Since patient pain rating is subjective data, the American Society for Pain Management Nursing states that “the practice of prescribing doses of opioid analgesics based solely on pain intensity should be prohibited.” At our facility our nursing team would like to remove this practice by transitioning to allow other patient specific factors to also be assessed for more individualized pain regions. However, removing pain scale verbiage within PRN orders and maintaining compliance for nursing administration has been a challenge for our team.

Good morning! We are inquiring with other children's hospitals to find out if a parental consent is required for Synagis (palivizumab) administration. We currently require consent using an immunization consent form, but we are reviewing the current process to possibly remove the requirement for consent.

We are planning to improve ADR documentation on the patient electronic medical record.

Currently on our practice ADR is being documented under the Allergy section. (we are using Cerner)

I want to know how do you document ADR on your practice?
Is there a specific section for it? (Other than the allergy)
And Who’s responsible to document ADR?

I’ll appreciate if you can share a screenshot of your ( ADR Alert) window.

Thanks

Looking for those that use Cerner that can provide any details as to how you manage sharing a medication history platform with your provider offices. This is in regards to the prescriptions that populate on the medication history (RX bottle icon) versus the scroll entries that are not actual prescriptions. We are seeing prescription entries hang out in the med history that patients are no longer taking.

We are an ambulatory care pharmacy within a clinic that has an opioid use disorder program. The clinic is in the process of revising their procedures.

Pharmacy is looking for perspectives on the standard of care regarding maximum daily dose of suboxone. Are other pharmacies noting chronic use of greater than 24 mg/day?

Hello,
Do you utilize protocols in the Ambulatory setting? If so--could you give a few examples? Do you use an "Initiate Protocol" order?

We have several inpatient protocols, but have some providers interested in expanding to the ambulatory space.

Thanks,
Stacie Ethington MSN, RN
Nebraska Medicine

Hello All,

Hi everyone,
We just received a citation from TJC on our stroke survey for having incorrect medication routes ordered for meds in patients with nasogastric feeding tubes. Looking to see what tips/tricks/processes have worked well with ensuring proper routes end up ordered for these patients- i.e. is it a provider, nursing, pharmacy responsibility...or all of the above? Thanks!

Good afternoon, I am curious to know how other hospitals handle the ordering, distribution and/or storage of skin and wound care products. For example, our facility carries multiple moisture barrier products such as Calazime and Hydraguard, and several different types of medicated dressings. We have an algorithm on what to apply when, to guide nurses and providers on usage.

My questions are:

We’ve recently been reviewing how our organization orders free water for hypernatremia in Epic, and is interested in learning about how this is performed in other organizations.

How does your organization place orders for free water for the indication of hypernatremia? Where is the order placed, who reviews the order, and how is administration documented?

Thank you

Matthew Beaulac

Matthew.t.beaulac@lahey.org