Any sites have pain/sedation kits for trauma cases coming into the ER? Recently we had a very difficult to sedate and delays obtaining the medications for a trauma patient. The ER and trauma surgeon are requesting a kit containing pain and sedation medications for urgent/emergent use, like the RSI kits. Example medications requested are fentanyl, midazolam and ketamine. 

The RiaSTAP package insert states, "Before administration, filter reconstituted RIASTAP solution with a 17-micron filter (not supplied) into an appropriate syringe."
Please share how you are doing this, where you are obtaining a 17 micron filter and if you are using syringes vs empty bag. If syringe, are you using a syringe pump?
Does your OR reconstitute their own and how do they filter it?
Thanks!

Good afternoon,

I recently had an issue where a patient was refusing doses of his anticoagulant. Per policy the nurses were indicating the doses were omitted on the MAR, but the physicians doesn't routinely view the MAR so he wasn't aware.

Does anyone have a policy that address a situation like this and provide guidance to nurses on when to contact the physician and make them aware?

Should such a policy address the number of refused/omitted doses?
Should such a policy take into account the type of medication involved?

Thank you ~Jennifer

Everyone's favorite hot topic, with a slightly different twist...

Thanks in advance for anyone who is willing to share and/or help us with this issue that seems to be a consistent (& persistent) focus for JC and one that we continue to post on on this site (thankfully).

We are in our JC window. We've had 2 mock surveys this past year, both of which always find something with titration orders albeit not always the same issue.

For those that have already done this, or are in the middle of mitigating this:

We appear to have some buy-in with oxytocin regarding the ISMP best practice, but we have not seen movement on the last portion of the recommendation in the actual data. It reads, "avoid bringing oxytocin infusion bags to the patient's bedside until it is prescribed and needed."

What have you found that can help change hearts and minds in this arena? Are there posters or something that someone can point to that would help?

Does your health system or hospital have a pharmacy-driven vaccination protocol for inpatients (influenza and pneumococcal)? Have you experienced any barriers? Would you be willing to share your protocol?

I am new to an institution that uses Cerner and trying to understand its build in relation to a problem I hope you can help me with.

For those that use Cerner do you have issues with viewing trade and generic names together?
We have several medications where if the trade name is ordered it does not display with the generic name.
This led to a patient having the same med ordered twice, one as the trade and one as the generic and received several doses before this was picked up.

In trying to solve the issue I was told it has to do with building the IV set

Wondering if anyone knows why Aminoglycosides are not on the NIOSH list since they are known to cause ototoxicity to the unborn fetuses?

what does your hospital do when administering amikacin/tobramycin as a nebulization?
Do the parents/guardians leave the room? what happens to the next patient/family in the next bed?

We are an Epic health system and recently implemented a best practice advisory prompting an oncology consult when a provider tried to continue a home oral chemotherapy during admission med reconciliation. We still have instances where the oral agent was continued without the consult or was continued upon discharge with discharge med rec. Has anyone blocked ordering to just oncology or have a different solution that has worked at your location?