Do pharmacists do an independent double check on pediatric doses prior to dispensing? Is this pharmacist IDC on all doses or do you specify only high risk meds, only hazardous meds, etc.? If standard procedure is a double check prior to dispensing, how do you handle shifts when there is only one pharmacist such as overnight? Any insights, policies or SOPs would be greatly appreciated.

Thank you

Has anyone heard from their nurses that they are having issues with albumin running with a vented administration set? Was it an issue with the administration set itself or with the way the nurse was connecting the administration set and albumin?

What were some successful ways this was resolved?

Hi there!

We had an recent concern escalated from our Children's Hospital around the dispensing of LORazepam from a retail pharmacy setting when it comes to sedation weans. (Children that had been on long term sedation in the ICU setting may require a somewhat prolonged wean from their medications, even at discharge.)

My institution is revising our policies related to IV therapy/infusion pumps but struggling to find the right language to mandate smart pump use for majority of infusions, but have specific/appropriate exceptions for scenarios when pumps are not used (eg. needing to give faster than the pump will pump (>999 ml/h), pressure bag use, limited/specific items given by gravity). Any examples of policies that people have would be helpful to reference as we are updating ours.
Thanks!
Katie Johnson
(katiejohnson@uky.edu)

Hello,

We recently had a near miss event at our institution where 2 patients with the same name (one Jr, one Sr.) almost received medications intended for the other patient.

Upon review, one of the gaps we identified was that the patient suffix does not display for nurses on Pyxis ES console. According to our BD Carefusion representative, the patient suffix information is transmitted over to Pyxis, but is information only and cannot be displayed for nursing at the console.

We are re-evaluating our guidance on Metoprolol IV. We are trying to find something that will work for all of the hospitals in our system, which have different acuity of patients. I would love to hear from you regarding what limitations, if any, you have on Metoprolol IV.

-Do you allow metoprolol IV on general units?
If yes, do you have a restriction on dose/frequency/number of doses/delivery/etc?

What standard monitoring is required?

How do you enforce your restrictions?

Any other pearls would be greatly appreciated!

We are an Epic facility using Dispense Prep and Dispense Check. We're having difficulty scanning Menveo. This product consists of 2 vials, each containing active drug component.
The solution for intramuscular injection is supplied as a lyophilized MenA conjugate vaccine component to be reconstituted with the accompanying MenCYW-135 liquid conjugate vaccine component.

Does anyone have an Epic build in place that would allow scanning both component vials at dispensing and administration?

Thanks!

​​We have had some issues that have come up with Heparin dosing since we went to Smart Pump integration in August of last year. Some patient are started in our Emergency Department on Weight Based Heparin for chest pain that are capped at a dosage of 1000 units/hour to start. Thus, the pump gets started in non-weigh based programming however, 6 hours later, once the patient is on the floor and the first Anti-Xa result is dropped the nurse has to adjust the dosage based on a weigh-based nomogram. We have had some errors and some confusion around this when this change needs to be made.

If anyone is able to share their nursing policy regarding provider notification for refused medications I would greatly appreciate it.

Discussion points surrounding this topic:
-should this be for all meds?
-should it only be for high alert meds?
-what is the ideal time frame for reporting a missed/refused dose (within 2 hour or at rounds, etc.)

Hi all,

Our system is currently preparing arthrectomy cocktails (e.g., Rotaglide/Viperslide variants) in the pharmacy. We've had request by interventionists for compounding in the Cath Lab.

Some concerns with preparation directly in the Cath Lab include USP 797 compliance and general risk associated with mixing several ingredients (e.g., verapamil, nitrates, heparin). Overall turn-around-time (TAT) from pharmacy is in the 20-30 minute range (order to delivery receipt). TAT is somewhat hindered by transportation time as the lubricants cannot be tubed.