we use a common vial that is located in the Omnicell.
The nurses are pulling the insulin doses up in the medication room, returning to the Omnicell. However, the label printed on the Omnicell printer is too big- the nurses are complaining that the insulin syringe is covered with that label - making it unsafe for the insulin unit reading when in the room. How are your nurses handling the labeling ?

Hi-
We are in the process of creating an IM Mag kit for eclampsia and have come across the issue of how to administer the 10 gram dose. All sources says 5 gram per buttocks which would be 10 mL on each side, but they don't further detail how many injection sites are used. Has anyone been able to get away with just two injection sites or are you having them further subdivide each 5 gram/10 mL dose into multiple sites?

Also, do you have them mix with lidocaine or just administer straight? I'm thinking the admixing on the floor may make this too complicated.

Hi-
We are in the process of creating an IM Mag kit for eclampsia and have come across the issue of how to administer the 10 gram dose. All sources says 5 gram per buttocks which would be 10 mL on each side, but they don't further detail how many injection sites are used. Has anyone been able to get away with just two injection sites or are you having them further subdivide each 5 gram/10 mL dose into multiple sites?

Also, do you have them mix with lidocaine or just administer straight? I'm thinking the admixing on the floor may make this too complicated.

Hi All,

Hoping to gain some insight on what is being done at other hospitals regarding the use of heparin infusion post-procedure. We use Meditech expanse EMR, but happy to hear about workflow using other EMRs.

At my site, we're seeing issues where heparin is not being resumed after a procedure. Our heparin protocol is nursing driven, and nursing has a protocol for holding heparin prior to IR procedures only.

1. When heparin is placed on "hold" in the MAR, who is responsible for resuming heparin after a procedure?

Anybody have a good process for dispensing non-formulary home meds from a patient's pill pack?

Good morning,

Wondering how other facilities are handling this. We have an orderset for newborns that has hep b vaccine (among a few other things) pre-checked and thus ALWAYS ordered unless provider unchecks which is rare to never. Of course, Hep B administration also requires parental consent to administer. So it could happen that the vaccine is ordered but the parents do not consent. How do other sites handle this? Any information would be helpful.

Thank you,
Lauren Boc

Good morning! We have had several events in which an order was verified for a medication stocked in a dispensing cabinet with a high dose/excessive dose units (e.g. 10 unit-dose oral syringes). I have seen a functionality in Cerner before in which a pharmacist receives a personalized alert when verifying an alert that is dispensing an excessive amount of tablets/syringes/etc. Does anyone have an alert like this built in Epic? If so, what is your threshold for the alert to fire to a pharmacist? Thank you! Jordan Anderson, Driscoll Children's Hospital

We are evaluating our processes for dispensing and storing large-volume fluids containing Potassium Chloride (KCl) and are seeking input from other institutions on the following:

•Are these fluids supplied by pharmacy or central supply at your organization? If your organization uses a mixed approach, do you have a defined potassium chloride (KCl) threshold—such as 20 mEq—where products at or below that cutoff are supplied by central supply, and products above are provided by pharmacy?
•Are these fluids stored in Automated Dispensing Cabinets (ADCs) at your organization?

Hi all - We are working on an adequate sedation during use of iv push paralytics initiative. Does anyone use an intubation checklist with line items for adequate sedation for induction as well as post-intubation? If you are able, I would love to see copies of your checklists as we are looking to revise ours. Thank you in advance!

Lara Ellinger, PharmD, BCPS
(she/her/hers)
Medication Safety Program Manager
Northwestern Memorial HealthCare Quality and Patient Safety
laelling@nm.org

Good Afternoon MSOS Members,

Any site added an ultra short acting, Remimazolam (Byfavo), to the formulary for induction and maintenance of procedural sedation in adults undergoing procedures <30 min (Instead of Propofol)? If so, would you mind sharing your experience?

Thank you,

Manisa