Good morning all - reaching out to see if any hospitals have evaluated diltiazem IV use and implemented any strategies in preventing use for patients with heart failure. We will be undertaking a medication use evaluation in the near future but this has already been identified as an area for potential action.

I see there have been other posts on this topic, but none recently, at least none that describe this scenario, so I'm hoping you can help. I'm posting from Prince Edward Island, Canada, so there may be somewhat different standards in the US, but we don't have very many CPOE Cerner sites in Canada, so I wanted to reach out on here. We use Cerner, and have CPOE, we are also a relatively small hospital, and don't have clinical pharmacists on the floor in most areas. We don't use traditional automatic stop orders.

Does anyone have any policies on the use of medication samples in primary care? The use of samples is generally discouraged in our facility however we are hoping to develop our own policy to give staff some direction on what to do when these situations arise.

Has anyone had an increase of infusion related reactions or adverse effects from a 30 minute infusion?

We are infusing remdesivir over 120 min. We are now re-evaluating the 30 or 60 minute options.

Thank you in advance for your feedback!

Good Afternoon, we are in process of writing a medical marijuana policy and are looking for guidance from other hospitals that may have policies and workflows already in place. Also, how is medical marijuana capture on the EMR? What are the roles of the physician, pharmacist and nurse?

Thank you,
Kristen Post
Kristen.post@nicklaushealth.org
Risk Manager
Medication Safety

Hello All,
We have been having trouble getting 2 Liter bags of sterile water for inhalation from Vyaire for the past several months and are faced with the possibility of going back to the 1 Liter bags. I would appreciate if anyone can share alternate sourcing for this product.

Chris Walsh

Dear all,

Is independent dual verification (IDV)/dual sign as defined by your hospital's specific medication list required in all care areas? In other words, if IDV is applied on the general med/surg floors for IV heparin bolus doses, for example, is it also required for IV heparin boluses in cardiac cath lab or interventional radiology suite?

If not required across the continuum of care, how did you justify the difference and define specific care areas in your policy?

Hello all!

I am looking to revise our HD policy to include an acceptable list of medications for nursing to give per protocol.

Can anyone share their policy on med admin around HD dialysis days? Do your nurses have the ability to hold or administer meds before dialysis per protocol.

I'm hoping to gather information to bring to our providers for review and consideration.

Thanks in advance!
Danielle

Hello all,