UpToDate references bactrim components as "trimethoprim-sulfamethoxazole", while the packaging on the products themselves are labeled as "sulfamethoxazole-trimethoprim". As the dose is based on the trimethoprim component, does anyone list trimethoprim first in their electronic health record? We can see why there are discrepancies/confusion between resources.
Thank-you, Heather Dell'Orfano
Brigham and Women's Hospital, Boston

Hi Everyone,

We've had some debate recently about the best way to enter medication patch orders when multiple patches are required to make a dose (ex: fentanyl 12 mcg + 25 mcg to make 37 mcg). Does your institution prefer one order to account for all patches or separate orders for each patch? What is the rationale?

There are definitely pros and cons to each approach, but I can't seem to find that one is preferred over the other in the literature. Thanks for the help!

Are any other organizations administering cerliponase alfa (Brineura) and if so, can you provide details around your pump configurations (specifically, pressure settings)? Anyone using/exploring use of an Alaris pump?

Hi,

Wondering if your institution uses StrataGraft for treatment of adults with deep partial-thickness burns?

If so, is the department of pharmacy involved in any way (i.e. purchasing, storage, distribution)? If not, who has ownership?

Thank you!
Frankie Mernick, PharmD, BCPS
Pronouns: She/Her/Hers
Drug Policy Coordinator
Massachusetts General Hospital

We currently allow selective autoverification in our Emergency Department (Cerner). We have additional opportunity to move towards an even more selective application of this process. We want to formalize and expand our criteria that would automatically exclude an order from autoverification. Per ASHP's Autoverification Toolkit, examples for consideration include pediatric orders, allergies, DDI, high-alert meds, and verbal orders.

Does anyone have an autoverify policy and/or list of meds/classes that are ineligible for autoverification that you can share?

Hello,
I was looking to see if anyone has any benchmark in place to limit the use of manual scan rates. Our EHR accepts the rx number as a manual scan rate but this is a safety issue as it does not verify the correct drug via NDC. When looking at scan rates for nursing most have very low manual rates but there are a handful of nurses with a much higher percent of manual scan rates. Our combined manual and scan goal is for the nurses to be 98%
Thanks,
Nancy

Does anyone have any best practices around ensuring 3-mL syringes are used to prepare 3-mL NICU doses?

We’ve had incidents of 3-mL doses dispensed in 5-mL syringes. The ordered rate was less than 0.1 mL/hr. Because the Alaris syringe pump cannot deliver a flow rate lower than 0.1 mL/hr from a 5-mL syringe, the doses had to be sent back to be prepared a second time in 3-mL syringes.

We are thinking about including syringes as components to be scanned when Dispense Prepping NICU mixtures in Epic but are running into some workflow challenges with that.

Hello everyone! We are wondering what other institutions that use CADDs for epidurals are doing due to the current CADD shortage. We are trying to switch to bags but can't find the correct tubing. Would love to hear if other institutions are running into the same problem and how they are managing this shortage.

Thank you so much!
Christine

To all,

I received a request regarding multiple use, commercially produced eye drops and the assigned beyond use date should be 28 days. I have seen the data regarding expiration of multiple use eye drops when administered to multiple patients in the healthcare settings.

Practice Setting: Long term psychiatric hospitalization in the State of WA. Most patients are admitted greater than 30 days. Not currently a CMS certified facility.

Current Practice for dispensing commercially prepared eye drops: