We are currently reviewing our pain assessment and management policy.

Would anyone be willing to share their current policy and/or IV administration guidelines for opioids? I am interested in monitoring for continuous opioid infusions, PCAs, and IV push opioids.

I am interested in when you recommend patients be placed on continuous pulse ox, frequency of vital sign monitoring, and any additional monitoring guidelines you may have in place following IV opioid administration.

I am looking for information on interoperability logistics, caveats, etc for any institution that has Epic and uses this feature with ICU Medical Plum 360 or BD Alaris smart pumps. Thanks!

Our nursing staff is advocating for the use of locked medication carts which could be used to transport medications for multiple patients from the ADC to patient rooms for administration. Pharmacy has a number of safety concerns with the proposed process, so I am curious if anyone has been able to successfully and safely implement these types of transportation carts while remaining compliant with medication management standards.

Thank you!

Hello,

Upon reading USP 797 revised, at line 1552 the new standard describes the BUDs required on the product label. It looks to me that they are requiring both a date beyond which administration must not begin AND the date after which a preparation must be discarded.

Have others interpreted this to mean that we need to differentiate and include on our pharmacy labels both the BUD and the expiration date?

Are any of your institutions currently using continuous inhalation Epoprostenol? If so, I'm curious to learn more about your dispensing process and logistics. Is pharmacy compounding your syringes patient-specific?

Thanks!

Does anyone have a policy or SOP for your IV batching process? I'm particularly interested to know how much RPh supervision you require when batching high risk meds. We are currently having to batch heparin 1000 unit/500mL bags.

When batching 200 of these bags, which of these methods would you find acceptable?

Does anyone have a hospital policy that limits the dose of metoprolol IV (push or infusion) that may be given to a patient at one time?

The best info I can find is that doses of 2.5 to 5 mg may be given at one time, but may be repeated every 5 minutes (max dose of 15 mg).

We have seen doses of 7.5mg and 10mg ordered here. We typically restrict IV push to tele/ICU floors only, the other non-ICU/non-tele areas will get metoprolol in an IVPB.

Would appreciate your thoughts and hospital specific practice on this issue.

Our hospital has had quite a few occurrences due to known, or suspected, self-administration of patients meds at bedside. Aside from going through everyone’s belongings, we are looking for some type of procedure/policy to help prevent this from happening. What types of procedures are hospitals following to discourage and prevent patients from taking their own medications (without the RN or provider being aware of this administration) from home while they are inpatient? Thanks!

Does anyone out there still use Milk of Molasses enema? If so, does Pharmacy provide, or does another service (ex: dietary) provide the ingredients? Our nurses are concerned about the potential for patient burns if they mix it on the floor.

Thanks!

Hello All,

After a recent state regulatory survey we had a finding around the use of allergens in hospital clinics. We currently do not have a hospital policy on this practice.

Do you a have a policy on allergens you could please share?

Thank you!
Daniel