For ambulatory locations that have medications but not within an ADC, how do you decide/limit what medications should be stocked in those clinics?
These locations are high risk for errors from medications because of lack of barcode scanning and no ADC to prevent wrong dispense, expired medications, etc.
-Do you have a decision tree to guide what medications are allowed for clinic locations?
-Do you have a committee that decides or is it a single person?

Our system Medication Safety Council has been working on BCMA compliance, and an interesting question has bubbled up involving practices around patient verification when patients decline to wear wristbands. A few of our neurobehavioral health units have come up with some rather "creative" workarounds to scan a patient barcode during medication administration. We don't want to encourage patient scanning just to comply with a metric goal, but rather to increase patient safety by confirming that the correct patient is receiving the medication.

Hi all,

Have a question, especially for institutions that have both peds and adult patients. How do you guys manage partial doses for oral tabs (when no oral solutions) for peds? For example a medication has no oral solution but tabs are available. Currently, since most meds are on ADC, we provide nursing instructions in medication admin instructions to dissolve the tablet to create a solution of a certain concentration and draw up the the specific dose.

Example: "Dissolve 32mg tablet in 5ml, give 3.3ml = 21 mg dose"

This request is posted on behalf of our TPN lead pharmacist....our current central line policy includes the following "Total Parenteral Nutrition (TPN) is administered through a dedicated virgin port or lumen if clinically feasible. Changing the CVAD over a wire to obtain a virgin port is not recommended." Infection Prevention and Nursing leadership are reevaluating "virgin' line due to potential need for placement of a new central line to make a 'virgin" port/lumen available.

What does your TPN and/or central line policy state about IV access for TPN administration?

We are looking to go live with Epic's Dispense Prep and Check in our sterile compounding suite(s) within the next 10 months. Looking for any tips from those who have gone before. Also which vendor did you use for equipment? Are you doing gravimetrics, image based, or a mix? Appreciate any and all insight!

We have noticed a lower incidence of barcode scanning of inhalers that we would like to see.
If you have BCMA how do you scan inhalers on administration-

Do you have the nurse scan the med itself (may require separating canister from inhaler cover each time), or a patient specific label, etc.
And if you use a patient specific label how do you handle it if the dose changes or how do you ensure the label stays attached to the product?

Any other thoughts are welcomed.
Thank you!

Hello Colleagues,

What safeguards to you have in place to alert staff to the presence of an epidural and/or potential concomitant anticoagulant use in a patient with an epidural? Any warnings build in your EHR? Consults to pharmacist upon ordering an epidural?

Thank you,
Megan Fragale, PharmD, MS, BCPS
Medication Safety Officer

I was wondering if anyone has experience using DUMMY PATIENT with PYXIS.
Is it possible to restrict dispense to one item only, such as RSI drug box with DUMMY PATIENT use?
Please share your pros and cons experience!

Thank you!

Has anyone updated their home insulin pump in the hospital policy to include language surrounding the use of sensor driven insulin pumps? Our endocrinologists are asking to update the policy but there still a lot of questions on next steps and safety on these newer insulin pumps.

Appreciate any thoughts/guidance and updated policies if you have them!

Thanks
Lindsey

Hello All,
For those of you who have placed 3% saline your ED ADCs, what mechanisms or safety strategies did you put into place to prevent confusion?
We have a request to add from our Trauma team specifically to the trauma Pyxis machine but I am apprehensive since it is a concentrated electrolyte in a nonprofiled area.
Thanks so much for your help.
Cicely Williams, PharmD