Does anyone have a policy about off-label use of medications they are willing to share?

The pediatric Sickle Cell populations is moving across town to my hospital. Is anyone have protocols you would be willing to share?

Recently with the increase census on our Mother Baby (postpartum) unit they have been asked to take D/C moms with HTN with Mg gtts. They are unable to do so, the ICU or CVICU is the only other place they can be admitted. Does any one admit to step-down or M/S tele floors? Thank you.

Hello,

I am wondering if any other Epic users have come up with a good way to alert pharmacists and providers about an active PET Scan order when a dextrose containing med is ordered? We currently have a pharmacy consult at the time of ordering but the time between ordering the scan and it being completed there is room for a dextrose to slip through.

Thanks!

Hi all,
We currently have a requirement for telementry monitoring during phenobarbital loading when being used to treat alcohol withdrawal (10-15 mg/kg infused over 30 minutes).

We have had a recent request to remove this requirement.

Does anyone out there allow phenobarbital loading without tele? Would like to hear about your experience.

Thank you!

We are getting requests from our emergency department to use nebulized tranexamic acid for patient's with hempotysis. I was wondering if anyone has experience using nebulized tranexamic acid or if anyone has a protocol or policy for using nebulized tranexamic acid that we could review.

Specifically for neonates, what resource/references do you use to ensure medication compatibility with the additives in TPN. Please share any internal or external references, thank you very much in advance.

For ambulatory locations that have medications but not within an ADC, how do you decide/limit what medications should be stocked in those clinics?
These locations are high risk for errors from medications because of lack of barcode scanning and no ADC to prevent wrong dispense, expired medications, etc.
-Do you have a decision tree to guide what medications are allowed for clinic locations?
-Do you have a committee that decides or is it a single person?

Our system Medication Safety Council has been working on BCMA compliance, and an interesting question has bubbled up involving practices around patient verification when patients decline to wear wristbands. A few of our neurobehavioral health units have come up with some rather "creative" workarounds to scan a patient barcode during medication administration. We don't want to encourage patient scanning just to comply with a metric goal, but rather to increase patient safety by confirming that the correct patient is receiving the medication.

Hi all,

Have a question, especially for institutions that have both peds and adult patients. How do you guys manage partial doses for oral tabs (when no oral solutions) for peds? For example a medication has no oral solution but tabs are available. Currently, since most meds are on ADC, we provide nursing instructions in medication admin instructions to dissolve the tablet to create a solution of a certain concentration and draw up the the specific dose.

Example: "Dissolve 32mg tablet in 5ml, give 3.3ml = 21 mg dose"