Has anyone completed ISMP TBP #9 and created/identified a list of antidotes, reversal agents, and rescue agents that can be administered immediately in emergency situations? We have the typical naloxone and flumazenil on override, diphenhydramine/hydrocortisone and famotidine for anaphylaxis and our adult ICU's have neostimine and sugammadex.

Curious if other institutions have created a list to see if we need to make any updates in order to complete this best practice and would appreciate any shared documents/protocols/policies!

Hi,

We are discussing our current setting of requiring BCMA for IV rate changes for some of our high alert medications. We have independent double checks (IDC) for these same high alert medication rate changes (opioids, insuling drip, etc) and intend to keep those. Having a med scan with these IDC during rate changes seems like low value. Do other organizations require BCMA for some high alert medication rate changes? If so what value are you seeing?

Thanks,

Paul
St. Luke’s Health System, Idaho

Does anyone have any information/experience with the administration of a second dose of KCentra? We're being asked to come up with literature to use in risk assessment and there's just not much out there. Thank you!

Good morning all!  We have recently switched from in-house compounded sildenafil suspension to a commercial preparation for batched oral syringe doses.  We have found significant foaming with the commercial product, leading to lower than expected volumes in the final syringe once the product has settled.  In discussions with the manufacturer, we have been told via one source to ensure vigorous shaking and by another to avoid vigorous shaking.   We have trialed preps at room temp and refrigerated, immediately after reconstitution and hours after, vigorous and non vigorous shaking, and still

Hi All,

For anyone using Epic Dispense prep with camera technology (I use Hovercam) I am wondering if you experience issues with failure to load photos during dispense check or other issues with majorly slowing down Epic?

If you have come across any solutions to this or ways to increase the speed I would love to hear more.

Thanks!
Merissa

Good afternoon everyone,

I had a few questions for those of you who have patients on CBD (OTC cannabidiol products like Charlotte’s web) at your hospital.

1. Do you allow OTC CBD products to be used inpatient (as patient’s own med)?
2. If so, what is your process/workflow for these products?
3. Do you have a policy? If so, can you share?

Thank you so much!

We occasionally receive requests to make additions to our override lists. These requests usually come through email, but we are seeking to establish a more formalized process. Does anyone have a request form that they currently use and are willing to share?

Thanks in advance!

I am looking into safe practices surrounding the use of methylergonovine for the treatment of PPH. In my experience this can commonly be found in PPH "kits" or "carts" that can be in or out of automated dispensing cabinets. I am looking for feedback on a few different questions:

Hello everyone!

Question about your lantus VIAL procedures (not pens). For some background, our facility makes ALL lantus doses in the IV room, it is not floor stock (Lispro however IS floor stock, but not in pyxis). Timing the lantus dose correctly with a discontinued insulin drip has occasionally been an issue. And although many ICU RNs know to wait for the lantus to DC the drip, there are delays in getting the lantus to the floor and also if the drip gets DC'd while RN is still waiting, there's no entry in the MAR for the RN to document the drip while waiting.

We performed an upgrade to our EHR last week, and it removed our ability to customize individual alerts. It is apparently the result of FDB moving to a cloud based format. Our EHR vendor says we are the only customer that has customized alerts. I just have a hard time believing that.