Hello MSOS,

Question for you all. How does your organization navigate the different doses and concentrations for the different vasopressin indications?

Do you have separate orderable options that clearly state one is for shock and one is for Diabetes insipidus and one for GI bleed?
Have you had errors with providers ordering the incorrect one?

Do your orders default to the different dosing units? ie munits/kg/hr for DI and munits/kg/min for GI bleed and shock?

Thank you!

Two questions for group:
1. Do you require Protect From Light bag over epinephrine continuous infusions? (See recent ISMP Medication Safety Alert Feb 2024 Issue 3 and linked Hospital Pharmacy
2023, Vol. 58(5) 448–475 for discussion about addressing PFL during the different stages of medication processes.)

2. If you utilize PFL bags, has anyone found availability of ones that offer enough visibility to be able to read easily and see fluid volumes?

Droperidol IM use has re-emerged at my current site. Due to the heightened acuity during most if not all of the cases where droperidol IM administration is indicated, questions have been asked related to whether co-administered IM medications can be put into the same syringe as that of droperidol IM's.

Any data/literature/experience from you all would be greatly appreciated on trying to answer:

"Is droperidol IM injection syringe compatible with diphenhydramine hydrochloride IM injection?

And even more comprehensively:

Hello MSOS,

I am curious if any inpatient facilities have a pharmacy technician and/or pharmacist involved in the process to program an IV pump prior to the RN initiating administration of the medication.

How do you utilize the data collected in your overrides and/or inventory function dashboards? Does a particular individual/committee review the data at a specific cadence? Do the findings get presented to any committees or leadership? Curious as to how other institutions might be leveraging this information.

Hello colleagues,

My system is discussing implementing continuous glucose monitoring to reduce hypoglycemic events among high risk patients. Would anyone be willing to 1) share their experiences/learnings or 2) be a point of contact for queries (i.e. Epic integration possible?)

With gratitude,
Megan Fragale, PharmD, MS, BCPS
Medication Safety Officer
Skagit Regional Health
Mt Vernon, WA

What units do you use for midazolam for status epilepticus in your EMR and infusion pumps

Currently, ASHP standardize for safety recommendations for midazolam dosing units is MG/HR

But dosing recommendations for midazolam for status epilepticus for continuous infusion are mg/kg/hr in guidelines and references

Thanks

With the recent addition of med reconciliation in the ISMP targeted best practices for hospitals specifically the recommendation of "Obtain most accurate medication list possible upon admission to organization before first dose of medication is administered"...

We have been converting to outsourced controlled substance products (ie, morphine 30mg/30mL), but we are concerned about the risk for diversion when the syringes are actually 32mL or 33mL because the outsourcing pharmacy includes about 10% overfill in some lots. We store these syringes in Pyxis so the nurses can remove them easily. How does your site handle this? Do you have a process to track these overfill volumes? Thanks in advance! -Melody Sun, CHOC Children's

Hello MSOS community.

PROBLEM:
- We are challenged with our outpatient pharmacy system which can not print reduced size symbols for half like 1/2.
- We do not use 1/2 as that could be mis-read as "one or two"
- We have seen a risk with members mis-interpreting "Take one-half tablet...." as 1.5.
- We have reached out to vendors (First Data Bank's Meducation, and ISMP) as well to see what can be done in our system.