Hi, what kind of policies and procedures does your institution have for medication orders for patients who are still housed in the ED but awaiting transfer with the disposition orders already in? Who is responsible for assuming care of the patient for medication orders/labs, etc if there is a delay in transfer? This could be situations where there is a transport delay to an outpatient facility. Or the more pressing issue is if there is a freestanding ER and transfer is pending to the main ED but there is delay in the transport or bed availability but disposition orders are already in.

The Joint Commission and ISMP mention REMEDI as a resource for improving safety/quality with the use of smart pumps. I've tried to contact REMEDI through their contact link on the website several times in the last few months but have not received any responses (https://catalyzecare.org/remedi). If you use their infusion pump analytics or succeeded in obtaining information from them, could you please answer the questions below?

The Joint Commission and ISMP mention REMEDI as a resource for improving safety/quality with the use of smart pumps. I've tried to contact REMEDI through their contact link on the website several times in the last few months but have not received any responses (https://catalyzecare.org/remedi). If you use their infusion pump analytics or succeeded in obtaining information from them, could you please answer the questions below?

We are reviewing our Standard electrolyte replacement protocol for adults, pediatrics and neonates. Kindly share your protocol including maximum safe range. Also protocol for volume restricted patients.

Hello everyone,

Our system is re-evaluating our processes around alteplase administration for stroke, and we are curious how other sites are administering the infusion? By hanging the bottle itself or transferring it a viaflex/piggyback for administration?

I would appreciate knowing what your site does, and if you have any specific reasons behind either method.

Thank you!

I was wondering if anyone has done an FMEA on HIGH ALERT MEDICATION? I was wondering if anyone has identified areas of risk and/or corrective actions. Anything you could share would be much appreciated.

Thank you!

Good morning,

A quick question for you all to start your weekend. Have any of your organizations seen an uptick in severe infusion reactions when administering Crofab over the last couple of months? We have preliminary reports of two recent incidents that we are investigating for any commonality.

Thanks,

Kevin

Hi Everyone. For all the hospitals that have converted to ENFit syringes are you having issues with drawing up doses in 1mL and 3mL syringes when you place the ENFit cap on the syringe it pushes the volume dispensed to almost .1- 0.2mL over the dose. we are dispensing a 0.25 mL dose, but when we put the cap it pushes the volume to 0.3 mL. Wondering if other places had the same issue.

Hello all,

The ISMP Action Agenda from 7/15/21 described a situation in which the preferred name of a transgender patient was not visible in the ADC, which caused delay in getting medications in a code situation. This also impacts pediatric hospitals, in which newborn naming conventions use preferred names in lieu of assigning a legal name to the patient.

Preferred names are located within our EHR (Epic) and print on all Epic-generated medication labels, but our ADC (Pyxis ES) does not have this information visible.

Good morning,
What is your process for managing patient's own controlled substances that come in a liquid formulation? Primary concerns are admin of accurate doses especially if dosing changes and diversion
1) Does the pharmacy take custody and draw up doses? What quantity of doses are drawn up in a given time?
2) Do you keep in pyxis? If yes, are doses drawn up in syringes and labeled or kept in original container? How do you keep track of count since liquid?
Tactics to avoid diversion?

Appreciate any feedback you may have. Thank you!