Our pharmacy prepares unit dose oral morphine syringes for NICU patients. Nurses have expressed concern because the product has a blue color and when drawn up in a amber syringe with a black plunger the nurse is unable to differentiate where the medication ends and the plunger starts.

Has anyone else experienced this concern? Recommendations would be appreciated.

Thank you, Mark

Our pharmacy prepares unit dose oral morphine syringes for NICU patients. Nurses have expressed concern because the product has a blue color and when drawn up in a amber syringe with a black plunger the nurse is unable to differentiate where the medication ends and the plunger starts.

Has anyone else experienced this concern? Recommendations would be appreciated.

Thank you, Mark

Hello,
Would anyone be willing to share their policy/procedure on high alert medications and your high alert list? We are looking to update ours.
Thanks,
Rachel

Would you please share your institutions practice for STAT SL nifedipine doses for pediatric patients? Does the dose come from the pharmacy or are doses available in the Automated Medication Cabinet? Thank you.

For those institutions that utilize automated dispensing cabinets, can you provide information regarding your error prevention strategies at the machines?

A recent mock surveyor noted that red and yellow bins should be used to differentiate/segregate high alert and look-alike/sound-alike drugs within the ADCs. We are using colored bins to differentiate these products within the pharmacy, but have not operationalized this outside the department. We want to ensure any process we put in place will be sustainable.

Hello! We are looking at revamping our fosphenytoin dosing guidelines/restrictions.
We currently have restrictions based on patient location and monitoring capabilities. For example, we do not allow loading doses to be given on a general floor due to the lack of bedside telemetry monitoring. We do allow maintenance dosing on a general floor.

We have standardized to insulin lispro for our glycemic control insulin protocols, but we still have Regular insulin product on floor stock for those instances when it is needed for hyperkalemia.
If those hospitals that have been successful in removing Regular insulin from floor stock, how do you manage hyperkalemia situations?
thank you!
Susan

How do you have staff dispose of partial vials of propofol? Does Surgery dispose it differently?

We are looking at implementing a guideline regarding ketamine infusions for acute pain crisis (palliative care) as well as post-operatively in reducing narcotic use in chronic opioid patients.

We are still debating the nursing piece and level of monitoring required.

For those of you that use ketamine infusions for these indications:

1. Is ketamine restricted to a particular floor (eg: telemetry)?
2. Can these infusions be adminstered on a med-surg floor?
3. How often are vitals needed?
4. Are nurses able to titrate the doses?

1) Does your institution allow for hydroxyzine to be given IV?
2) If you can give IV is it limited to certain patient populations only?
3) If you can give IV what safeguards do you have surrounding it's IV administration to avoid extravasation?

Thanks,

Randi