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

Hi everyone! We use Kitcheck at our facility for replenishing and dispensing code trays and intubation boxes. How do you ensure that the visual check is being done?
Thanks!

We have both an adult and pediatric hospital and have been approached by our Peds ED to allow for the RN to reconstitute and administer partial vial/pt specific doses via IV push to improve turn around time (meet 60 min).
-example - dose is 700 mg cefazolin. RN pulls vial, reconstitutes to standard conc, draws up pt specific dose, labels syringe and administers via syringe pump guardrails.

Can you share how your pharmacy labels intrathecal medication syringes that will be used on a sterile field? For instance, do you draw up the drug and place into a sterile sealed bag then label the bag? or do you place a sterile label on the syringe then place into a bag?
Thank you, in advance, for your help.
Cathy

Hello all

We are in the process of upgrading our current diversion software and are working on a functional requirement document to provide vendors for initial screening purposes. Anyone willing to share their current diversion software requirements?

Thank you advance for your consideration.
Amy

What is your institution's policy/practice around the use of sample medications? Does your institution have a policy governing the storage, distribution, and use of sample medications? If so, would you be willing to share this document?

Hi all,

Can you share your dual verification practices for a prn controlled substance pump bolus dose from a continuous infusion (non-PCA)? For example, at initial administration, dose change, at shift change, new syringe, change in pump, at every pump bolus administered, etc.

Thank you,
Brennan

We continue to see errors with insulin pump management at my health system, specifically when insulin pumps are removed because a patient is unable to operate during the acute stay. The error is that basal insulin requirements are not met as patients are usually put on only sliding scale as a transition. Re-education has not been successful and since it's a low-occurrence situation we are struggling to come up with a good solution. Does anyone have a good EHR driven (or other) process in place? One idea was to somehow force a 'time-out' but looking for other ideas.

The question relates to the instructions for the ceftriaxone 1 gram vial reconstitution instructions.
The instructions have you instill 2.1 ml of diluent into the 1 gram vial to get a concentration of 350 mg/ml. We have had several Nurses and Pharmacists complete this - each time the average final volume of the vial is 2.4 ml. You would need a final volume of 2.85 ml to get the required concentration.
These instructions are the same across the generic manufacturers of ceftriaxone and we have gotten the same results for more than one generic product and across lot numbers.