Hello,
How do you manage preparation and administration of testosterone & medroxyprogesterone?

-do you use a CSTD if drawn up from vial?
-what level of PPE do you require?

Thank you,
Stacie Ethington MSN, RN
Nebraska Medicine

Dear all,

While we are reviewing the JCI 8TH ED MMU standard 4.01, under measurable element 5:

Hospital policy of medication orders which includes "Signed and held orders: New prewritten (held) medication orders and specific instructions from a
physician or other licensed practitioner to administer medication(s) to a patient in clearly defined circumstances that become active upon the release of the orders on a specific date(s) and time(s)"

Hello,

After experiencing several medication errors when prepackaging. I would like to implement the EPIC prepackaging function. Is anyone using EPIC prepackaging function?

This is mostly in regard to pill prepacking and 79 prepacking solutions etc.

Any help will be greatly appreciated.

Hi everyone, how does your institution address the following TJC standard:

MM.02.01.01 - EP 10: The hospital follows written medication substitution protocols to be used in the event of a medication shortage or outage.

For hospitals using the Alaris infusion pump, how have you adjusted local practice to account for the recall notice affecting infusion rates < 1 mL/hr with the LVP module? Have you been able to convert 100% of these low-rate infusions to syringe module dispensing?

Also, the provision affecting bolus delivery of < 5 mL -- have you successfully addressed this? For more concentrated infusions, boluses are likely to be <5 mL and we are evaluating how best to address (ceasing bolus from bag vs changing concentrations).

Hello,

When administering a 50 g dose of albumin, scanning a single 25 g bag allows the MAR to register the full 50 g dose. The following concerns have been raised:

- Documentation of different lots and/or expiration dates when two 25 g bags are required

- How to ensure both bags are scanned and administered appropriately when the MAR registers the full dose after a single scan

- How infusion rates should be programmed and documented for each bag when administered sequentially

We outsource our Care at home nursing and provide emergency kits. I would prefer that we send these rx's to our outpatient pharmacy instead of sending kits into the home for obvious safety risks.

Would love to hear how others are treating this issue if you outsource.

Thanks!

Does anyone have a renal dosing policy that utilizes eGFR adjusted equations instead of Cockcroft and gualt CrCl?

Hi All
We are looking at improving our current pediatric process for alteplase (cathflo) for intracatheter use. Currently it is dependent on patient weight (<30kg) and catheter size, which has lead to administration errors.

Has anyone implemented standardized weight based alteplase (cathflo) doses for pediatric patients? We do have NICU babies less than 500 grams so need to take that into account. Anyone > 30 kg gets the standard 2mg dose.

Thanks
Lindsey Eick
Medication Safety Supervisor
Oregon Health and Science Univeristy

Dear Colleagues,

I am writing to inquire about your current processes for administering Nitrous Oxide in L&D. I would appreciate insight into the following:

- Do nurses document the usage of Nitrous Oxide on the MAR? (Is it self-administration? Do nurses document the usage?) Any issues with BCMA scanning, or is it on the exclusion list?
- If this is not documented on the MAR, what processes have you implemented to minimize potential drug interactions or the concurrent administration of opioids?