sandoz ampicillin 2-g)
0781-9261-85 (Sandoz ampicillin 1-g)

Is anyone else seeing an uptick of ampicillin injection allergic reactions?

Hi all,

In the past few weeks we've had a dramatic increase in reports from our interventional cardiology, EP cardiology, and CT surgery teams about our Fresenius Kabi heparin 1000 unit/mL 10 mL vials not providing an appropriate response in ACT.

We did just send off two different lots for potency testing to help alleviate concerns about this, but I was wondering if others have also recently experienced this?

The lot in question for us is: 6036976.

Thanks!

Hello everyone,

Our hospital gets mix ups between adult and peds ERXs every now and then. This can lead to medication errors b/c these ERXs are built differently with different dose/duration limits and safety features.

Curious to know how other hospitals differentiate adult vs peds ERXs in their EHRs?

Any other methods in place to help prevent inadvertent selection of adult ERXs when providers should search for/choose the peds ERX?

Our institution uses Epic.

Thank you!

Hello everyone,

We recently had an issue where a provider used our usual bronch order set to order prn fentanyl and midazolam:

- Fentanyl 25mcg iv Q3min PRN for moderate sedation (only as directed by physician)
- Midazolam 1mg iv q2min PRN for moderate sedation only as directed by physician)

This procedure was done on an ICU unit. Since this wasn't actually done in a designated periop area, it was a nurse who was administering the medications (not a provider), but these were documented in OpTime and not on the MAR under their respective orders.

Good morning,

Do you have restrictions on WHO can pushed meds during ACLS (during a code)?
Do you require only an ACLS/PALS trained nurse can push, or can any nurse push at the directive of the ACLS team leader?

Thanks,
Stacie Ethington MSN, RN
Nebraska Medicine