The BUD date on short stability medications is hand written on the med label at the time of preparation. We often get reports that administration was started after the BUD time, so I'm wondering if anyone has incorporated the BUD on the MAR that alerts the nurse that the medication is expired?

Does anyone have a protocol/policy for patients who have high blood glucose level on morning labs or at POC, sometimes for several consecutive days? This would be for patients who have no insulin orders.

Is your policy lab, nursing, pharmacy, or physician driven?

Would appreciate any copies you are able to share.
TIA

We recently had a request to compound an epinephrine drip for anaphylaxis and came across a potential safety issue with ordering. The recommended concentration for anaphylaxis is 1 mcg/ml. We have the standard concentrations of 20 mcg/ml and 40 mcg/ml built into Epic. This resulted in considerable manipulation and work-around by the pharmacist in order to correctly enter an order for the 1 mcg/ml drip.

Has anyone come across this issue, and how did you improve safety for future orders?

Thanks!
Rachel

For self-reported errors, we most certainly do not benchmark error rates for all of the reasons we are familiar with. But, for those things where we can pull 100% data from the EHR like late doses and early doses, is there a source for benchmarking this data? Thanks in advance.

Holly Trotter, PharmD
Siskin Hospital for Physical Rehabilitation
Chattanooga, TN

Good morning dear friends and Colleagues,

I’m assisting with creating a Pharmacy Dashboard and I hope you can help. Can you please share with me what are the metrics (clinical, operations and medication safety) do you have on your dashboard and monitor routinely?

Thank you so much in advance.

Sincerely,
Mohamed Sarg

Good morning my dear friends and colleagues,

I’m helping creating a pharmacy dashboard and I was wondering what are the Clinical, operations and medication safety metrics you have on your dashboard?

Thank you so much I’m advance.

Sincerely,
Mohamed Sarg

I am wondering if others have a process or protocol for allowing nursing to pull out carrier fluids for administering small volume IV antibiotics?

I was made aware today that our nurses tend to pull out fluids from our ADCs on override to administer IV antibiotics that are of smaller volumes, such as 50ml or 100ml, but never have an order. This makes me concerned about errors, including possible incompatibilities and inaccurate documentation. I am wondering:

Does anyone have safe staffing guidelines (internal or published) for the number of pharmacists necessary to staff a hospital pharmacy (order verification/dispensing role) based on census numbers or bed numbers?

Do you flex your staffing numbers daily for census fluctuations (up/down)?

Does your ratio change for overnight coverage? If so, please elaborate.

I found a very general answer at ManagedHealthCareExecutive.com (from 1:50 to 1:100), but not really from ASHP, DNV, CMS, TJC, etc ... unless I'm missing it.

Thanks -
Chad

Our EHR has"malignant hyperthermia" as an option in the allergy list. However, this term is not coded to the drug library, so alerts won't fire if an order for succinylcholine, for example, would be entered.
Do you have MH as a selectable term on your allergy list?
If so, is MH coded to any drugs in the drug library?

We are looking at our “sleepers/z-drugs/etc” on our formulary. Currently we use melatonin (83% of our use), zolpidem (14% of our use - almost exclusively at 5mg doses), and temazepam (3% of use). We are considering suvorexant and Ramelteon in our review as well.

We are getting a lot of different feedback from our physicians, and the evidence that we have found doesn’t highly favor any of the agents in the hospital setting. Would you be willing to share your experience?