Hello,
We are considering the addition of shrink wrap to all NMBA vials. There are many other threads on MSOS regarding this topic, however, none of them address 2 questions that have come up during our process for consideration:
1) Has anyone looked into the concerns around applying heat to medications that require refrigeration. Reportedly we have heard from some manufacturers in the past that they can not guarantee integrity of the product if heat is applied.

Hi, all -
Looking to get some insight on how other sites have configured their CPOE systems for Suboxone.

-Do providers select a specific strength and order in terms of numbers of "film"?
-Do providers order in terms of "mg" or "mg of buprenorphine"?
-Have any Epic users started using the new functionality allowing IMS for combination drugs?

Appreciate your thoughts!
Kelsey Keeley

We have providers asking for pharmacist order entry during multidisciplinary rounds, noting it is safer than them doing delayed order entry after rounds. The rounding providers wish to focus on the patient not on their computer for order entry during rounds.

Does anyone permit pharmacist entry of verbal orders on rounds? If yes,

Curious if anyone has CARPEDIEM machine in their NICU. If so, how do you BCMA HBio fluids, there is no NDC code or barcode on the bag. Just really frustrating that these bags have no standard identifiers.
But if anyone has experience for workarounds, please chime in.

We are having a discussion on what to use to flush enteral feeding.
1. The question on the table is for neonates at what age can we start using purified water to flush enteral tubes?
2. Is the age actual or gestational age?
3. What is the reason that neonates need sterile water for flush and cannot use purified water?
4. Are we worried about hyponatremia when using sterile water in neonates/peds?
4. If you have any policies or studies that you can share with me for flushing enteral feeding in neonates and pediatrics, please.

Thank You.

Hi all-

Does anyone have a pharmacy peer review process in their organization, and would be willing to share policies, process, etc? Thank you in advance!

Best,
Liz

Greetings to all,

I want to inquire about dashboard utilization. I have a few questions for colleagues who are currently utilizing the dashboard in their current role as medication safety RPh or as an Officer.

- What are the pros/cons of having a dashboard?
- Do you have any recommendations as to What dashboard software is better in your
opinion if any?
- What is the dashboard content like? e.g., reports, stats, etc...
- For those with the Epic EHR system, how is your dashboard integrated with Epic?

Thank you, ladies and gentlemen.

Our institution is in the process of revamping our alcohol withdrawal order set to allow more liberal use of phenobarbital. With the change patients may receive a single loading dose of up to 15 mg/kg. We have received a question of whether patients receiving these higher doses need to be monitored on telemetry (due to bradycardia risk), but we have not historically required such monitoring for phenobarbital.

Do any institutions require telemetry monitoring during loading doses of IV phenobarbital? If so, how long does this monitoring occur?

Hi all,

I am certain most of us have an independent double check policy for administration, but curious if you specifically spell out anything related to nurse prepared compounding?

We try to provide medication drips pharmacy prepared but some drips may be prepared at bedisde.

Is it included in your double check admin document?
If you require a double check on nurse preparation, do you just require that for all of your high alert meds or does it extend to any compounding (including attaching vial and bag with adapter,ADD Vantage, etc).

Hello,
My organization is evaluating EHR vendors: Meditech Expanse, Cerner, and Epic Community Connect. Happy to hear about your experiences with any of those.

Especially interested if anyone utilize or has experience with Epic Community Connect. How does your partnership work? Are you on the same GPO group? How much flexibility does your site have? Any other pros/cons/things worth knowing?

Thank you,
Renu Bajwa, Pharm.D.
Community Memorial Health System