Greetings:

Due to COVID19 nephrology has requested using 5000units/ml heparin for a heploack flush. Because at the time the catheters varied and thus the amount of volume to be used to flush the catheter varies - we have been asked by providers to allow them to order by ml - does anyone have a guidance on the best practice for ordering a heplock flush

Does anyone have a policy on the newer concentrated insulins available (U-200, U-300)? When these are meant as basals, do you:
1. Convert to formulary basal?
2. Use patient's own pen? Where is the pen stored?
3. Bring pen to pharmacy and draw out individual doses? I know you're not supposed to draw out of a pen device, but would also prefer not to have this pen on the floor.

Good morning !
We have had a few medication errors around Heparin that involve changing weights of patients.
Do you allow the patient weight changes to automatically change a dose ? Or is there a % change cut off that you use ?

Just looking to make this action plan is around any high alert weight based medication- and not just heparin.
Thoughts ? Experiences?

Any information much appreciated
Laura

We are wondering what other facilities are doing for patients on BiPAP or CPAP regarding medication and nutrition support.

There are concerns that even with the gut working, removing the respiratory support for even a few minutes has significant impact on some COVID-19 patients. The results seen include significant tachypnea and decreased oxygen saturation levels even for short periods of time.

For those of you who use Pyxis or Omnicell in the OR for your anesthesia workflow, what is your time to automated sign off of the machine? There is a concern that needing to sign back in frequently during a case will create delays that could cause harm. The time out for the BioID to remove a controlled substance is usually set much shorter (15 - 45 seconds), where the time to complete sign off has ranged from 15 min - > 4 hours in our area hospitals. We are looking to see what other institutions do.

Thank you!

Hello everyone, wanted to see if there were any individuals with multi-site responsibilities without any direct reports at the local campus level. If you'd be willing to informally discuss with me by reaching out to my email, I would appreciate it.

Thanks in advance for your consideration!

Ellen Germain
New-York Presbyterian
etg9004@nyp.org

Hi all,

Is anyone using in-house compounded nimodipine solution?

We recently changed over from extracting solution from capsules to a compound product, and have had some events associated with the use of this compound via feeding tubes.

Hello everyone

I would like to know how do you define potentially significant medication errors in your hospital setting?

Thank you.

We are working to update orderables for drips to include all TJC-required order elements within the order itself (initial dose, titration parameters, max dose), and ran into this issue - the approved titration guidelines differ across the three hospitals in our system. Our IT team is hesitant on creating two (or more) versions of the same order customized per facility due to difficulties with maintenance.

Hi
Seeking guidance from any other users of the Silent Knight tablet crushers from Links Medical. we have over a hundred of these in use across our organisation and after about 18 months of use we are seeing that the rubber stopper under the handle is falling to pieces. I have tried contact Links Med via email (I'm in New Zealand) but no response. They supposedly have a life time warranty but that's no good if no-one responds!!!
Has anyone else had this issue? Has the company supplied replacement stoppers (they just pull out)?
Any advice appreciated.
Thanks