Hello! I was wondering what strategies are being used at other facilities to improve IV pump compliance? Our compliance rates are dropping and I am trying to determine strategies to improve this with our nursing team. I appreciate any suggestions!

Our NICU wants to switch to NeoMed ENFit supplies.

After reviewing ISMP articles and other documentation, I'm concerned that this may not be the safest path to go. Even with the low dose tip, it seems there are concerns dosing variances higher than legacy male tip oral dose syringes. Yet, when I go to the manufacturer's website, their main focus seems to be neonates.

Any thoughts from any of you who have already been down this road?

Any effective strategies out there for preventing the wrong med from being refilled in ADCs? We use Pyxis ES. Occasionally these events are matrix drawers, but this frequently happens with cubies as well. Our tech-check-tech process is that one tech pulls the med from our pharmacy stock and a different tech refills the ADC. As far as I know, Pyxis only allows scanning of one med when refilling each pocket. And it can be difficult to impossible to find out which staff members were involved, what the contributing factors were, the initial cause, etc. Any ideas?

With ISMP's survey results about the implementation for the newest two best practices for hospitals, it is brutally apparent that many of us have a long way to go with opioid stewardship. Specifically with identification of opioid-tolerant vs. opioid-naive patients prior to verification of extended released opoioids. Only 15% being fully implemented.

With Sapphire pumps halting manufacturing next year, we are in search of what others are doing regardless of if you use these particular pumps.

1. What pumps does your hospital/system use for epidurals?
2. Does your epidural pump have the capability for interop with the EMR. We are interested specifically with Cerner, but any would be useful.
3. If you utilize the PCA module (for example with Alaris), what interventions are in place to avoid wrong route administrations?

Thank you in advance for your responses.

Now that we are several years into coming up with risk assessments for hazardous drug handling, and now we even have a new NIOSH list pending, I am wondering where hospitals have settled on hazardous precautions for the preparation and administration of phenytoin and fosphenytoin.

This specific issue may not be clinically significant, but I wanted to inquire if others have developed standards for labeling OTC vitamins with multiple ingredients. We recently encountered a bottle of Vitamin D 10 mcg that had both Vitamin D and calcium listed under the "Supplement Facts" portion of the label. Percentage of RDI was 50% for Vitamin D, and 2% for calcium (25 mg as calcium carbonate). All would have been well, except the front of the label contained Vitamin D with no mention of calcium.

Hello,

Do you allow providers to order insulin in the primary IV?

We allow insulin to be infused via an IV insulin protocol, and a TPN protocol both with monitoring parameters. However, when does adding insulin to the primary IV become an insulin infusion? Is this allowed at other hospitals? If this is allowed, is monitoring required? Please share your thoughts?

Thanks
Dale

Good evening,

We are in the process of evaluating how to incorporate investigational drugs into our smart pump library (Alaris) and would love to learn how others handle this type of infusion.

1. Do you add investigational drugs to your smart pump library?

2. If so, how? Are they incorporated within your general care area profiles with unique naming nomenclature (i.e. IDS___), within an investigational drug profile, or through another mechanism?

Greatly appreciate any and all advice you would be willing to share!

Thanks!

Good afternoon all, (I am sorry for the typo on the other posts)

Hope all is well and Safe. ISMP recommends not putting NMBs on override in ADCs and use kits if possible. Can you please share how did you setup your NMBs kits (if you use them)? what are the contents of each kit? where do you store them? are they on override? who have access to them (only anesthesia or there is no restriction)

Thank you so much for your help and insight.

Sincerely,
Mohamed Sarg