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?

Our outpatient oncology team has noticed an increased rate of cutaneous reactions to docetaxel not related to a specific manufacturer or lot number, some requiring ED transfer or other intervention/escalation of care.

The package insert includes a warning regarding cutaneous reactions, but we were wondering if anyone else is experiencing a similar trend. We have assessed our docetaxel utilization to see if it might be related to an increased utilization over the past few weeks, but our utilization has actually decreased.

Thank you!

Our site has had requests to add several new insulins to formulary for use in pediatrics. There is concern for look-alike/sound-alike storage and dispensing errors by adding new formulations.

Our site was requested to add Fiasp (insulin aspart), Lyumjev (insulin lispro), Humalog U-200 (insulin lispro 200 unit/mL), and diluted Novolog (insulin aspart 10 unit/mL).

Can any sites share if they have utilized any effective strategies to minimize this risk? A few examples are noted below but would appreciate if sites can share any helpful practices.