Hi All
we currently allow 2 dosing units for IV nitroglycerin - mcg/min and mcg/kg/min. We have seen some errors where providers enter in 10 mcg/kg/min (instead of 10 mcg/min) and are hoping to switch to using only 1 dosing unit. almost all of our other pressors/inotropes utilize weight based dosing so we would like to be in alignment with those.

Has anyone converted their nitroglycerin dosing unit to weight based dosing (mcg/kg/min)? if so what are your standard dosing range(s)? Was there any literature you used to support this transition?

We are in the process of reviewing how our department deals with Pharmacist and Pharmacy Technician errors and the delicate balance of education, assessing root cause, as well as implementing discipline when needed.

Would anyone be willing to share their Policy or current process that seems to be effective?

Thanks in advance,
Kristin Judski, PharmD.

Hi all-
We have IV products that are refrigerated. Once the product comes out of the fridge, is labeled, and warms up a bit, the labels tend to fall off. How have others dealt with this?
Using another label manufacturer is not an option and our best solution is to use clear tape to secure the label.
We are an Epic facility and use the Seneca Medical labels with the detachable patient information.
Thanks -
Maria Cumpston, PharmD, CPPS
Medication Safety Officer
WVU Medicine

Do you have examples of how you track and manage recommendations or topics from ISMP alerts and/or other sources.

With the bi-weekly information and the variety of topics it takes time to communicate out on the information and identify the specific groups to take action. I am looking for tips and ticks for what others have found helps to organize the work.

TIA - Rhonda

Hi everyone,

Heparin Drip Protocols can widely vary in how they establish maximum thresholds for initial doses and subsequent boluses/continuous rates.

For instance, one standard approach to acute coronary syndromes incorporates:
1. Initial Bolus = 60 units/kg (maximum: 4,000 units)
2. Followed by 12 units/kg/hour (maximum: 1,000 units/hour) continuous rate

Hello All. I wanted to reach out to see if anyone has any new policies/procedures or data regarding what is ok to infuse via a midline catheter. This is coming up once again as we try to better our CLABSI rate and I have not yet been able to find any clearly defined reference. I have seen the updated infusion nursing guidelines, but am just wondering if anyone has developed anything since the last postings on this.
Thanks in advance.

I'm wondering if any organizations have started managing gabapentin as a controlled substance? If so, are you storing gabapentin oral solution in ADC refrigerators? DO you have any additional processes in place for confirming or reconciling inventory?

We are reviewing our policy/practice regarding push-dose vasopressors in OR, ED, ICU areas. Hoping to get some input on how others are doing (or not doing) this safely.

Good morning,

Wondering what kind of solutions are available for the kind of error below. We are on Cerner. I've been told it is not possible to have the naloxone/ondansetron/diphenhydramine attached to the Morphine so that if the morphine is stopped, all of it is stopped.

Morphine PCA order stopped on 5/14
However PCA plan still active with orders for naloxone, ondansetrone and diphenhydramine

Thank you,

Paul

Hello!

I wondered if anyone had any experience with management of aerosol products in the ambulatory setting ~ for example, when it would be acceptable to use an aerosol or spray product as multi-use or are all of your outpatient offices using products like this as single-use bottles, criteria established for multi-use, additional infection prevention measures established, etc. (for example Hurricaine spray, or other topical anesthetics?)