At our institution acetaminophen is most often given for (1) Fever >/=38.5 (2) Pain scores of 1-3 (3) Pain prn adjuvant to pharm and non-pharm interventions. There has been concerns with having 3 separate active prn orders on our patient’s profile due to potential for duplicate therapy (giving too soon or exceeding max daily dose). For those with multiple active orders for the same medication with different indications, have you addressed this with alerts or what additional strategies can be considered? Thank you in advance.

We are looking to narrow down our medication override list and improve overall override numbers. Would anyone be willing to share the list of medications that are allowed on override (and/or reasons if required)?

Thank you,
Kelly Salzar
Medication Safety Pharmacist

For those health systems using Cerner, can someone tell me if there is the ability to have various interventions that are site specific for high alert meds? (nurse double check, labeling differences, etc.). Since we are converting to Cerner for both VA and DoD nationally, the ability to do some modicum of customization would be useful with over 200 locations. (e.g. if it were peds, an IV of plain D5 vs the usual solution of D5/0.2NACL would perhaps need double check since D5 plain has been associated with clinical injury. If it were adults, it might not be so critical.

Dear all,

We have been discussing about re-evaluating our current options for pump modules and the different routes of administration given the current recall of one system and recent technology update requirements.

We currently use BD Alaris for IV infusions, CADD for epidural route, CADD for PCAs, and Smith Medical for pediatric infusions.

I would be interested in hearing from other institutions what types of pump modules are being leveraged for different routes of administration.

Thank you kindly,
Natalie

Wondering if anyone has a standard process or template that you use for Just Culture coaching? How do you document that it occurred? How do you determine if coaching made a difference? Thanks!

Hello there ~

For those of you with oversight of or visibility to the medication management practices happening in your Ambulatory / Outpatient clinics & office spaces... I was wondering if you would be willing to provide some commentary on the 'in-office' management of hypertension or elevated blood pressure.

I am reaching out to find out how insulin is currently managed in the OR suite.

1. Who obtains the insulin for the anesthesiologist to administer to the patient?
2. What is the method of ordering?
3. How is the insulin dispensed? Omnicell or Prepared by the OR Pharmacist?

Thanks for sharing your insights.

Charlene

I am reaching out to find out how insulin is currently managed in the OR suite at your institution. Looking for responses to the following questions:

1. Who obtains the insulin for the anesthesiologist to administer to the patient?
2. What is the method of ordering?
3. How is the insulin dispensed? Omnicell or Prepared by the OR Pharmacist?

Since misoprostol is considered a hazardous drug we currently cut the 100 mcg tablet into ¼ a tab (25 mcg) for our L&D areas. Our pharmacy staff has expressed concerns and issues cutting these tablets since they tend to break and crumble, making it difficult to consistently get an accurate ¼ tablet. I am interested to hear what other organizations are doing.

Do you cut misoprostol in pharmacy or do nurses cut on the floor?