Good morning all,

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

Good morning all,

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

Good Morning,

Does anyone have guidelines or references on medication administration via central or peripheral line?

With the shortage on dopamine 400mg/500ml which we standardly give peripherally, want to know if it is possible to safely use other concentrations such as 400mg/250ml via this line.

A document with this plus other meds would be helpful to try and devise something at my facility.

Thank you
Hera

Submitting on behalf of a pharmacy student on rotation with me:

Hello,

My name is Kwesi Sefa and I am a 4th year pharmacy student at Shenandoah University. I am currently on my APPE rotations at Johns Hopkins Hospital with the Pediatric Medication Safety officer, Dr. Meghan Rowcliffe.

Hello down there,

We just learned that Vyaire discontinued the distribution to Canada of the 1L sterile water rigid plastic bottle we were using with our Optiflow nasal high flow therapy as a risk mitigation for 1 L bags. This was our only source of this format from Canada. Wondering if anyone has alternative source in your country we could inquire with the manufacturer for distribution here?

Two litre bags are not ideal for the respiratory therapist because of the added weight and possibly increasing waste, but remain an option.

Thanks!

Hi all.

I am working on revamping our High Alert medication policy and came up with a few questions...

1. Is digoxin included in your high alert med list? Do you require a nursing assessments prior to administering such as heart rate? dig level?

2. Do you require an administration co-signature (an independent 2nd check) for insuliln? Do you standardize how these independent 2nd checks are supposed to happen?

Good afternoon,

I was wondering if any institutions are drawing up commercially available IV fluids for neonates in 50 mL syringes? Our NICU requested that pharmacy makes 50 mL syringes for 6 commercially available IV solutions (examples: D5W-0.225% NaCl, D10W) for our neonates who weigh

How detailed are safety event review policies at your organization? Do policies list every step in RCA/ACA process? Anyone willing to share policy/workflows?

Do you store boxes of alcohol swabs in a flammable cabinet?

We store bulk bottles in the flammable cabinet, but I never thought about the swabs until the question was posed to me recently.

If you do, was a recommendation from CMS/DNV/TJC or a state board inspector or based on other data. If you intentionally do not, I'd be interested to know about the documentation or discussions that led to that.

Just trying to do what is safest in our pharmacy.

Thanks!

Does anyone have standard operating procedures for PAH therapies (focus on nursing staff) and willing to share?

Thank you!