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.)?

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?