For intermittent dosing of IV DHE for pediatric patients with migraines. Is there evidence to support dilution of the medication (stability). Have your team's extended the duration of administration beyond 2-3 minutes.

What evidence sources did you utilize for stability to dilute and extend the duration?

Lexicomp:
IV: Children ≥6 years and Adolescents: May be administered undiluted slowly over 2 to 3 minutes; or diluted and infused over 60 minutes (Ref). Test doses have been administered over 5 minutes

We have seen a trend of RFP 404 & 400 NxtStage dialysate bags either having holes in the bag once removed from outer packaging OR seams "exploding" or "popping" when the seal that separates the two compartments is broken for mixing. We have about 15 reports of this occurring over the last couple of weeks. I have reported to ISMP and we are in the process of reporting to the manufacturer. Has anyone else seen this? These are experienced ICU nurses that hare having the issue--I don't think it's training or knowledge related.

We've had a few issues rear up at my hospital recently. So, I have a couple of questions for the smartest group of people I know:

1) What type of notification process do you use at your facility when shortages occur? Do you have a Pharmacy bulletin or just coordinate with the specific affected department? Do you have any sort of formal policy? If anyone has something they could share, I'd be interested to read.

Hello colleagues,

With drugs like terbutaline, labeled for subcutaneous use only but used intravenously in practice, how do you address safe use with providers and nurses? A review of appropriate use of inactive ingredients makes sense as well as sharing literature support. Any thoughts/wisdom would be appreciated,

Megan Fragale, PharmD, MS, BCPS
Medication Safety Officer
Skagit Regional Health

Hello,
Does anyone have a process where procedural techs (cath lab, IR, etc) are authorized to remove silver nitrate from pyxis? For our organization, it is not deemed within their scope of practice and are therefore not authorized to handle silver nitrate. Does anyone have a different process at their site?

Thank you

How are sites handling compounded eye drops that have to be administered every hour? Are you keeping on ice at bedside or are they stored in the refrigerator with the expectation that the nurse should remove from Pyxis refrigerator for every administration? If at bedside how are the drops dispensed from pharmacy - label on bottom and inside a plastic bag?

Hi all,

We are pushing out some education on the risk associated with crushing extended release nifedipine. In doing so, the question was asked if this is the only medication that reaches that same level of concern.

So, I wanted to poll this group - Does anyone have any other medications they would include in this targeted education about crushing specific, high risk medications?

Thanks in advance!

Hi all,

Does anyone have any experience in determining if IC green and iodine allergies are truly a concern? We use EPIC and recently realized it doesn't fire an allergy warning in the event of IC Green order being placed on a patient with an iodine allergy documented. When I look further into it, it seems as though the jury is out on whether it is truly a concern or not. Has anyone else investigated this and come to a solid conclusion? Thanks in advance!

Question about how other hospitals are administering famotidine IV push?

The famotidine package insert recommends to dilute 2 mL of famotidine 10 mg/mL solution with NS or other compatible solution to a total volume of 5 or 10 mL prior to administering IV push.

Does anyone have any experience with the safety of administering undiluted famotidine 10 mg/mL by slow IV push into a patent IV followed by an NS flush?

I think there are benefits to reducing the amount of dilution performed by the pharmacy or bedside RNs in this case.

We are forming a BCMA work group to dig into our BCMA reports and evaluate medications that do not scan. Do you currently exclude any medications from requiring a scan? Do you have a rubric or criteria that must be met before excluding a medication from the scanning requirement?