Are inhalers dispensed from pharmacy at your facility or loaded in the ADC (we use Pyxis)? If dispensed from pharmacy, how do you deal with changes in dose? We currently only load albuterol inhalers in the ED Pyxis stations, but recently, we came across the issue of when a dose is changed, we do not dispense another inhaler nor routinely send a new label. This applies to ICS as well. Nurses scan the medication barcode directly, so the actual dose given is on the MAR.

-Melody Sun, CHOC Children's

Good morning,

Thank you in advance for your feedback.

Have you been able to implement amphadase for the use of subcutaneous hydration for pediatrics?

Most of the info appears to be targeted towards Hylenex use for this indication.

We are working towards getting all of our units to a BCMA goal of 95% for pt and med scanning and one idea that we wanted to try was getting the patient involved as well. I am curious if anyone else has done any work in this regards? Our first thought was to start with messaging in the pt rooms along the line of signs that say "did your nurse scan you meds today?"

Appreciate any comments on sites that did implement something similar.

Does anyone store alteplase in ADC in ICU for PE?

Hi all,

Wondering if anyone else has come across this issue and/or what your policies are:

Turns out our infusion nurses are often running IVIG concurrently with IV fluids for "patient comfort/minimizing side effects." This is definitely not done on our inpatient side (we would simply decrease the infusion rate). We mostly use Gammagard liquid and Privigen, and neither one has information on concurrent IV fluid administration or compatibility information.

Leapfrog has a proposal to expand their reporting requirement of BCMA to procedural areas. In giving this some serious thought, a number of challenges become apparent and I'd like some feedback from the MSOS community to better understand if these are specific or general challenges.

There's no question regarding the benefit of expansion of BCMA into the procedural areas - and it is largely implemented in our facilities. The true challenge comes with reporting BCMA activity, and that strikes at the heart of Leapfrog's query: should reporting be expanded to include these areas?

Would anyone be willing to share their Medical/Surgical standards for documenting patient weight in their organization?

There are best practice recommendations regarding documentation on admission (in metrics only), but most of what I can find for frequency after admission includes the organization setting their own standard for subsequent weights.

Interested in what other facilities require as we are seeing pushback from our Med/Surg nursing division about re-weighing patients.

Thanks!

Wondering if facilities are drawing up patient specific doses for retacrit or sending vials? Had an incident where 2 vials were send and only one vial administered giving the patient only have the needed dose.

Hello,

For hospitals where pharmacists order TPNs, how do you ensure an independent double check?

Our TPN pharmacists enter TPN orders, verify their own orders and then transcribe that info for CAPS. We have have seen incidents of transcription errors likely due to the lack of independent double check.

Would love to learn more about everyone's TPN workflow!

For hospitals with a beta blocker/calcium channel blocker toxicity order:

What concentration is your insulin drip?
What size is your bag?
What is your rationale for the size bag?