Hi all -

Does anyone have an audit checklist for administration Independent Double Checks that they'd be willing to share? I'm thinking of direct observations but will take anything you may have.

Thank you!
Elizabeth

We have removed droperidol from the hospital formulary some time ago due to concerns over QT prolongation and Torsades. However, there is increasing pressure from Anesthesia to use droperidol post-operatively for N/V as the risk of TdP is low (<0.1%) and there is EKG monitoring in the OR so the team can avoid giving the medication to those with prolonged QT.

I would appreciate your responses to these questions.

1) Do you have droperidol on formulary?
2) What restrictions do you have in place for ordering, if anY?

Thank you.

Hello,

Wondering what other institutions allow for documentation of pediatric medications given in a code? My institution uses Epic and code team staff is asking to allow documentation in the Code Narrator to be entered as mL as this is what is used for the dose given when using Broselow tape. Our institution policy indicates pediatric medications must be weight-based dosing but does not specify any outliers for code scenarios.

Thank you for your input!

Good Evening,

We are in the process of evaluating our restraint freedom policies/program and I would be interested in what strategies other health systems have implemented.

Would anyone be willing to share any tools, assessments, order sets, etc. they have in place?

What role do medications play? Specifically antipsychotics, antidepressants, anxiolytics?

Any special considerations for mechanically ventilated patients? Brain injury?

Thank you.

We are an EPIC system with Alaris pumps and went live with EHR-pump integration approximately 18 months ago. It came up recently that we actually have 2 active barcodes on our internally compounded IVs - the QR code on the patient label and the manufacturer barcode from the fluid bag. The concern is that if the RN scans the manufacturer barcode, the system might recognize it and run it as a fluid (and therefore at the wrong rate) if the patient has an order for that agent, despite the fact that drug has been added to the bag.

Good morning!
Does anyone have a preceptor manual/guide to share including expectations for precepting resident longitudinal CQI projects?

Thanks for sharing!

I am trying to find Joint Commission, regulations or best practice workflows when it comes to medication errors. Are nurses supposed to amend the chart and document the error on the MAR? Do they leave the MAR as is and make a note. If anyone cam provide links I'd greatly appreciate it.

Has any institution moved away from rounding heparin to the nearest 50/100 units? Considering this as part of the solution to heparin-related errors, but have not found any information on it one way or the other yet.

I know this topic had been discussed a few years back, but I wanted to repost in case anyone has any new experience/knowledge on the topic. Has anyone operationalized an opioid assessment for tolerance, and if so, who does the responsibility lie with - the physician, the nursing staff, or the pharmacy? Is that assessment used for prescribing? Also, if anyone would be willing to share what their assessment looks like in the EMR it would be appreciated!

Thanks,
Michelle Heidel

Hello,

What does your organization use as a required time for administration, waste, or return of controlled substances?

Do you have exception to policy for procedural use?

Would you mind sharing your policy?

If you don't require a time, do you have an alternate strategy to mitigate risk of diversion?

Thank you!

Jeff Schnoor, Pharm.D.
Medication Safety Coordinator
UVM Medical Center