The following drugs are needed for post partum hemorrhage: oxytocin vial, methylergonovine vial, carboprost vial, tranexamic acid 1 gram infusion bag, and misoprostol 200 mcg tabs x 4. The Birthing Center wants them in a kit (not an Omnicell virtual kit). The challenge is that methylergonovine and carboprost are typically stored under refrigeration. Does your organization have a physical kit and how is it stored?

Dear Med Safety Board,

As part of our effort to standardize practices across our pharmacy departments, we are implementing the use of leur slip syringes for dispensing all SQ/IM doses, including those for pediatric patients. Under this new process, pharmacy will dispense medications without needles attached, and nursing will add the appropriate needles at the bedside.

Hi-
ISMP's guidance on IV push med safety prompted us to examine how we are giving IV push opioids. We determined that a fair amount of nurses are using carpujects as vials and are not using carpuject holders. Can anyone share their best practice recommendations on using carpuject holders? Are they used on multiple patients? How are they cleaned in between use? Where are they stored?

Thank you in advance.

Sara

Good morning,

Could you share the epinephrine concentrations you compound for drips at your institution? If more than one, how do you guide providers on which to select?

Thank you!

Helen Lee
Medication Safety Officer
Nicklaus Children's Hospital

Have any institutions experienced ruptured feeding tubes when utilizing ENFit syringes and enteral connectors, especially if the tube becomes clogged?

We are internally debating the usefulness of High Alert Warnings on our anesthesia workstations. Currently, our sites are not consistent if they do or not. The debate is are they useful vs. causing alert fatigue. I'm leaning towards the alert fatigue side with the exception of Neuromuscular Blockers. Curious on what others are doing.

Good Morning All,

Just wanted to get a pulse check to see what everyone is doing with the products that have been granted extended expiration dating.

What process do you use for addition of antibiotics and/or heparin to peritoneal dialysis fluids?
What BUD do you assign to PD fluids with additives?
Do you require the PD bag to be warmed prior to addition of medications?

We require nursing to bring a warmed PD bag to pharmacy for the addition of medication, and consider the prepared bag to be for immediate use.

Hi,
Does anybody have an electronic ordering process that screens CHG wipes against a patient's documented allergies? Do you have screening for other topical CHG products (washes, swabs, dressings, etc.)? If so, I would love to connect and learn more.

We had several instances where RNs tried to connect the fluid to Abx they were trying to mix and it felt like the adaptor was plugged and it did not mix. It appears it was more than just a single Lot of these devices. Is anyone else seeing these issues on the administration end w/Vial2Bag?