I'd be interested if anyone would be willing to share any information regarding policy or practices surrounding medication infusion management during MRI or other intrahospital transport for NON-CRITICAL CARE patients. Of particular interest is management of patients on heparin drips while in MRI. Other medication infusions (vasoactive drips such as diltiazem) more clearly require an RN present for patient monitoring of vital signs, etc.

Thank you!

Hello everyone,

I wanted to take one more shot at the following question. Does anyone's institutions provide a guideline or algorithm for redosing medications after a patient vomits? And if so... do you mind sharing?

Thanks!
Mel

Children's Health, Dallas

How does your organization track ADE events? Do you enter ALL ADE events into your organization's voluntary/staff reporting system?

Hi,

Have any of you been experiencing any product issues/complaints with Sagent manufacturer propofol 20ml vials? We have had multiple reports of unprovoked coring at our facility.

Reported lots:
Lot # 24D012 Exp. 2.26
Lot # 24D017 Exp. 2.26

Hello Members,

We are in the process of implementing TNK for AIS and our nursing team would like to know what other institutions do when it comes to administration of TNK in ED and outside ED. Can you share which discipline(s) is/are allowed to administer TNK in ED and outside ED at your site?

We also have a challenge with RN shortage and our current RNs to patients ratio are pretty high; therefore this can impact patient monitoring post TNK. Can you also share what is your monitoring guidelines for TNK if different than tPA?

Thank you for your time.

Manisa

A question was posed to our med safety team about the proper dispensing connection for bladder irrigations. We currently dispense with a catheter tipped syringe to prevent IV administration. The nurses are emptying the solution into a cup and drawing it up into a luer lock syringe to administer into the bladder. Nursing is in agreement about the concern for wrong route errors and not using the luer lock.

Our EHR currently allows pressor infusions (e.g., epinephrine, norepinephrine, phenylephrine, etc.) to be ordered with two different dosing units for adults--weight-based and non-weight based. Currently the default dosing unit is non-weight based, so naturally our using data indicates that is the most frequently used dosing unit (~95% of orders). We are aware that the ASHP Standardize for Safety group has recommended weight-based dosing for these infusions, but there is some concern for change trauma for both our providers and nurses.

Hello - we’ve been experiencing intermittent shortages of lidocaine 5% patches and are considering using lidocaine 4% patches as a substitute. I’m hearing that other institutions only use 4% patches in the hospital setting and curious if the 4% patch used the same way as the 5% patch, i.e., up to 3 patches at a time for max duration of 12 hours within a 24-hour period? Or do you follow the Drug Facts label and use just one patch at a time?

Hello, the excipients sodium benzoate and propylene glycol are on the Kids' List for oral medications in neonates. The concentrations of these excipients in oral products are not on the label, and getting information from the manufacturer is not easy or timely. How does your institution handle this issue?

We are encountering odd issue at our site with discolored acetaminophen injection (pink-ish discoloration). Expected appearance is clear, colorless to faint yellow, per pkg insert. We are actively working through this issue with the manufacturer, but curious if others have experienced similar, maybe with a different lot than we have (below).

Picture featured appearance is attached, but may not be able to read specifics. Including as follows- Product: Acetaminophen 1000mg/100mL bag, Mfg: Hikma, NDC: 00143-9386-01, Lot: 2307123.1