Can you share how your institution dispenses insulin when patients are receiving 2 units or less? Are you sending up the vial (100 units/ml) or are diluting in pharmacy and sending up patient specific syringes?

Thank you.

Is anyone willing to share if your hospital has an IV push policy and what it looks like?

Thank you!

For those institutions doing solid organ transplants, is pharmacy purchasing your preservation solutions (ex, Belzar, Custodial, Perfadex)? Due to the high electrolyte contents, do you have any specific safeguards in place for safe use? Is it ordered as a medication through CPOE and dispensed from pharmacy patient-specific?

Thanks for your insight!

It appears that our interventional radiologists use nitroprusside diluted to a concentration of 100 mcg/mL and adenosine to 10 mcg/mL for intracoronary administration. Does anyone prepare this for them or do your providers mix it as immediate use? Anyone have any other safe suggestions (e.g. use of kit or something like that)?

We recently discovered that our Nuclear Med techs are drawing patient's blood, mixing with 100 units of heparin to prevent clotting while they prepare for procedure then inject back into the patient. They also use heparin when centrifuging to tag white blood cells. There is no second person validation that the correct amount of heparin has been drawn up and no documentation that patient received heparin. Our Radiology NM is new to the position and is wondering what practice other facilities are doing with these processes?

Second attempt - any feedback and help is greatly appreciated!

We have a situation that has recurred several times, and we struggle with it every time.
Currently, there are no insulin pumps that have settings based on U-500 insulin. Periodically, we have patients who come in with U-500 in their pump, so their pump settings do not accurately reflect the number of units they are receiving. How do we document this pump in the EMR? We try to move away from their pump to our medications, but that comes with conversion issues as well.

We are currently performing an FMEA on change to a room-service food tray delivery model and impact on medications that are timed with food (most obviously insulin).

Looking to determine how other organizations have handled/adapted to scheduled insulin administration times & documentation when meal trays are delivered via a room-service model where meal times are no longer standard.

Thanks!

Don McKaig
Lifespan--Rhode Island Hospital
Providence, RI

Hello,
How does your organization prepare for procedures for known drug addicts in recovery and scheduled for a procedure, such as a Transespohageal Echocardiogram (TEE).

What meds are used to sedate? We generally use fentanyl and versed however that does not work for these individuals.

How do you identify this patient population to avoid giving opiate/narcotics,

Does your EMR alert providers?

If you have process or guidelines you are willing to share that would be most appreciative.
Thank you

Hello all,

In light of news of the fatal medication event from Vanderbilt University Medical Center, I was wondering if any of you can share some error-reduction strategies you have in place at your institutions to prevent similar mix-ups. I have several to share but would like to hear from the group.

Can you describe your process for tracking/monitoring controlled substances that leave the hospital for transport (i.e. your transport team goes to pick a patient up and bring back to your hospital).

Thanks.