Hi - my org uses Pyxis ES and in compliance with ISMP Targeted Best Practices, has an alert that fires when a user attempts to remove any paralytic.

I am curious how other orgs have similar alerts configured because we cannot figure out a way that does not have an option that allows user to bypass confirming patient is intubated/sedated or backing out of system.

My automation team tells me options are:

1. Alert with desired text, then user options of "Yes", "No", and "N/A" - and they say "N/A" option cannot be removed

Hello / Happy Friday!

1) Just wondering if any other organizations have rolled out BCMA - bar code scanning in their Ambulatory Clinics? Would be interested in connecting / networking to learn!

1a) Do you wristband all patients?

2) Also, anyone else have any experience with AccuVax in their Ambulatory offices for Vaccine management?

Given the new ISMP 2022-2023 best practice recommendation to standardize oxytocin concentration for both labor & delivery and post-partum, have any institutions successfully done this or already use one concentration for both indications?

We currently use 30units/500mL for L&D dosed in milliunits/min. Post-partum, once the anterior shoulder is delivered, we switch to oxytocin 20units/1000mL bag which is dosed in mL/h.

If you use one concentration, do you use the same dosing units (milliunits/min)?

We are looking for examples of a patient friendly medication reconciliation report that could be used after admission to communicate clearly with our patients (actually parents, we are peds) each medication we have on their Prior to Admission med list and what was done with each medication on that list.

Does your process for preparation and dispensing of vinca alkaloids differ from other chemotherapies? If so, how does it differ? Any input is greatly appreciated.

What expiration time does staff put on medication syringes that may be drawn up in a procedural area? This does not include compounded syringes--this is for single drug in syringe drawn up in prep for a procedure. Our policy states expiration date and time must be on the label if medication is not immediately administered. Thanks, Mary

What expiration time does staff put on medication syringes that may be drawn up in a procedural area? This does not include compounded syringes--this is for single drug in syringe drawn up in prep for a procedure. Our policy states expiration date and time must be on the label if medication is not immediately administered. Thanks, Mary

Hi all,

I am wondering, for those who use both a heparin by anti Xa nomogram and a heparin by aPTT who manages which protocol? Here we currently have nursing driven anti-Xa protocol and pharmacist driven aPTT protocol. Mix-ups occur and looking to improve our process. Thanks!

Hello everyone!

Does anyone have processes in place to mitigate transcription errors? We are an Epic based system and often times ERXs are being updated or we are constantly having to swap orders due to shortages. Therefore transcribing or swapping orders is not uncommon. Does anyone have a standardized double check process in place for when high risk medications are being transcribed? We've had instances where administration instructions were forgotten on titratable drips or dosage units were mixed up (weight based vs non weight based), etc.

Based off of our last few AHRQ Culture of Safety surveys and the intense view of medication errors during transitions of care, we have been focused over the last several years on finding a handoff tool that could be used within Pharmacy. Many safety organizations have focused on communications between clinicians at transitions (including shift change).

While the I-PASS has shown so much promise and extremely great results for providers and nurses, this does not seem to translate well to Pharmacy.

How do you hardwire handoffs in your area? Specifically: