Does anyone use an external air bubble detector for syringe pumps that do not have an integrated air bubble detection system (i.e. Alaris)?

If you do not, are you concerned about the potential risk for large air injections?

Randi Trope, DO, MBA, FAAP
Medication Safety Officer
Pediatric Intensivist
Cohen Children's Medical Center
North Shore-Long Island Jewish Health System

I've been asked to put together a 1 page educational flyer for nursing about how to properly document medication allergies. I wanted to see if anyone had already done this before I reinvent the wheel. Problems we see with documentation:
-RNs document known side effects as allergies (opioids cause sedation)
-RNs document as an allergy, when "intolerance" or "contraindication" is the more appropriate classification
-If pt reports a family history of an allergic reaction to a med, RN enters it as a patient allergy

I am interested to learn what safety strategies your site has implemented to address the 2013 FDA boxed warning on codeine use in children following tonsillectomy and/or adenoidectomy e.g. removed Codeine from formulary for children, changes to EMR, alerts etc.

For hospitals that serve both adults AND pediatric/neonatal populations. What safeguards (i.e. pharmacist double check, NICU preparations only in syringes, special labeling, etc.)do you have in place to help reduce pediatric/neonatal medication erros??

Any particularly helpful references I should review other than ISMP for improvement ideas?

Thank you in advance!

We are updating our policy regarding administration of cytotoxic oral agents.

Do you wear an impervious gown when giving an oral cytotoxic agent?

Thanks, mm

I am interested in how other facilities are handling HELD medication orders after an OR patient returns to an inpatient bed. We are an EPIC hospital and our system currently places these medications on MAR HOLD status while in the OR. The system changes the order to a MAR UNHOLD status when they return to the nursing unit. The nurse must manually change this status to administer the medication. We are seeing multiple errors where needed medications are not given. I would appreciate any policies that address this issue. We are also looking at possible EPIC system changes.

I am interested in any current policies regarding the holding of scheduled medication doses prior to hemodialysis procedures. We are revising our current policy which is leading to medication errors. Anything that you are willing to share would be appreciated.

Thanks, Vic

Dear List,

What are your thoughts about adding a "Contains Heparin" sticker to the labels of low volume/high risk preps such as neonatal hydration fluids that contain heparin for maintaining line patency? It was suggested that this may be a way to reduce the risk of inadvertently administering a heparin-containing fluid.

Thank you in advance for your responses,
Jeff

Good morning,
I would like the pharmacy at our adult acute care hospital to automatically discontinue oral hypoglycemic agents on admission and sent an alert to prescriber recommending basal/bolus/correctional insulin as the preferred alternative if indicated, as a way to decrease our hypoglycemia rates. Item has been tabled at P&T due to lack of consensus from our Diabetes Specialists/Endocrinologist practitioners.

Can you please share what you do at your institution and include name of where you practice?

Thank you in advance for your time and collaboration!

A question has come up in our pediatric area about the preparation of medications by the nurse at the bedside vs. the med room. If for example, a nurse needed to draw up a dose of an injectable medication, do you require that it be done in the med room?