MSOS Discussion Board

Standard stock criteria for automated dispensing cabinets (ADCs)

Jennifer Zimmer-Young's picture

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Hi all,
We are revising our criteria and process for which medications can be considered "standard stock" in our automated dispensing cabinets. I'd appreciate your insight on how you've addressed this at your locations.

1. What criteria do you apply to decide if a medication can be "standard stock"?
2. Do you have restrictions on who (what roles) can tag a medication as standard stock in our ADC software?
3. Who approves the requests to add a medication to the standard stock list? Do you use your Medication Safety Committee? P&T Committee?

Floor Stock In ADC

Christopher Walsh's picture

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Hello All,
For anyone currently using their ADC's to store floor stock items (i.e. Hydrogen Peroxide, petrolatum, povidone-iodine solution, etc.) what has been your approach? Build out each product to vend individually or have a section reserved for them similar to a bulk med drawer? Thanks in advance for any information you can share.

Chris

Medication continuous infusions using vial plus bag

Dana Miller's picture

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Has anyone transitioned any high alert med infusions (pressors etc) to vial plus bag using a vial mate adapter or RIO device that the nurse could put together?

If you have, how did you mitigate any safety concerns?
If you evaluated and did not go that direction what led you to that decision?

Currently we have diltiazem and a couple of other meds but want to thoroughly consider before the system moves forward with additional meds, especially any high alert ones like phenylephrine. We also do this for antibiotics etc. so nurses are used to this process.

Height Measurement in Bedbound Patients

Perry Shafner's picture

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We had a recent error involving an erroneous height (3 feet), caused by incorrect nurse estimation. The patient was elderly and bedbound, which made it difficult to measure an accurate height.

How to other institutions measure height in patients that are unable to stand or lie straight?

Does anyone use knee height or demi-span (sternal notch to finger roots)?

If so, could you describe your process?

Thanks!

Low volume infusions - Carrier fluids

Emily Buchanan's picture

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This has been posted before but I wanted to check again - does anyone have a best practice for KVO / carrier fluids for low volume infusions? (e.g. concentrated furosemide, PCAs, insulin, heparin, etc.)

The system I work for doesn't have a great process for nurses to recognize when a patient may need a carrier fluid or ordering and administering the fluid. Some of the additional questions are:

Delivery of stat medicationsto the nursing unit.

jiptin mathew's picture

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Our facility currently using two process to deliver medications to the nursing unt. Using a pneumatic tube system and sending the medication Via pharmacy staff. we looking for a different process, that will ensure the on time quick delivery of STAT medications to the patient and would like to hear from others about the process you follow in your facility.

Thanks

Med Rec Techs

Carol Labadie's picture

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We are considering re-evaluating our med rec tech reporting structure and wondering how others manage these techs. I appreciate responses to the following questions. Willing to share the data if others are also interested. Thank you!

Racemic Epinephrine Shortage Strategies

Laura Monroe-Duprey's picture

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Inhaled Racemic Epinephrine is used as first line treatment for CROUP.
Given the busy RSV season, the timing of racemic epinephrine inhalant shortage is not good!!!

Does anyone have a strategy to prevent wrong route errors by using PF epinephrine ampules for nebulizer use ?

Or is there another strategy ?

thank you!

Laura

Heparin Bolus for Donation After Cardiac Death

Sarah Gallup's picture

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Wondering how other institutions handle the large heparin dose that is administered to patients who are undergoing Donation after Cardiac Death (DCD). The doses we see range from 30,000 to 50,000 units. Does nursing draw up the medication on their own or does pharmacy dispense via a high alert process? When is the medication administered in relation to the withdraw of the ventilator, etc...? We just want to make sure we have a consistent process that is safe for the patients. Thank you!

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