We have been asked to prepare for some low volume pediatric surgery cases. I wondered if anyone had any ordersets already developed for pediatric patients they would be willing to share?

Thanks,

Kim Gaillard, PharmD

RSFH Medication Safety

We recently had a patient on suicide precautions who was on a fentanyl patch, which was disposed of incorrectly (in the trash vs. fold and flush).  The concern was raised about the availability of concentrated drug to be ingested in this manner.  As we thought more deeply, we became concerned about any topical patch used in this patient population.  Anything could be ingested causing an overdose.

Have any of you addressed this?  Do you utilize a suicide precaution checklist that might incorporate this?

Does your institution use one concentration or multiple concentrations of morphine, hydromorphone, and/or fentanyl for PCA?

For those organizations who have been able to utilize only one concentration per medication for PCA, what concentrations do you use for:

• Morphine -
• Hydromorphone -
• Fentanyl -

For those that utilize multiple concentrations, have you tried to limit to one concentration and if so, what have been barriers to implementing?

When automated dispensing cabinets are restocked at your institution is every individual medication scanned or do you only require that one item from the group be scanned?

e.g. When stocking tylenol is one scanned or isevery tylenol tablet scanned?

Hello,

How does your institution document the waste of the fentanyl patch? We were documenting the waste in pyxis, but have recently upgraded to Pyxis ES and are searching for a solution.

Do you utilize instutional guidelines for timing of home meds post-operatively?

Do you delay start times based on certain category of meds?

thansk

Are there any institutions that you know of that have successfully implemented a medication history technician program? I am on the brink but need some more information for my board.

What is your facility implementing for the caridoplegic solution drug shortage? Is the cardioplegic solution being compounded? If so, what is the formula being used?

Do other L&D departments require cardiac monitoring for patients on continuous magnesium?