Are verbal orders allowed at your facility and if so are they limited to certain medications?

How can I get a copy of an April 2001 ISMP acute care alert?....it's the one that described an issue with PO and IV caffeine citrate.

Thanks!

Randi

Our health authority currently utilizes 3 different concentrations of norepinephrine: 16 mcg/mL, 32 mcg/mL and 64 mcg/mL.
We’d like to reduce this to one concentration, which will likely be 64 mcg/mL (for fluid restricted patients). Does anyone have any experience using 64 mcg/mL concentration (or similar)? Concerns raised are:
- some patients are sensitive to norepinephrine and only need 0.03 mcg/kg/min (1.25 mL/hr in a 45 kg patient)
- is this too concentrated for a peripheral line start in Emergency, if not added to a Y-site with running fluids?

Hello, I looked through the archives and only found one similar question with one response...

For those places that draw up SQ insulin doses in the IV room, do you draw up in a regular syringe or an insulin syringe?

If yes for insulin syringe, do you recap with original cap, or have some other capping mechanism?

Thank you!
Jane Mauro, PharmD
Irwin Army Community Hospital
Fort Riley, KS

I am having an issue being reported to me concerning communicating discharge orders with stop dates on the AVS when the patient transfers to a nursing home or other facility. The example is on medications that are for short use. When our providers fill out the discharge medication reconciliation and add in a prescription for something like an antibiotic BID for 7 days then just fill out the quantity dispense (#14) and don't fill out an end date. I have asked my Epic Willow team if Epic can calculate the end date and auto fill based on the number dispensed and they say NO.

Hi again!
One more question for the group...

Who is permitted (or restricted) from administering Rho(D) Immune Globulin in the ambulatory / outpatient clinic space?

Do you require RN administration?
Is this within the scope of practice for an LPN?
(...We recognize that this scope of practice for LPNs could differ from state to state, but are still interested)
Are Medical Assistants permitted to administer Rho(D) Immune Globulin?

Thanks so much in advance for your response!
Emily

Hello ~
(two questions coming to you today!)

First is this (in light of the epi auto-injector shortage):
In your Ambulatory/Outpatient spaces (if you have oversight) - do you currently stock EpiPens (or the generic auto-injectors) or do you supply epinephrine anaphylaxis kits (with the vial and instructions for dosing)?

Would you be willing to share your kit / label design and any additional safety measures / training that you have in place for staff, if you are currently stocking providing epi kits to the clinics?

Good morning,
What timeframe does your facility allot for nursing to administer meds with the following order priorities?

STAT -

NOW -

ROUTINE (non-time critical meds)-

Trecia Swanston

This question is specific to Cerner hospitals. Patient specific labels have a barcode, which is great for compounded products where there is not a manufacturer barcode to scan during BCMA. However, on items were the manufacturer barcode should be used (unit dose, premix etc) the pt label can still be scanned. This makes mislabeling particularly risky if the label barcode is used rather than the drug product barcode. We are told by the vendor that it is not possible to remove the label barcode or differentiate products in the system that need them (or do not need them).

Hi,

We're struggling with our bar code scanning rate for Baxter's "Mini-bag Plus" containers. The bags have a white bar code, and our scanners won't read them if there is fluid behind the bar code or if there is a white label on the other side of the bag.

The only way that we can get the bar code to scan is if we squeeze the bag so that there is air behind the bar code AND also angle the scanner so that the flat water surface is below and serves as the background.