One of our facilities is developing a hyperbaric chamber service. Pharmacy was not initially consulted on this and we recently found out they have bought IV pumps for use in the hyperbaric chambers. Since they are monoplace chambers the pumps have to be able to generate 30 psi or more without alarming. Something most cannot do. The pumps they purchased are Zyno Medical Z-800F pumps. From a DERS standpoint the Zyno pump does not appear to have that capability, which is against our policy.

Hello!

We are an Epic hospital and currently require CRRT dialysate/replacement fluids to be ordered every 24 hours per institutional high alert policy. We have been running into problems getting orders placed incorrectly or orders expiring before providers have a chance to order or order for the flow/removal rates not matching with the orders for the actual dialysate and replacement fluid. I wanted to get some general sense of what other institutions are doing:

We have been using these Norepinephrine bags 8 mg/250 mL from WG Critical Care and the spikes have been coming loose and falling out of the bags. Has anyone using this product experienced this and what was your resolution?

Good morning,

Does anyone have a process for preparing this product and what precautions you have taken? Have you or would you allow this to prepared bedside? It has a short stability of 1 hour per the manufacturer. They do provide instructions for preparing the product (from their fact sheet for HCPs):

Good morning,

Does anyone have a process for preparing this product and what precautions you have taken? Have you or would you allow this to prepared bedside? It has a short stability of 1 hour per the manufacturer. They do provide instructions for preparing the product (from their fact sheet for HCPs):

We recently started looking at how and where our pediatric/NICU IV medications are being prepared, in the pharmacy or on the floor by nurses. Many of our IV push medications for NICU are prepared and diluted by the nurses on the floor with a 2 nurse check before administration. ISMP and Joint Commission both recommend supplying medications in the most ready to use form which would mean preparing these medications in pharmacy. Our NICU and pediatric departments are not large so this does not come up often.

Hi all,

We recently implemented a pharmacy to dose TPN protocol and are now re-evaluating potential potassium limits. Does anyone have a suggested or hard limit max for either total potassium contents per TPN or a mEq/L limit for TPNs at your institution?

Thank you!
Sheena Burwell, PharmD, BCPS, CTTS
Medication Safety Specialist
WVU Medicine - WVU Hospitals

I was wondering if there is a clear medication safety rationale on how specific dosage forms make their way onto the High Alert Medication list, requiring a double check by two registered nurses (RNs) during administration in the Epic system. IV morphine requires a double check by two RNs, but PO morphine doesn't.

Hello colleagues,

Our Epic institution utilizes an active interval setting of ZERO hours when it runs interactions for currently placed orders. Therefore, it does NOT capture completed ONE TIME orders for duplicate therapies, which may pose a safety concern given particular medications. Can anyone speak to their Epic configuration of this setting? I am wondering if this setting should be adjusted to capture doses within the past 24 (or less) hours to prompt a closer review, or if this would result in nuisance alerts.

Your insight is much appreciated,

We have been compounding L.E.T. solution in small cups and have had a request to switch to L.E.T. gel. In searching 503B compounding companies, we are only finding this stored in oral syringes. We are uncomfortable dispensing a topical product in an oral syringe but are hoping to outsource this. What are other adult or pediatric hospitals doing?