In our IV guidelines, Adenosine is restricted to our progressive care unit and ICU. It is only allowed on the other floors for a RRT or a Code Blue. MD's are requesting we revisit this guideline and allow it to be pushed by a physician on a general floor if needed. Makes sense instead of having to transfer a pt just to break a SVT and then transfer back if they don't require higher level of care.

Do other institutions allow this practice? What are your restrictions on Adenosine?

Thanks!

Tanvi

We are an Epic hospital and have been seeing issues with patients receiving extra doses of medications because the nurses are "adding" doses to the MAR instead of moving/charting on the pre-populated due times. When they add an administration, it still shows up as due at the originally scheduled time. We had requested from Epic to remove the ability of the RN to "add" new due times, but they said this would impact the functionality for nurses to be able to give PRN medications.

Hello!

I might be overthinking this, but do other organizations have a stance on whether or not prescriptions can be sent to Canada directly from the office or handed to patients based on their request (to have them filled in Canada)? Or any sort of verbiage that they provide to patient when/if this is done?

Thanks in advance!
Emily

We are interested in the workflow organizations are using to apply an expiration date to fluid bags when they are first removed from their outer wrap. This is required by Joint Commission.

Is your workflow different for those bags stored in med rooms on patient units (these are currently supplied by our central supply services) vs. in central pharmacy?

Hi all, our hospital currently has outpatient oncology with one full time oncology pharmacist on staff. Our current practice is for our oncology pharmacist to perform first checks, and then an inpatient pharmacist performs a second check before the chemotherapy can be administered. After a recent conference, our oncology pharmacist asked if we were required to have a pharmacist second check when there is a full time dedicated oncology pharmacist on site.

I am wondering if any organizations have a standard process for code tray changes. We have a large quantity of code carts and we are looking to improve this process. For example, if a decision is made to add a medication to all code trays, how is this change made throughout your facility?

Thanks,
Rachel

Hello Medication Safety Leadership

We had a question that came up in our last P&T Meeting and wanted to hear everyone's feedback. Can Registered Nurse IV Push a neuromuscular blocking agents (IV Paralytics) on a intubated patient without physician at a bedside? There is some questions on whether this is within a registered nurse scope of practice.

Thank you!

Good morning everyone -

Reaching out to see if someone would share examples of communications or educations sent out to nursing staff regarding smartpump updates. We aim to do about monthly updates to the pumps and are trying to figure out the best formats and amount of information to share with staff regarding these updates.

Thanks

Hello all,

Would anyone be willing to share (especially if you have Alaris pumps) how you have Acetylcysteine infusion built in your smartpumps? Considering the concentrations and the dosing, it is quite a beast. Would love to know what you all have done!

As always, truly appreciate any insight you may have!

Jameika

Jameika Stuckey. PharmD
Univ of Mississippi Med Ctr
Jackson, MS

There has been some discussion in our institution about re-instituting a weekly order "rewrite" in the EHR similar to what was done back when we were on paper.

The thought that some have is that this will eliminate some of the errors we are seeing in relation to timing and meds "falling off the MAR."

I've been arguing against this practice as I think it will increase other errors and increase workload for all (physicians, nurses and pharmacists).

Can you provide me your pros/cons for this practice as well as any supporting literature?