Hello,
Does your hospital employ any particular safety strategies in the eHR build of IV sodium bicarbonate to ensure the resulting solution is not too hypotonic? For example, does it block sterile water or D5 from being used as a base solution? Any insight would be appreciated. Thank you.

Hi All
We currently have both an adult and pediatric hospital. Digoxin is considered high alert (both oral and IV) for our pediatric patients but it appears that our practice is out of date. Our digoxin order set is not used and needs updating, but I am curious if digoxin is considered a high alert medication for pediatric patients at your institution and if so what are the strategies that are used to help mitigate potential harm? I am looking for some strategies that other hospitals are using for digoxin in pediatric patients to help improve safety.
Thanks!
Lindsey

Looking for ideas on how patients’ discharge or transferred meds are removed from patient unit/patient bins, prior to the next patient arriving? Is this a nursing responsibility, pharmacy responsibility or shared responsibility at your institution? Any reminders used for this process?

Hi Everyone,

Wanted to ask if any of you have a safe and pharmaceutically appropriate way to dispense oral cyclosporine solution to inpatients. Apparently the oral solution is only available as a bulk bottle and only comes with a single syringe (which is not EnFit tubing compatible) and is the only oral syringe recommended by the manufacturer for administration.

Thank you! Alex

Do other facilities have a nursing protocol for basal rate titration of a PCA? Would appreciate any input as to why your facility does or does not allow this practice.

A couple of questions:
1) how often do you re-evaluate and recommend changes?
2) Is anyone willing to share their list, we are trying to expand ours step-wise?

Has your organization ever been cited for failure to perform First Dose education?
Do you monitor this metric, and if so, how do you do it?

We use Epic and do have a report built but it is noisy and aren't having much luck making positive improvement in compliance.
Thanks,
Stacie Ethington MSN, RN
Medication Safety Nurse Specialist

Hi - my org uses Pyxis ES and in compliance with ISMP Targeted Best Practices, has an alert that fires when a user attempts to remove any paralytic.

I am curious how other orgs have similar alerts configured because we cannot figure out a way that does not have an option that allows user to bypass confirming patient is intubated/sedated or backing out of system.

My automation team tells me options are:

1. Alert with desired text, then user options of "Yes", "No", and "N/A" - and they say "N/A" option cannot be removed

Hello / Happy Friday!

1) Just wondering if any other organizations have rolled out BCMA - bar code scanning in their Ambulatory Clinics? Would be interested in connecting / networking to learn!

1a) Do you wristband all patients?

2) Also, anyone else have any experience with AccuVax in their Ambulatory offices for Vaccine management?

Given the new ISMP 2022-2023 best practice recommendation to standardize oxytocin concentration for both labor & delivery and post-partum, have any institutions successfully done this or already use one concentration for both indications?

We currently use 30units/500mL for L&D dosed in milliunits/min. Post-partum, once the anterior shoulder is delivered, we switch to oxytocin 20units/1000mL bag which is dosed in mL/h.

If you use one concentration, do you use the same dosing units (milliunits/min)?