Is anyone compounding 10unit/ml insulin bags to give high dose insulin for CCB or BB overdose (alongside dextrose/K infusions)? I'm worried about the 10 fold difference and also how to provide this after-hours at a small community hospital.

How does your facility document RN boluses doses off a continuous infusion or PCA pump? We use Cerner and currently have the PRN or additional RN boluses ordered separately, which is often a different concentration. As a result, our nurses are unable to confirm and chart the correct volume delivered, and this also leads to inaccurate I/Os documented. Thanks in advance!

-Melody Sun, CHOC Children's

Hello colleagues,

My system is acquiring Pyxis machines for our diagnostic imaging departments, and we are discussing whether or not these ADMs should be profiled.  We are being told that most sites to not profile their radiology machines.  Based on 1) what we plan to stock and 2) low BCMA rates for the department, I am inclined to advocate for profiling.  Contrast agents currently autoverify unless there is an allergy.

Interested in anyone's experience.  If you are profiled, what challenges have you faced?

We are in the process of standardizing infusion pumps across our IDN and taking the opportunity to standardize drug libraries. We will be utilizing Baxter Spectrum IQ.

Anyone willing to share their drug libraries and/or successes/lessons learned from a similar experience, I would greatly appreciate it.

Thank you.

Good morning,

We are undergoing an evaluation of our current Emergency Drug (Code) Boxes stored in patient care areas.   The primary goal is to provide end users with a more standardized box/tray/bag that is better organized with human factors engineering in mind.    

(Note:  We have standard contents; just looking to purchase new containers and improve organization within the container)

Hi Everyone,

ISMP recommends to "Embed safety strategies for potassium chloride for injection concentrate and other concentrated electrolytes such as magnesium sulfate injection..."

For our system, we've attempted to safely limit storage to emergency carts or pharmacy. However, there is a recent request to consider allowing the 50% vial to be included in a Pre-Eclampsia/Eclampsia kit in OB.

Questions:
1. Where does your system allow storage of concentrated magnesium?

Hello!

Wondering if your institutions currently stock and administer oral antidiabetic agents in the inpatient setting If so, do you have a policy or processes in place to support the safe utilization and also agents on formulary that you would be willing to share?

Related - can anyone share the alerts or safeguards that you currently have built out / in place for metformin with inpatient use? (we have Epic)

Our organization previously had not stocked or utilized oral antidiabetics - but is integrating with another health system and now looking to stock.

Good morning,

Quick question (or maybe not so quick) about where to place an IV label on IV bags, when compounding. There is several scenarios and the three I am asking about:

1) large volume IV with additive ( i.e. compound 1000 mL LR with 40 mEq KCl
2) previously batched and labeled product (i.e. Vanco 1.75 grams in 500mL NS with a compounding label on one side)
3) small volume parenteral (any compounded IV in 50 mL or 100 mL)?

Hi All,

We have furosemide on our OB/L&D override list in our Pyxis for flash pulmonary edema.
We received a request to expand furosemide override access outside of this area.

1. Do you have furosemide on your override list?
2. What is the clinical indication?

Thanks!
Liz

Good morning,

Our organization is looking at monitoring anticoagulation quality and safety measures to assess current practice and to identify CQI opportunities. What metrics does your facility currently measure (i.e.-INR, anti-XA).

Thank you!

Natalie Zilban
Medication Safety and Pharmacy Officer
Memorial Healthcare System