MSOS Discussion Board

Insulin Prior to Surgery/Procedure

Derek Pohlmeyer's picture

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Hi Everyone,

I am reaching out hoping to find out what other institutions are doing in regards to insulin dosing prior to surgeries/procedures for patients who are NPO? What methods do you use to prompt nursing to reduce the dose?

Thanks,

Derek Pohlmeyer
PGY1 Pharmacy Administration Resident, UW Medicine

Repackaging from Sterile Single Dose Containers BUDs

Sarah Durham's picture

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This is a topic that gets tricky for me to comprehend, so wondering if others could weigh in on whether I am on the right track or not....

When repackaging a sterile single dose container (for example, fluconazole RTU 200mg/100ml into two 100mg/50ml doses), do the repackaged doses get the same BUD as the SDC once opened? So 6 hours with previous 797, 12 hours with new 797?

What if the container is not labeled for single dose or multi-dose?

Black Box Warning updates and dissemination

Shannon Manzi's picture

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Does anyone have a process for disseminating updates to black box warnings to your prescribers? We have weighed the options we could think of and none are great. If we email all prescribers, it is spam to those who never prescribe the drug and email is ignored even by those for whom it would be relevant. If we target the email to specific departments, we run the risk of missing those outside the notified departments who also prescribe the drug. If we post it somewhere centrally, then it requires the prescriber to go there to look (not likely).

Hemodialysis Catheters Requiring ALT (Antibiotic Lock Therapy) for peds

Marina Rabin's picture

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Good Morning,
We are trying to implement the guidelines for ALT in pediatric patients on hemodialysis. But ran into an issue where stability of the final product lacks any supporting data.
Our list for ALT is:
1. Vancomycin 5mG/mL + heparin 1000 units/mL
2. Gentamicin 1 mG/mL + heparin 1000 units/mL
3. Cefazolin 5 mG/mL + heparin 1000 units/mL

Biktarvy and Other Drugs that Require Original Packaging

Donna Lisi's picture

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Biktarvy(R) (bictegravir, emtricitabine and tenofovir alafenamide) states that the drug needs to be dispensed in its orginal container. I checked Pharmacist's Letter and it said it was because of having a desiccant. I called Gilead and they said that all research on the drug has been done using it from its original container so they do not have any stability data outside of that packaging.

For those who have a unit-dose system, how do you handle the dispensing of Biktarvy(R) or other drugs whose labeling states to dispense in their original containers?

Bar Code Scanning and Crushed Meds

Anna Schmidt's picture

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Our nurses utilize a Silent Knight in the med room to crush meds prior to administration but then struggle with bar code scanning if the bar code is no longer scannable after crushing or if the barcode is torn when opening prior to scanning. Any tips/tricks/best practices for crushed meds and barcode scanning?

Thanks!
Anna Schmidt

Crushing Meds

Stacy Austin's picture

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Hello!
I was hoping some of you would be willing to share what your policy/practice is relative to crushing medications by nursing prior to administration. I am specifically looking for whether meds are being crushed in a medication room/other designated area or the bedside AND if medications are crushed all together or individually.
Would also appreciate any resources you may have to support the practice.
Thank you so much!
Stacy

Crushing Meds

Stacy Austin's picture

Forums: 

Hello!
I was hoping some of you would be willing to share what your policy/practice is relative to crushing medications by nursing prior to administration. I am specifically looking for whether meds are being crushed in a medication room/other designated area or the bedside AND if medications are crushed all together or individually.
Would also appreciate any resources you may have to support the practice.
Thank you so much!
Stacy

IV contrast infiltration

Renu Bajwa's picture

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Does anyone have a reference benchmark for IV contrast infiltrations? Incidental finding that I'd like to review for my site, but what is an "acceptable" or common number for this type of event?

Also, do your sites have special/specific procedures for IV lines that will be used for contrast media? Does anyone require verification of line placement by Doppler before use?

Even if your institution does not have a specific policy/protocol, do you have any thoughts that could be explored further?

Best,
Renu

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