Besides evaluation of reported events, how do improve safety with anticoagulants? Do you use triggers? If so, what do you measure, monitor, and report? What successes have you had in preventing harm with anticoagulants?

Wondering if anyone has guidelines for when RPhs and techs should submit med error reports? If the error leaves the pharmacy? If it reaches the patient? If it has the potential to cause serious patient harm? I'm working with Quality to come up with a reasonable standard.

Thanks!

Hello safety gurus,

I hope this message finds you well. I am reaching out to see if anyone is willing to share information regarding medications that require dual checks/signoffs at your respective institution.

A few things would love to receive include:
1. The included medications or medication class
2. If you are willing to share your policy/policies
3. Which EMR you have and any EMR specific build around this you may have performed
4. Do you just involve nursing or is pharmacy included as well

Our system is approaching a project to integrate smart pumps (ICU Medical) with our EMR (EPIC). It would help to understand how others answered the question about nominal vs actual volume for large volume parenterals (LVP) and small volume parenterals (SVP). Our concern is greatest in the outpatient infusion center population where standard overfill in bags and medication additives, if left unadjusted, results in longer infusion times and shrinks capacity for treating patients.

Hello,
I would appreciate anyone that could share their push-dose pressor policy. We are in need. Thanks!

For ED nurse triage protocols, does your facility narrow the focus in terms of the population of patients who are candidates for certain meds?

TIA :)

For use of lidocaine infusions for pain within enhanced recovery after surgery (ERAS) workflows, comment on your practice regarding:
(1) Any restrictions (eg. criteria for use/specialty/population/dose/duration)
(2) Any required monitoring (eg. neuro checks, lidocaine levels, etc)
(3) Your standard dosage form and concentration for infusion
(4) Smart pump safety strategies outside of Guardrail file limits
(5) Any additional mechanisms of medication security

Terry Bosen, MSO
Vanderbilt University Medical Center
Nashville, TN

We have limited storage of 23.4% sodium chloride to pharmacy, but are continuing to receive requests to have it available for emergent use in the NeuroICU, ED, and IR.

We are interested in learning about safety strategies employed by others who have elected to make these available via an automated dispensing cabinet outside of pharmacy.

Thank you for any information you have to share about your experience.

Sondra May, Pharm.D.
Medication Safety Coordinator

We have limited storage of 23.4% sodium chloride to pharmacy, but are continuing to receive requests to have it available for emergent use in the NeuroICU, ED, and IR.

We are interested in learning about safety strategies employed by others who have elected to make these available via an automated dispensing cabinet outside of pharmacy.

Thank you for any information you have to share about your experience.

Sondra May, Pharm.D.
Medication Safety Coordinator

Our health system is looking at allowing clinicians to hold medications from the manage orders activity in Epic. I'm looking for some feedback from other facilities that have implemented this functionality in Epic.

1. Are there any medications that you do not allow to put on hold (e.g,
anticoagulants, antibiotics, TPNs, etc.)?
2. What time limit did you set for the BPA reminder to fire? (Epic default is 72
hours)
3. Have you seen any issues or errors with this functionality?