Good Afternoon,

Greetings,

Our organization is reviewing our ADC override policy and procedures and would like to benchmark what other organizations are doing. I created this quick 3-5 minute survey to get some insight of the practice in other organizations. I can also share this to anyone that is interested in the data.

https://childrens.surveymonkey.com/r/ADCoverrides

Thank you in advance,

Jay

Hi Everyone,

It's that time again!

Hi All,

Looking to connect with an organization that has implemented the ISMP best practice around requiring 5 Letters/Characters during ADC drug searches via override. In reading past MSOS threads, most were still in the planning phase or stepped back from 5 characters to 4.

Please share in this thread any learnings or feel free to email me directly! I am also happy to set up a quick chat if that's easier.

If you are starting to look into this for your organization, I pasted some quick references below to get you started.

Interested in other organizations process and policy on dispensing one dose in multiple syringes (i.e. large doses of subcut insulin, chemotherapy regimens):
1) If a single dose requires multiple syringes, do you require separate line items on the MAR?
2) Are you using one label for both syringes or labeling both with the same label and indicating 1/2, 2/2, etc?

Any insight would be appreciated!

Can anyone comment on anesthesiologists infusing oxytocin wtihout an infusion pump in the OR setting after the baby is delivered? We're finding that in our 8 hospital system, this seems to be standard practice by them. I'm curious what others and ISMP have to say about this.

Thanks in advance,

Hello all. we have recently had several reports from our Cath lab of patient's requiring high doses of heparin to attain therapeutic ACTs. We have perhaps found a correlation between this and a new heparin product we are stocking > Meitheal Heparin 10,000 units/10 ml vial. We have seen doses reported as high as 24,000 units to attain an ACT > 300. Has anyone else encountered a similar issue recently?

Hi,
The notice about mislabeled isoflurane sent by ISMP made us realize that the way our gas machines are filled results in potential mixed lots and expiration dates without anything indicating it on the machine (arghh!)

Has anyone worked through this problem and come up with good solutions with your anesthesia folks? Also interested in how people handle partial bottles, storage etc.
We currently have them (isoflurane and sevoflurane) in our OR ADC but I'm thinking that may not be optimal in the event of a spill or breakage.

How are orders built to provide a time for preop antibiotics? We use Epic and have a frequency of ON CALL or PREOP. The order still populates the MAR with a start time so we are seeing an increase in antibiotics being given early. I would love to hear how others have addressed this.

Hi everyone,
We are trying to be more proactive in catching overrides that don't have orders/aren't documented/aren't wasted, especially with agency staff who might not come back for days.
Years ago I worked with AcuDose and it was very easy to run an override report on demand, or schedule it to be printed on the unit. The charge RN would run the report at shift change and anyone who had an override had to sign off that it was complete before they left for the day. We are struggling to find a similar workflow for Pyxis.