We are working to establish a single health system policy that addresses medication safety (or similar) committee roles and responsibilities. If anyone with a system policy is willing to share your policy, we would be very appreciative. Thank you in advance.

Dear all:
I need your advice in this matter.
Currently in our hospital we are in the process of initiating a medical gas committee to govern the process for handling all aspects of medical gases in the hospital.
The hospital team is proposing that the pharmacy to lead/ chair this committee
Others are proposing that this shall be under the anesthesia department.
May I know in your hospital who lead/ chair similar committees if available.
And if not available, in your opinion/ experience who shall take the custody of this process.

How are other pediatric hospitals dispensing tiny doses of SQ desmopressin < 0.04 mCg (0.01 mL)? Does anyone have stability data to further dilute the 4 mCg/mL concentration that they could share.

For those institutions following the requirement to filter fat emulsion infusions with a 1.2 micron filter, have your nurses reported issues with the filters, especially after pausing the infusion to administer intermittent medications? Our nurses are getting downstream occlusion alarms on the pumps once the fat emulsion is started again. If you've experienced this, any suggestions on how to prevent this?

Thanks!

Our institution seems to have had a recent uptick in life-threatening adverse reactions to protamine administration in the past couple of months (hypotension, pulmonary vasoconstriction, cardiovascular collapse). We have reported 4 cases to FDA MedWatch, but are interested if this increase has been noted at other institutions. We have not identified anything preventable upon review of the cases. Have any of you noticed this at your facilities?

We have recently switched to monitoring heparin assays for our weight based heparin drips and have had several situations where the heparin assays have remained subtherapeutic despite high doses of heparin (>25units/kg/hr). This has been occurring more in our critical care population. Has anyone encountered the same issue and have any guidance on how to manage ( argatroban vs giving thrombin vs alternative monitoring vs other) thanks.

Does your facility allow insulin to be pushed on med surg units besides hyperkalemia and under what conditions? thanks

We are an Allscripts (Sunrise) institution and are instituting BCMA for our pediatric services.

For medications ordered PRN or a one time dose that are pulled by the RN from the ADC and not dispensed by pharmacy, how do you have this set up to scan?

Currently the provider uses the regular order for a one time dose however, when the RN scans the vial removed from the ADC we get a mis-match warning and therefore no warning that only part of the vial has to be given.

We are a pediatric hospital and frequently use empty, sterile IV bags. With the national shortage we are implementing processes to conserve our supply. We have: 1) split IV doses up to 240ml into equal volume syringes 2) Compound selected drips in pre-made IV fluid bags 3) Compound stock bags of medication in larger volumes 4) Communicated with providers for IV to PO conversion and timely discontinuing of IV fluids 5) Antibiotic Stewardship will help ensure antibiotics are ordered with the longest acceptable frequency.

I would like to network with organizations that have a low number of heparin events and/or have completed work to improve safety surrounding heparin. Our hospital is doing a comprehensive review of our heparin processes. Please contact me if you would be willing to speak concerning heparin. Thank you for your consideration.