We recently implemented IV smart pumps with a provincial drug library. We have several patients on home TPN, for whom we've also ordered new pumps. I'm just wondering for any sites who use IV smart pumps with drug libraries, do you also provide a drug library for your home TPN patients, or do you have them continue to manually program their pumps volumetrically (mL/h)? We're thinking of creating a separate smaller library specific to the home TPN patients.

Hello,
Does anyone have any guidelines or standards that discusses time outs for the ADC s? For example, currently if the drawer is open for more than 1 min 30 sec an alert shows up to close the drawer and signs the person out of the ADC. My question is what times frames have been deemed appropriate? Our pharm techs are asking to have that time frame extended because they are doing legitimate outdates in the drawer, however I am concerned nurses could leave it the drawer open accidentally and someone unauthorized could get access. Thank you.

Good Morning,
We are having quite a discussion about how to build scopolamine patch whose outer wrapping information was recently changed by manufacturers to depict, more accurately, how much drug gets delivered in 72 hours (or how they put it in 3 days).
Any institutions made the change in their CPOE yet? Curious how you handled it.
Did you leave the build as is and put a note in admin instructions " each patch delivers 1 mG/72 hours"
Or, you completely rebuilt CPOE generic item to reflect packaging change?
Thanks,
Marina.

When a new order is written for an existing medication (i.e. changing the dose or changing the frequency) who is responsible for making sure the timing of the new order goes to the MAR at the correct time based on the last dose given? Is this the responsibility of the prescriber? the verifying pharmacist? or the RN utilizing the retiming option?

Thanks,

Randi

Greetings for all,
Our hospital is accredited by the national board and the Joint Commission International.
We had an incidence wherein a patient refused to handover the medications brought by him at the time of admission (Patient's Own Medications). Some of these medications were to be continued during the hospital stay as per the order of the treating physician. (As per our policy these medications should be taken over by the pharmacy and dispensed as unit dose on daily basis.

We have had several requests (often in response to safety incidences) to make medications be dual sign in the EHR (Epic is our platform). In evaluating these requests it has come to light that we have no guiding principles to determine if a medication should be dual sign or not. Currently all chemo, investigational, epidural/PCA's and some medications on our high alert policy require a dual sign at the time of documentation on the MAR.

In updating our LASA system-wide policy, we have considered adding morphine oral liquid concentrate and morphine non-concentrated liquid. This pair is on ISMP's list of confused drug names. However, opioids are on our high alert medication policy. We were wondering if that's enough? Does your organization include this pair in your LASA policy? What strategies do you use to prevent a mix-up between these drugs in the ambulatory and acute care setting?

Hello all, we are currently experiencing difficulty obtaining IV digoxin for our pediatric and neonatal patients and are looking for guidance on oral alternatives. What are others currently using? If you are compounding, do you have a recipe that you are able to share? Any help is greatly appreciated!

Warm greetings!

Does your facility's order set for Stroke alteplase orders also include reversal agents for angioedema?

During my facility's stroke survey, the surveyor recommended adding reversal agents for angioedema as part of the standard Stroke Thrombolytics Therapy order set. She stated there is an increasing incidence of angioedema (1 to 5% incidence) with alteplase, most notably in patients also on ACE Inhibitors.

We are in the process of implementing USP 800. We are using peridox to decontaminate our bags prior to dispensing. We are finding some of the labels are holding after dispensing. We are waiting for the peridox to dry prior to labeling. Does anyone have a better process?