Hello!

Curious how others are dispensing medications that are NIOSH group 1, but listed within NIOSH table 2 - where known carcinogenicity - but teratogenicity / reproductive hazard. (specifically, curious on degarelix - which requires reconstitution, comes as a kit with required supplies; Eligard - packaged as two syringes)

Do nurses prepare these doses? (inpatient? clinics?)
PPE requirements?

Thanks in advance!
Emily

Good morning! We are writing a formal policy for BCMA for our facility and I was wondering if anyone has an example they are willing to share? While we want to outline the entire process, we want to focus in on the escalation process for scanning issues. Any guidance is much appropriated if you have a policy/process that works well. Thank you! Jordan

I am writing to see how folks are approaching the administration of premixed medications to pediatric patients for doses that result in volumes greater than 50 mL (so they cannot be infused on a syringe pump).

After a recent medication event we are looking to improve our IV push insulin processes. I would love to know what other health systems are doing regarding the dispensing and preparation of IV push regular insulin. Does pharmacy draw up the doses or do nurses draw this up on the floor? What type of syringes are they using? If you are using 1mL luer lock insulin syringe, what brand do you have (we are having a hard time finding any)? Do you have any restrictions as to where IV push insulin can be given?

Bottom line question to the group:

- has your institution reviewed and/or approved the usage of non-BD syringes for your smart infusion pumps?

More details below:

In the last few years, there have been recalls for both smart infusion pumps and syringes issued by the FDA. At our institution, our main smart infusion pump used is the BD Alaris system. Recently, BD Alaris pumps received full 510k FDA approval. These new pumps now have a more restrictive syringe and PCA compatibility list.

Does anyone have a Pediatric High Risk Med policy that can share?

How do your institutions handle peritoneal dialysis patients who need a partial dialysate bag instilled? We recently had a patient who required 1200 mL per exchange but we only carry the 2000 mL bags (we do try to get changed to the full bag size whenever possible). Pharmacy has been draining off the extra in our compounding suite prior to sending up the bag. This doesn't come up often but can cause some confusion when it does. Thank you!

Does anyone use Epic, utilize an insulin calculator, and have a multi-dose insulin model workflow. Just started using MDV....for nurses to access the calculator they must scan the vial first. Though, with MDV the vials must stay at the ADC, anyone found a better workflow?

Our organization currently supplies a cangrelor "kit" in the cath Lab ADC for CL RN to prep prior to use.

We are looking to decommission many of our kits, where appropriate and would like to know if other institutions:
1) have cangrelor on formulary
2) supply in ADC in CL for RN to mix?
3) mix by pharmacy, send to floor

Thank for your help!

Would anyone be willing to share how you facilitate appropriate transition to SUBQ insulin from IV insulin once DKA/HHS has resolved?

Do you incorporate your SUBQ transition orders (e.g. basal/bolus) into your DKA protocol/order set, or do you obtain the SUBQ orders once DKA has resolved (e.g. via individual MD orders or use of a separate transition order set)?