We are re-evaluating our lockout intervals for our PCA's as part of an Opioid Safety group. We currently use 8 minutes for all. Can you tell me your lockout intervals for PCA:
Morphine
Hydromorphone
Fentanyl

Thank you,
Ann Jankiewicz, PharmD, BCPS, FASHP
Medication Safety Officer
Rush University Medical Center
Chicago, IL

Hi Everyone,

I am writing today to ask about your institution's practice when dosing rivaroxaban for Afib. For Afib, there are two labeling recommendations based on CrCl: US and Canadian.

The Canadian labeling recommends avoiding use with CrCl < 30 mL/min. However, the US recommends avoiding use with CrCl < 15 mL/min.

Please let me know what labeling your institution follows when dosing rivaroxaban for Afib in patients with CrCl < 30 mL/min.

Thank you,

We are seeing an increasing population of dementia patients that we are having to care for long term as we cannot find placement post their acute care stay. Many of these patients remove their arm bands as soon as staff puts them on(or leg bands which we have tried).

We are in the design process of building a new pharmacy for a psychiatric hospital (census approx. 850) and is Joint Commission accredited. We currently use Pyxis and are moving to using Cerner late this year. The current pharmacy has been in place since the mid to late 1970's. We do prepare occasional IV admixtures which mainly consist of antibiotics. The architecture firm and our management is ensuring that this facility, when complete, needs to take us into the future as well. If anyone has any design elements or safety equipment we should be including, we are open to any ideas.

Do you have a single standard for dispensing INTRATHECAL products such as vancomycin IT, cytarabine IT, methotrexate IT?
Do you dispense in syringe? Or do you dispense in vial?
Thank you!

Has anyone started working on this one yet? I am wondering if "segregate from all other medications in the pharmacy" means a separate refrigerator for only NMBs or would a section of the refrigerator with separate bins for each NMB and appropriately labeling work for this best practice.

Are there any Cerner hospitals out there that have put medication level "draws" on the emar? As a way to remind the nurse to draw the levels at the right time?
Thanks

What has your organization implemented to eliminate the use of prefilled saline flushes to dilute or reconstitute medications.
ISMP newsletter update stated........

"Do NOT dilute or reconstitute IV push medications by drawing up the
contents into a commercially available, prefilled flush syringe of
0.9% sodium chloride".

Megace (megestrol) is on table 1 of "NIOSH List of Antineoplastic and Other Hazardous Drugs in Healthcare Settings, 2014".
We have patients admitted to our hospital who are taking Megace to treat anorexia. Our nurses are asking if we really need to take all the precautions (especially assigning a private room) that we take for patients on other antineoplastics.
When hospital census is high nurses often struggle to find a private room for patients on Megace.
Can you please comment on precautions you take for Megace patients?
Thank You,

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