I am beginning work ISMP Best Practice 15. I work in a children's hospital.

1. How did you define opioid tolerant in pediatric patients?

2. How did Cerner hospitals incorporate this into their EHR?

Thank you for any input you can give.

I know there has been some discussion about block charting, but we are specifically interested how other Cerner users are putting this workflow into documentation. Also if anyone have policies they would be willing to share as well this would be greatly appreciated!

Thanks in advance!
Melissa Robertson PharmD, BCPS
UofL Health

It has been a few years since anyone has asked the question, so I'll give it a try! How do you dispense HDs that require crushing for administration via an NG tube? Let's assume it is a chemo, and there is no recipe for making an oral liquid. If pharmacy crushes the med and mixes it with water, how much water do you add and what BUD do you give the syringe?

Hi everyone,

I would like to reach out to see if any institution might have had experience on high load of medication request messages to pharmacy, and what strategies you have in reducing med requests (especially in nurse requesting cart fill medications that are already on the floors)

Looking forward to any feedback.

Thank you!

Amy

Hello all,

I just wanted to reach out to those institutions that have HIET protocols and use a more concentrated insulin infusion concentration (e.g., 10 units/mL) for those patients, and ask what safety measures do you have in place to help minimize the opportunity for errors with regards to the standard 1 unit/mL concentration in your hospitals.

Looking forward to any feedback.

Thanks
Jameika Stuckey
Univ of Mississippi Med Ctr

BD has released a software upgrade for their Alaris smart pumps under a certificate of medical necessity program to address previous recall issues. The upgrade also provides some clinical and security benefits, but is not yet FDA approved. We are interested in identifying organizations that are planning to implement the upgrade prior to it being FDA approved.

Sondra May, PharmD
Medication Safety Coordinator

Our ED provider group has concerns about delays in compounding of patient-specific weight-based levetiracetam for status epilepticus as it comes from our pediatric pharmacy satellite or from our central pharmacy (during limited hours on the weekends).

We have a technician that spends many hours preparing thousands of batched oral syringes each month of OTC items for our pediatric patients: Poly-Vi-Sol 0.25 mL, ferrous sulfate 0.3 mL, Vit D 1mL, and simethicone 0.6 mL. Since the syringe size is so small, there is no way to automate the process with a syringe filling pump or autowrapping label machine. Everything must be done by hand. I support drawing up exact doses of most pediatric oral liquids, but I would like to draw the line at OTCs.

Has anyone switched to tenecteplase as your primary thrombolytic agent for acute ischemic stroke? If so, did you take any steps to address the fact that there is a prominent dosing table on the inside of the box for myocardial infarction? See https://www.tnkase.com/dosing-and-administration/dosing-guidelines.html

Hi all,

We are an Epic based system and only have Beacon in our outpatient infusion side currently (not inpatient). I was wondering if anyone could share any safety improvements for using Beacon on outpatient infusion side. Specifically:

1. How do you document or keep track of interventions, changes to regimens, or pertinent discussions with MDs? iVents don't work as well in this setting because these orders aren't released yet and each time is a different encounter so it requires a lot of digging..