Good evening MSOS Team,

I have some questions (below) which I appreciate your advice regarding Medication Reconciliation Continuum for EPIC Institutions.

1) Prior to Admission, when do they stop looking at this (how far back from the admission date).
2) Admitting medication Reconciliation: Who is completing this or reviewing this?
3) What level of work or review occurs with transfer or change in level of care?
4) How are they integrating High Risk Med Reconciliation (Best possible med history).

Our health system currently has three standard insulin infusion concentrations: 1 unit/mL (adults), 0.5 unit/mL (peds), and 0.2 unit/mL (NICU). Our medication safety council has received a request to eliminate the use of the 0.5 unit/mL concentration for multiple reasons--reports of wrong concentration errors, decreasing compounding needs, facilities that we transfer pediatric patients to do not use 0.5 unit/mL so our pharmacists are manually manipulating orders resulting in potential errors, etc.

Hello,
The number of hospitalized patients with insulin pumps and/or CGMs is continuing to increase. Does anyone have surgical decision trees for intraoperative use of insulin pumps, CGMs, AIDs, and BG monitoring that they could share? I have found very little in the literature.

Hello Everyone,

Our anesthesiologists reported that the rocuronium was not effective when used at appropriate doses in three different patients, requiring a second dose. We typically buy rocuronium by auromedics. Has anyone heard of any issues using this manifacturer at your institutions?

Thank you,

Viktoriya Fridman, Pharm.D.
Medication Safety Specialist
Ocean University Medical Center
Brick, NJ

Our institution is currently in a season of incredibly high scrutiny on BPAs (including non-provider BPAs and those that would be 100% actionable). I am curious if others are experiencing this same thing, and if so, have you developed specific criteria to meet in order to recommend a BPA and/or a flowsheet when assessing whether or not a BPA is the best way to incorporate a safety measure. We are an Epic institution.

Thanks!
Amanda Hurst, PharmD, BCPPS
Sanford Medical Center

Hi everyone,
We are receiving some complaints of worse GI reactions to generic regadenoson, especially from IMS. Has anyone else seen this? Since it's still so new we aren't sure if this is a lot issue vs generic nuance we need to adjust to.
Thanks!
Erin

What is the actual process for wasting controlled substances infusions at your nursing units?

Does the unit nurse measure out the remaining solution in both the bag and the tubing to document how much volume they are wasting?
If so how is it measured?

If it is not measured, what volume is used to document the waste?
From the infusion device or from the EHR?

Thank you for your insight.

Dears, I have a query about the repacked loose tablet medications in the brownish bottles for outpatient use, as you all know after repackaging all the bottles looks the same and the labels used also with same colors and fonts. the query is about how we assure the safety of using these medications as patients may receive two or three repacked bottles and all looks the same.we encountered many complaints from patients about this point despite each medication is labeled with the name and instructions.

Hi all,

For DNV hospitals, could you share what measure/metric you are using to track look-alike/sound-alike errors?

I don't want to use voluntary event reports.

Thanks!

Is anyone familiar with sterile saline irrigation being updated from being hypotonic to isotonic? There is a large body of literature that says irrigation and injectable are not interchangeable due to the irrigation being hypotonic. The current preparations of irrigation we stock are isotonic.

Looking for any updated information on this topic.
TIA!