We are evaluating our goal for insulin-induced hypoglycemia. As part of the review I would like to gather what other children's hospitals have as their own goals for this metric.

•How do you measure IAH? What is your Num/Denom?
•What have you set as your goal?

Thank you in advance for the information.

Allison Romain-Dika

I am interested to know if anyone has pharmacists programming IV pumps or just verifying that a pump has been programmed correctly. Our ED pharmacists at times are programming pumps during emergent situations (code stroke, trauma) and there is concern from some of the staff that this is 'administering' medications. We are reaching out to our BOP but also wanted to learn of other practices. Thank you for your time.

Carol Labadie
Vidant Medical Center
Greenville NC

My understanding is that State Law dictates whether an RN in ED, PACU, OB has the authority to dispense take-home packs of meds to patients in these areas. I am familiar with the understanding that staff RNs in Colorado can administer medications, and that they are NOT authorized to dispense meds; that only the Care Provider (PCP, ED docs, OB docs, APNs, CNMs, PAs) may hand the take-home meds to the patient.

at 4mg/mL vancomycin appears y site compatible with zosyn-does anyone infuse both routinely as zosyn is 4 hr infusion? will this practice affect vancomycin blood level validity? promoting concurrent administration can optimize rn practice workflow as it's tough to stagger both esp if vanco also q8hrs...any thoughts appreciated.

Background: We are a large government health system that uses ScriptPro dispensing robots in our retail service lines. We are reviewing compliance with placing hazardous medications in these machines.
Questions:
(1) Do you currently place hazardous medications (e.g. phenytoin, spironolactone, fluconazole, carbamazepine, capecitabine, azathioprine, zonisamide) in your ScriptPro robots?

Hi! Wondering what your process is for dispensing of nitroglycerin from an automated dispensing cabinet. We want to avoid dispensing 1 bottle of 25 tablets, but are concerned about the removal process, including labeling, barcode scanning, light-sensitive drug, etc.

Thanks so much!

When we have TPN running at a rate that would require 2 standard TPN bags, we hang Bag 1 of 2 (Clinimix containing multivitamins and trace elements) @ 2000 today, run until complete, and then hang Bag 2 of 2 (plain Clinimix) tomorrow. How do you all deliver Bag 2 of 2, PLAIN Clinimix, if, for example, it is not due until 1400 or 1600 the next day? Do you send BOTH Bag 1 of 2 and Bag 2 of 2 together, or do you send Bag 2 of 2 with batch medications the next day?

Thanks so much!!

About a year ago when the Versed/vecuronium issue was being discussed, one of the pie-in-the-sky ideas that was batted around was a DO NOT LOAD list for our ADCs. However at that time, it would be a manual list and not something that could be hardwired into ADC "brains". Now that it has been a year-ish, has anyone found anything like this that would not be a manual process?

We use Omnicell, and have restricted the addition of medications to machines to a core team. This obviously helps, but desire to go a bit further than human vigilance on this if possible.

Thoughts?

ISMP received a report recently about confusion between Activase (alteplase 50 mg and 100 mg) and Cathflo Activase (alteplase 2 mg). We previously published recommendations (in 2008) to: communicate the purpose of the drug, communicate complete orders (i.e., dose, route, administration directions), use disease-specific ordersets in non-emergent situations, and avoid the abbreviation “tPA”.

Just curious, but what additional strategies is your institution using to avoid medication errors with these two products?

Thanks!

Mike

Hello!

As you are likely aware, there have been safety concerns reported with the packaging of Recothrom [as it comes in a box containing supplies for medication preparation including a 5-mL sterile empty syringe (luer-tip)]. (reference links below)

Wondering if you might be able to speak to the process around dispensing, preparation and use of recombinant topical thrombin (Recothrom) in your organizations.