Hi all!
My institution does weight-based heparin infusions with aPTT guided dose adjustments done by nursing according to detailed titration instructions.
We often see medication errors in which the nurse enters the dose into the incorrect field. All doses should be entered in "unit/kg/hr," but the RN often mistakenly enters the dose in the "mL/hr" field in Alaris -- of course this ends up in the patient receiving the wrong dose.

Hello all,

We are working on a justification to grow our Medication Safety Team. We are being asked to collect information regarding number of Medication Safety Team members at other institutions.

How many team members are on your medication safety team?
How large is your hospital/system?
What is the makeup of your medication safety team (technicians, leadership roles, etc)?
If you are willing to share number of medication related safety events, please do!

Hello! We dispense a standard bag size for all adult patients on tacrolimus IV (2.5 mg/250 mL). It is built as a continuous infusion to allow for dose adjustments as soon as the level comes back in the morning. We also have this med on our Time Critical List and a standard administration time of 1800 (new bag is hung at 1800 regardless of how much is left in the bag). We are running into issues since the continuous infusion build in Epic does not put due times on the MAR and the med occasionally is being administered late.

Our facility infrequently uses PPN for patients with post-op ileus who may require just 1-2 weeks of parenteral nutrition and otherwise don't have or need central access. Due to osmolarity we require lipids run simultaneously with the dextrose/amino acids compomnent of the PPN. We have had events where the lipids were not run concurrently. This has led to discussion of a 3-in-1 PPN formulation. Our TPN (central parenteral nutrition) would remain a 2-in-1.

Does anyone utilize a 3-in-1 PPN (peripheral) formulation at their site? Thank you kindly.

-Mack-

Our institution is re-examining pharmacy sample workflows in light of the updated USP <797> requirements. Outside of organism identification which requires microbiologist expertise, we are curious about the role of microbiology labs in pharmacy sample processing at other organizations.

Our acute care leadership has been reviewing current policies around our intrathecal injection for methotrexate. We were wondering if other sites are using filters since all components used to compound would be sterile and it would be compounded in a clean room suite. Additionally, has anyone used CSTDs for intrathecal administration or preparation of methotrexate? We haven't found any clear guidance or data on CSTD use for IT administration.

Thanks!

Hi all!

Hi all!

We are in the process of updating cleaning processes for our Alaris infusion pumps. we have run into some questions and I was hoping to get feedback from other facilities on how they are accomplishing the process:

How frequently are the BD Alaris PCU and modules being cleaned for both inpatient and outpatient infusion centers. Between every patient, daily, or weekly?

Who is responsible for cleaning process for Alaris pumps?

Are the modules disconnected from the PCU and cleaned each time?

Are IUI covers used during the cleaning process?

Hello,
We are discussing a restriction on ordering of sildenafil for pulmonary hypertension following a safety event for treatment initiated by family med (investigating if there was an actual ADR vs therapeutic disagreement).
Please share if you have restrictions or actively decided not to restrict.
Thank you!
Erin