Now that Blincyto is on the NIOSH list:

1. Has any site been successful preparing with a CSTD?
2. If so, what CSTD/process is being used to prepare?

Hello everyone,

We are reviewing our ordering and dispensing process for Kcentra. Hoping to hear what the current practice is at other institutions.

1.Do you round the dose to the nearest vial size according to the nominal vial range (ex: 500 U range) or actual units of factor IX (ex: 569 units)?

Hi All
We still have IV promethazine on formulary (restricted to dispensing in IVPB bags from pharmacy) and our OB team is requesting to use IM promethazine for 'therapeutic rest' in some of our OB triage patients (patients not admitted, don't have IV access). They are citing the article below.

Obstetrical & Gynecological Survey
Therapeutic Rest as an Intervention in Early Labor: A Literature Review
September 2024 , Volume 79 ( 9 ), p 533 – 538

Good morning,
What workflow to you use in your sites for DepoProvera, since it is considered a HD?
a. stock a pre-filled syringe; needle applied for admin with full PPE
b. stock a vial; dose prepped using a CSTD and appropriate PPE
c. other (please elaborate)

Thanks!
Stacie Ethington MSN, RN
Nebraska Medicine

I would like to seek your experience and your current practice of the "NPO" orders in the system we are a tertiary care hospital, and we are planning to modify the current NPO order in the system.
Can you share your current practice regarding the following:

-How is authorized to place the NPO order in the system?
-What is the default duration on the NPO order in the system?
-what do the default indication build in the system for the NPO order?

Thank you,
Zainab ALZuhair, RPH, MSc, BCNSP, CPPS
Medication Safety Specialist

We are reviewing patients own medication policy, given hospitals cannot take possession of patient's-controlled substance per the DEA, nor can specialty medications be utilized during hospital stay per insurance companies.

I see previous discussion of either topic, however, I would like to get updated feedback encompassing the above. I am requesting input if you would be willing to reply to the following:

1. Has any institution established policy to not allow any patients own medication, whether to dispense or simply store?

Hello Everyone,
Currently the health system I am at uses 3 different therapeutic heparin infusion protocols across different hospitals with 2 protocols using aPTT monitoring and 1 using Anti-Xa monitoring with aPTT for patients on DOACs prior to admission and other indicated patients.

HI All

I am just wondering about your policy/procedure for neonatal RSI meds, specifically midazolam and fentanyl, if you allow IV push undiluted or if you are diluting and administering via syringe pump. It seems as though IV push should be utilized given the emergent nature of the situation, but our neonatal nurses are thinking they are supposed to use the syringe pump.

Thanks, Katie

HI All

I am just wondering about your policy/procedure for neonatal RSI meds, specifically midazolam and fentanyl, if you allow IV push undiluted or if you are diluting and administering via syringe pump. It seems as though IV push should be utilized given the emergent nature of the situation, but our neonatal nurses are thinking they are supposed to use the syringe pump.

Thanks, Katie

Are you using actual body weight or adjusted body weight for calculating heparin infusion doses? Does it depend on indication? Thanks!