Hi All
We missed this and were caught off guard by the albuterol 20 mg/100 mL shortage. We use this to make our cont nebulizations of albuterol, especially for our pediatric population. Right now we have to open up 40-50 of the 2.5mg/0.5 mL ampules to make the nebs, which is less than ideal and a huge time suck. How are others handling this shortage? Of course it is now back to school and we're getting quite a few kiddos with bronchospasms d/t all the viruses and smoke (fire season here).
Greatly appreciate input!
Thanks
Lindsey

We recently had a potential error where a patient was recieiving mag (20gm/500mL) for pre-eclampsia who was also receiving maintenance fluids (LR) at the same time. The provider instructed nurse to turn of LR as the patient had a high urine output. Nurse was under the impression that magnesium must be infused concurrently with fluids to minimize irritation/infiltration. Our order sets/guidelines do not state this.

Have other institutions encountered this? It doesn't appear to be in any guidelines...is it just a best practice? I have not heard of this practice before.

I am looking for practices that other facilities are doing in regards to the administration of IV push diazepam. The dosing administration instructions and other compatibility references state not to mix with other solutions or use as a continuous infusion and the y-site compatibility info is not clearly defined either. Does anyone else have specific guidelines for diazepam administration at your institution? In particular, doing a slow saline flush after undiluted administration? Diluting to a least a 1:20 ratio as stated has been done(according to Trissel's without precipitation?

We have been using the same modified Del Nido Cardioplegia solution "recipe" for a few years now without incident. Today we had reports from perfusionists that they feel our solutions "aren't working as well". This is the first we've heard of this and the solutions we had analyzed were spot on for active ingredients. As a result, I'd like to see if anyone can share the recipe(s) you use?

Has anyone been cited during a survey for using Silent Knight Pill Crushers on nursing units? Our institution does use the pill sleeves. Was warned recently that these might not be compliant. Has anyone had an issue and what do you use instead?

We are seeing an increased usage of intermittent IV ketamine for non-sedation indications like pain and agitation, especially in our movement disorder patients. Does your site allow nurses to administer intermittent or PRN IV ketamine? If so, what parameters are used to distinguish from mod-deep sedation? Can you share your policy? Thanks! -Melody Sun, CHOC Children's

Does anyone have a process for oral chemo monitoring they would be willing to share? How do your pharmacists or nurses document monitoring? How often do they monitor (daily? weekly?) Do you have any formal oral chemotherapy agent monograph they use to determine monitoring and adjustment parameters or use drug references like lexicomp?

Thank you in advance,
Mara

Good afternoon,
We are preparing for EHR-Infusion Pump interoperability and wanted to know if anyone did an FMEA prior to their interoperability implementation. If you did do you mind sharing with me?

For outpatient/ambulatory settings, what is your process for treatment of anaphylaxis? Do you stock anaphylaxis kits w/vial, epi-pens, singular items in your regular med storage? Do you have standing orders in place?

Intrigued at what other institutions are doing well that we can learn from as we analyze our processes.

Thanks!

Hello,

Has anyone ever reviewed their list of repackaged medications to ensure they are suitable for repackaging (i.e. moisture degradation, light sensitivity analysis). If so, I'd be curious to learn how you went about doing it?

Our health-system repackages around 650 different medications and we are about to begin a full audit.

Thanks,
Nowshin