Does anyone know of a best practice guideline for a timeline requirement for clinicians to return unused / unopened medications to the automated dispensing machine (Pyxis, Omnicell, etc.) after they've taken the med out of the machine for a patient and then not used them (ie. patient refused, etc.)?

Or, if you don't know of a published guideline, what timeline does your facility require?

Note: I'm not talking about wasting medication, but rather returning unused / unopened medication.

Thanks -
Chad

Our health system would like to start creating MERP. We currently have a medication safety scorecard that anchors our medication safety committee but would like to create a more formal MERP. Can anyone share a template, guidelines or example of what you used or are doing at your facility? Thanks!

What system functions do you leverage to ensure nurses are administering IV medications through a central vs. peripheral line appropriately? We are encountering increased infiltration and extravasation risk and actual events because of several peripheral administrations of infusions that should be given through a "central line only." Currently, our pharmacists need to remember to copy over an order comment for nurses to remember to hover over the order to see them (we use Cerner).

We have continued feedback from regulatory surveyors regarding pain management and providing medication for the appropriate score.

Typically a handful of one-offs where the patient in one of the two areas:

We have continued feedback from regulatory surveyors regarding pain management and providing medication for the appropriate score.

Typically a handful of one-offs where the patient in one of the two areas:

We are a pediatric Epic(with First Data Bank) facility and currently working on reducing alarm fatigue in our systems. We have a suggestion before our committee currently to disable all Drug-Disease Warnings in the system. We have data showing that these warnings are bypassed 98.8% of the time and are looking into what happens the other 1.2% (same drug ordered later, or drug changed). One of the questions our committee got hung up on was whether or not other facilities utilize these warnings.

We recently implemented Alaris / Epic interop throughout our 8 hospital system. We're using Epic's daily compliance report to monitor compliance and identify & resolve issues.

Compliance with albumin administration via interop is almost zero. Nurses are administering via gravity because it takes hours to infuse with vented Alaris tubing due to the frequent alarms.

Do your sites allow pharmacists to be the independent double-check at the bedside to support nursing? We received this specific question for tenecteplase used in stroke alerts, but other meds have come up as well. Our primary concern is that administration is not in the pharmacist scope of practice for most medications. We also have concerns of a pharmacist cross-checking their own work. However, we recognize that the pharmacist is already at the bedside and very capable to support tenecteplase dosing. Thanks in advance.

We're working on a pharmacy specific active shooter prevention/training plan. Does anyone have one they would care to share? I'll share ours when completed.

Our current IV KCl policy states we can run KCl at 20 meq/hr on cardiac monitored patients with PERIPHERAL lines. There have been numerous error reports of RNs using two different peripheral sites to administer two different bags of 10 meg/100mL on cardiac monitors at the same time, which technically meets the max of 20 meq/hr. I think there is a lot of confusion on if this is appropriate or not. Does anyone spell this out in their policy if this is appropriate? Thanks in advance!