We are experiencing a cardinal IV luer lock insulin syringe disruption. There is no equivalent substitution on the market. What is your hospital doing to give IV push insulin?
Options we are exploring include
- using a slip tip syringe with the friction fit technique
- pharmacy dispensing all IV insulin doses
- pharmacy making IV insulin "kits" with instructions for dilution and administration using a syringe in mL

I appreciate any insights into other institutions.
Thank you!
Emily

Hello - we are estimated to increase our cardiac surgery cases by a significant amount, and are in discussions with Anesthesia on how to accommodate increased workload safely and efficiently. They are proposing to pre-spike and pre-program pumps (epi and norepi) each morning for the planned cases that day. I am most interested in others' experiences and thoughts with pre-programming (vs. pre-spiking, which I have more info on). We use Alaris. Thank you!

Looking for information on how other Cerner/Oracle health systems are handling orders for holding, suspending and/or resuming medications for procedures or tests for inpatients. Specifically looking for processes around holding anti-coagulants (po or IV), antidiabetic medications, etc. Also, for medications like Vancomycin where we may need to hold due to a supratherapeutic level. Appreciate any feedback! Thank you!

Our hospitals are switching from dispensing insulin pens to multidose insulin vials stored in the pyxis station. Nurses will withdraw insulin doses for patients in the med room.
How does your institution prevent insulin syringe mix ups with IV or tuberculin syringes? Are insulin syringes stored separately, in color coded or labeled bins? Any details and photos would be helpful. Thank you!

I assume most facilities are having discussion about updating their Vitek GN AST cards- we are wondering if anyone has selected or will be selecting a card without the ESBL confirmation test. If you have selected a card without the ESBL confirmation test, how will you identify patients who should be placed in contact precautions due to potential ESBL infection or colonization?

Thank you!

Rachel Durham Pharm.D
Director of Pharmacy
Fulton County Health Center
725 South Shoop Ave.
Wauseon, OH 43567

Hello,

I was hoping to gain some ways to cut down on duplicate orders/therapy without reaching out to the physician. While searching this site, I read about P&T approved policies that allows pharmacists to discontinue duplicate orders and a "Pharmacist Authority Policy" that allows pharmacists to make corrections to certain orders. Would anyone be willing to share these policies or policies like this with us? We are a small hospital still on paper. This, along with many things, is hard to tackle without the use of an EMR.

Thank you, Marysia

We have seen a handful of "wrong time" errors recently during our overnight shifts where either the ordering provider or the verifying pharmacist is unaware that the dose is scheduled for the following day when they retime an order - leading to significant delays. Have any Epic organizations leveraged technology to help our nocturnists recognize that the order is not scheduled to start until the following day? We have been trying to think through ways that we could accomplish this but are trying to limit the noise recognizing that this will be sometimes intentionally done.

Hello,
we are evaluating the behavior of sign and held orders in our ambulatory clinics. For sites using Epic, do you have the orders automatically discontinue at the end of an encounter (or after some other time period) or does your policy dictate that nurses act on the orders if not needed? Any other information that you can share is greatly appreciated!
Thank you,
Emily

Hi all,

I was wondering if anyone could provide an insight into endo order sets used at your organization. We are working on implementing barcode scanning at med administration, and one of the items is to create and revise endo order sets.

I would appreciate any guidance and information you are able to share.

Thank you!

Good afternoon,
Curious how other organizations provide education for patients who are discharging from your facility who have received medications that affect hormonal contraceptive effectiveness (i.e. sugammadex, aprepitant, certain antibiotics)?

What is your strategy?
1) Pharmacy provides targeted education regarding use of alternate form of birth control
2) Information included on discharge instructions
3) Something else

Which medications are included?