We use EPIC and are looking to create an order set for alteplase and heparin used during EKOS procedures to treat pulmonary embolism. If anyone has an order set already built (Epic or non) please share. Thank you for your time!

Shari Waldron
Providence St. Mary Medical Center
401 W. Poplar Street
Walla Walla, WA 99362
(509)897- 2055

Hi there,

Per Package Insert (25% vial)-

"Crystals may form in Mannitol Injection, especially if the solution is exposed to low temperatures. If crystallization occurs, warm the vial in water at 80°C and periodically shake vigorously to dissolve the crystals."

While the above recommends water for rewarming, other resources such as ASHP Injectable Drug Information book suggests, "The use of a water bath is not recommended."

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Dear safety partners

I am trying to establish a quality assurance program in pharmacy with a focus on operations and production, addressing different stages of the medication use process. Appreciate sharing any resources or examples you may have Raya_z@hotmail.com

We currently use the BD Alaris PCA pump module for epidural administration. Our purchasing team is telling us there is not a yellow striped epidural tubing set available for use. They went on backorder awhile back and now we're being told there isn't an option to use with this pump module that has the stripe at all. Anyone else use this pump for epidural administration? What tubing are you using? Thank you!

With the ongoing shortage of epinephrine "bristojets" and recall of 503b 1 mg/10 ml syringes, we are discussing potential failures of stocking epinephrine kits (containing epinephrine 1 mg/ml vial/ampule, sodium chloride for dilution to 10 ml, syringe with luer lock, filter needle, alcohol wipe, and preprinted syringe label for diluted product) in code carts for cardiac arrest events. What failures have other institutions considered/seen in practice? This epinephrine preparation is NOT intented for anaphylaxis as we have EpiPens widely available on all patient care units.

In regards to controlled substance drips and PCAs, I was wondering how your facilities view/calculate the amount used within the shift or within 24 hours. We have Cerner for an EHR. Nursing and pharmacy are doing a lot of manual calculation to figure out the total 24 hour mg used. Our main purpose is to be able to easily see all the controlled substance use and waste to ensure that we can make accurate clinical adjustments in dose. Our biggest concern is with intubated or hospice patients that are the most likely to use pain and/or sedation drips.

The New York State Department of Health recommends Expedited Partner Therapy (EPT) to facilitate partner management among individuals diagnosed with chlamydia, gonorrhea, and/or trichomoniasis -- it's the clinical practice of providing individuals
with medication or a prescription to deliver to their sexual partner(s) as presumptive treatment for a STI, without completing a clinical assessment of those partners.

Do any of your facilities have established workflows for EPT that you would be willing to share?

Thanks in advance!

Dear Members,

At my institution, our pharmacy has been asked (by Regulatory & Quality Department) to take over the lead of the Pain/Opioid Committee. I would like to ask how your organizations structure this committee/taskforce. For example: who is the chair/co-chair? Which departments participate in this committee. Meeting objectives and agendas...etc. Thank you in advance for your time.

Manisa

For those of you that utilize BCMA and Pump Interop in your Emergency Departments, what goals have you set for compliance %? We recognize the ED is a unique environment and want to help them set realistic goals.

Thanks!
Stacie Ethington MSN, RN
Medication Safety Nurse Specialist
Nebraska Medicine