Hi all,

Wondering if anyone else has come across this issue and/or what your policies are:

Turns out our infusion nurses are often running IVIG concurrently with IV fluids for "patient comfort/minimizing side effects." This is definitely not done on our inpatient side (we would simply decrease the infusion rate). We mostly use Gammagard liquid and Privigen, and neither one has information on concurrent IV fluid administration or compatibility information.

Leapfrog has a proposal to expand their reporting requirement of BCMA to procedural areas. In giving this some serious thought, a number of challenges become apparent and I'd like some feedback from the MSOS community to better understand if these are specific or general challenges.

There's no question regarding the benefit of expansion of BCMA into the procedural areas - and it is largely implemented in our facilities. The true challenge comes with reporting BCMA activity, and that strikes at the heart of Leapfrog's query: should reporting be expanded to include these areas?

Would anyone be willing to share their Medical/Surgical standards for documenting patient weight in their organization?

There are best practice recommendations regarding documentation on admission (in metrics only), but most of what I can find for frequency after admission includes the organization setting their own standard for subsequent weights.

Interested in what other facilities require as we are seeing pushback from our Med/Surg nursing division about re-weighing patients.

Thanks!

Wondering if facilities are drawing up patient specific doses for retacrit or sending vials? Had an incident where 2 vials were send and only one vial administered giving the patient only have the needed dose.

Hello,

For hospitals where pharmacists order TPNs, how do you ensure an independent double check?

Our TPN pharmacists enter TPN orders, verify their own orders and then transcribe that info for CAPS. We have have seen incidents of transcription errors likely due to the lack of independent double check.

Would love to learn more about everyone's TPN workflow!

For hospitals with a beta blocker/calcium channel blocker toxicity order:

What concentration is your insulin drip?
What size is your bag?
What is your rationale for the size bag?

We are rolling out our EPIC Ambulatory MAR and wondering what other institutions have done with nursing dual sign offs?

Our clinic ambulatory MAR (for the most part) currently uses all of the “inpatient” medication configuration settings. Curious to see what other institutions have done with their implementation. Thanks!

Jenni Shahan, PharmD, BCPPS
Medication Safety Specialist
WVUMedicine

Hi there - what are other institutions doing to prevent IP Alteplase being given IV? Giving ONLY in non-luer lock syringes? Utilizing other types of syringes? Thanks Much appreciated

Dyan Fleming
Oklahoma Children's Hospital

I wanted to re-address this question since it has been a few years since it was last asked. What container does your Pharmacy dispense unit-dose nebulizer medications in if not available commercially in unit dose? Looking through past questions it seems some of us have utilized containers such as sterile eye drop bottles and slip tip syringes. 60 mL Aerogen syringe specifically says 'for continuous nebulization' on it so thinking that is not an option? Wondering if there are any other solutions out there. Thanks in advance for your expertise!

Now that it is generic, we are struggling to get prasugrel in unit-dose form and the bottles state "keep and dispense only in original container". Have struggled with a response from company so I was wondering how everyone is handling this.

thanks in advance!