Can anyone comment on anesthesiologists infusing oxytocin wtihout an infusion pump in the OR setting after the baby is delivered? We're finding that in our 8 hospital system, this seems to be standard practice by them. I'm curious what others and ISMP have to say about this.

Thanks in advance,

Hello all. we have recently had several reports from our Cath lab of patient's requiring high doses of heparin to attain therapeutic ACTs. We have perhaps found a correlation between this and a new heparin product we are stocking > Meitheal Heparin 10,000 units/10 ml vial. We have seen doses reported as high as 24,000 units to attain an ACT > 300. Has anyone else encountered a similar issue recently?

Hi,
The notice about mislabeled isoflurane sent by ISMP made us realize that the way our gas machines are filled results in potential mixed lots and expiration dates without anything indicating it on the machine (arghh!)

Has anyone worked through this problem and come up with good solutions with your anesthesia folks? Also interested in how people handle partial bottles, storage etc.
We currently have them (isoflurane and sevoflurane) in our OR ADC but I'm thinking that may not be optimal in the event of a spill or breakage.

How are orders built to provide a time for preop antibiotics? We use Epic and have a frequency of ON CALL or PREOP. The order still populates the MAR with a start time so we are seeing an increase in antibiotics being given early. I would love to hear how others have addressed this.

Hi everyone,
We are trying to be more proactive in catching overrides that don't have orders/aren't documented/aren't wasted, especially with agency staff who might not come back for days.
Years ago I worked with AcuDose and it was very easy to run an override report on demand, or schedule it to be printed on the unit. The charge RN would run the report at shift change and anyone who had an override had to sign off that it was complete before they left for the day. We are struggling to find a similar workflow for Pyxis.

In efforts to help bring attention to scheduled CHG (chlorhexidine gluconate) wipe baths, our CLABSI taskforce is requesting it would be helpful if these orders populated the MAR.

Do any other hospitals populate CHG to the MAR? If you have experience with CHG on the MAR any input would be appreciated (barcoding, bypass pharmacy verification, etc.)

Thanks,
Jenn

Please share if you have a policy clarifying medications administered via a feeding tube (specifically jejunostomy tube).

Hi,

Our health system uses EPIC, and we have a nurse-driven vaccine protocol for inpatients who qualify for a pneumococcal vaccine or flu vaccine. Our current process is that the order generates an entry on the medication administration record in the PRN field. The entry says to give the vaccines "prior to discharge". We've found that most patients don't end up getting vaccinated.

Do any of you have a successful strategy that you can share? We'd love to learn from you.

Thank you,

Dan

We are revisiting the issue of insulin pens vs. vials and would be interested in knowing what safety measures other institutions have put in place to ensure the safe use of vials?

Our organization has been reviewing the utilization of Sugammadex and would like to explore what other institutions are limiting their use of sugammadex (protocols, usage criteria, etc.)?