We will soon have a direct connection between our EHR (Epic) and our ExactaMix TPN compounder. This eliminates having to transcribe TPN orders into Abacus, which is a big step to reduce errors and improve efficiency! I am now rethinking all of the double checks we have done historically with TPNs, and wondering if they are still necessary. Obviously, there is no longer a need for a 2nd RPh to check the transcription step since it doesn't exist. I am now wondering if there is still a need for 2 RNs to confirm the amounts of each ingredient in the TPN label.

Hi All,

For those who have BCMA systems that track max cumulative dosing for PRN meds, what medications do you include?

Examples:
- acetaminophen PRN - alerting the nurse if dose about to be administered exceeds 4,000 mg/ 24 hours
- sumatriptan oral PRN - alerting the nurse if dose about to be administered exceeds 200 mg/ 24 hours

Also interested in any thoughts in general on the subject i.e. barriers to implementation or why your organization decided not to pursue this.

Thank you!

It's been a while since there was a question about U/D packaging of medications that state to "dispense in original container". What is everyone doing in the inpatient setting with some of these moisture sensitive drugs that are not available commercially in U/D packaging?
Anyone aware of U/D packaging systems that address this concern?

Hi,
Appreciate recent discussions surrounding heparin infusions.
There is one aspect that remains challenging at our site and it involves "holding" heparin infusions for surgeries/procedures.
How is this done at your site? Do you allow "holds" vs discontinuations / new orders to restart? If holding is OK, how is this communicated to nurses? My concern is an active heparin infusion order on the MAR even though the infusion may be on hold. Any processes in place at yours sites regarding this?

Hello,
We are continuing to see events happening in which the tech does not load the Omnicell cabinet correctly. There have been discussions about scanning the meds at the time of loading but there is a lot of push back about how much time that would take. Does any one else scan the meds as they are entered into their cabinets?
Thank you,
Jen

Hello all,

I wanted to inquire about the implementation of Myxredlin. I searched the site here and found some answers but had just a couple more questions.

1. If you have Myxredlin, do you have it house wide and are only using that product? Or do you have a mixed system of a some Myxredlin and some that you continue to prepare?

2. When you made the transition, how did you handle storage in your pharmacy and in deployed areas? (We have some serious space and refrigeration considerations as we are already suffering for space).

Our hospital system is wondering if anyone out there has successfully implemented this ISMP Targeted practice, and if so how did you do it? Or any tips on how to get started? It seems very overwhelming! Thanks

Wondering if anyone has any advice for the naming of generic mycophenolate at their institution in electronic computer entry systems. Historically mycophenolate was referred to as the salt forms sodium and mofetil however over time generic packaging has changed to label mycophenolate sodium as mycophenolic acid. Additionally, generic unit dose packages have dropped enteric coating labeling provided by the manufacturer. Any advice with this would be helpful if previously encountered.

Hi,
I have started as a MSO for our hospital system. It is a brand new role for the organization so I am looking for any insight, valuable tools, tips, any information that would assist me on getting started in this new role to pave forward. Any type of charter/committee policy would help out as well for areas of focus.

Thank you in advance,
Pratixa

Quick survey: who manages heparin infusions protocols at your hospital: Nurse, pharmacist or provider?