Hello,

Our hospital system is currently undertaking some work to expand our capability to bolus medications from a continuous infusion bag. We are looking to build EMR orderables and program said bolus/infusion orderables in our smart pumps.

What drugs do you commonly bolus from the bag? Is this function limited to specific areas of the hospital?

What other measures do you have in place to make sure this process is done safely?

Thank you in advance for your response!

How does your facility handle home medications during observation stays? Do you provide them free of charge or allow the patient to take their own? If the patient takes their own does the pharmacist verify prior or are they handled differently than inpatient home medications? Are there other times when home medications are handled differently within your institution?

I'm looking to capitalize on what you seasoned experts have come up with for education to your new pharmacy caregivers, as well as perhaps annually for your regular pharmacy team. I've reviewed something form ASHP, and didn't love it so I was just looking for what others might have come up with.

Has anyone implemented the new enteral feeding connectors yet? Please share any lessons learned in terms of medication preparation and delivery via the new system.

Thank you.

Nursing has brought up a safety problem: they often do not get clear instructions from the surgeon on which meds to give or hold prior to an inpatient going to surgery. They often use their own judgment (clearly outside of nursing scope). On top of that, we have the classic communication problems when multiple providers are co-managing a patient (Example: Will the cardiologist d/c the Plavix or is it the surgeon's job? What's the plan?).

I'm looking for ideas! If your institution has this figured out, please share.

Thank you,

Erica

Does anyone have a policy/procedure/protocol for administration of insulin infusions outside of the ICU? Specifically, I am looking for safety strategies, monitoring parameters for nurses, and patient indication.

Thank you in advance.
Amanda

For those that started filtering their lipid preparations, have you seen an increased incidence in line clotting? We have had several of our neonatal PICC lines clot off which is temporally related to filtering the Nutralipid preparation. They switched back to the Intralipid preparation and have not been filtering it and have not seen any further issues with line clotting. Before deciding if this is a product issue or a filtering issue I wanted to see what others have experienced?

Thank you,

Randi

How many of you practice in institution that primarily utilize SSI and how many of your institutions currently primarily utilize basal bolus insulin (BBI) regimens? If you primarily use BBI regimens, how did you implement and what types of outcomes are you having?

We are currently a primarily SSI driven institution but are exploring becoming more BBI driven.

Thanks,
Emily

How many of you practice in institution that primarily utilize SSI and how many of your institutions currently primarily utilize basal bolus insulin (BBI) regimens? If you primarily use BBI regimens, how did you implement and what types of outcomes are you having?

We are currently a primarily SSI driven institution but are exploring becoming more BBI driven.

Thanks,
Emily

I am wondering if there are best practice and/or standard concentrations used by neonatal units for UAC flush bags to maintain line patency. I am most familiar with hePARIN 0.5 units/mL and hePARIN 1 unit/mL but unsure if that is the standard of practice? Additionally, how do most facilities prepare this infusion? What hePARIN concentration product is used? Do you use the hePARIN IV flush syringe 500 units/5 mL syringe (100 units/mL 5 mL- classified as a device by FDA) or use hePARIN from another product(vial)? Do you add to prefilled NS or 0.45% saline bag or make exact volume?