Hello everyone,

I am curious to learn more about policies/processes involved with Medication History/Inventory in systems with both ambulatory medical offices and inpatient facilities using the same EHR.

What we are currently challenged with is the very different approach these two care areas tend to require (see example below).

This really complicates maintaining a clean medication list as orders must be continually reconciled from split line items to singular orders and vice versa.

Hi All,

When sending outpatient chemotherapy prescriptions, do any of your institutions require an attending and/or chemotherapy authorized prescriber signature (i.e. a second signature if prescription was originally written by a resident)?

Thanks,
Courtney

Courtney Doellner (Carroll), PharmD, BCPPS
Clinical Pharmacy Specialist – Pediatric Medication Safety Officer
cacourtn@med.umich.edu

Are there any institutions that permit range orders for PRN medications? More specifically, ranges in dose (not frequency). If so, how are these range orders interpreted when it comes to times of administration?

For example, if a patient is prescribed oxycodone 5-10 mg PO q6 hours PRN pain, the patient is administered one dose of oxycodone 5 mg at 0900 and then another dose of 5 mg at 1200 because their pain is not controlled, when can they be administered another dose of oxycodone? Is it from the first dose of administration or from the last dose administered?

For those who have Lumason on your formulary for ECHO - what is your policy for pregnant patients or females of child-bearing age?

We added Lumason to our formulary about a year ago and did not specifically address this population. While we are doing a thorough literature search to evaluate risks vs benefits, I thought I would see if others have addressed this. Thank you for your time.

Carol

Hello!

Do any sites have best practices for alternatives to barcode scanning of a patient's identification wristband prior to medication administration in order to perform barcode medication administration (BCMA)? There are some special patient populations, including patients in behavioral health, who need safe alternatives to patient identification wristbands. What highly-reliable alternatives have you observed that can help ensure that the right medications are administered to the correct patient in the absence of a patient identification wristband?

How is everyone else setting up their REMS programs?

Do you have specified people who have a delineation of roles (ensuring that all aspects are incorporated, education, auditing, electronic rules, etc.)? I'm looking to set something up that can become hardwired and not reliant on periodic audits.

Thank you,
Joel

Good Morning,

Our lab just changed their instrumentation and started using the Ortho VITROS® XT 7600. The reference range for Vancomycin changed from 10-20 to 5-10 and we were told we can not modify it. Does anyone else's lab use this instrumentation and how have you been able to integrate this change clinically. Were you successful in changing the reference range?

Thank you!

Natalie Zilban
Medication Safety and Pharmacy Officer
Memorial Healthcare System

Hello!

Looking to resurface these medication administration topics...
Curious for each:

1) Labeling lines
- is this a requirement / spelled out in policy?
- are nurses compliant?
- do you use colorful stickers (a different color for each drug)?
- do you provide printed labels or are they handwritten?
- where are stickers placed?
- any higher leverage strategies in place to increase compliance?

Greetings!
I didn't see anything recently on this topic - But wondered what other organizations were doing with diluted insulin for their littlest patients.

Trying to figure out the new EUA for Remdesivir for peds. More specifically the fact that EUA seems to addressthe following 3 out of 4 groups in terms of dosing:
1. > 12 yo and >40 kG - FDA approved
2. < 12 yo and > 40 kG
3. < 12 yo and < 40 kG
What do we do for 12-18 yo pediatric patient who weighs < 40 kG?