Hello,

Not directly a med safety topic, but I think some of us are also residency directors or preceptors.

Do any of you currently prime the TPN tubing for your central line patients in an effort to prevent CLABSI?

Our NICU is asking if we could do this on our neonatal TPNs.

We prime the tubing for our chemotherapy, but nothing else currently.

Wondering if any of you have experience in your facilities priming TPN tubing?

In my opinion, if we start this for NICU, we should probably do it for pedi and adult patients as well.

Thoughts?

Thanks -
Chad

We are beginning to notice something that we hope others can help with, as we are weeks to months behind the surges of COVID-19 than others around the country. From the patient perspective, COVID-19 treatment within acute care would be traumatic, especially with not being able to see loved ones (at least in person). Some facilities have been able to set up ward-style units. However, all this can and has led to post-traumatic stress disorder. How could it not. The front-line heroes have PTSD, but imagine from the patient perspective.

We are working with our system hospitals that do not have 24/7 pharmacy services on the ISMP TMBP. How are other sites dispensing SSKI with non 24/7 pharmacies?
Thanks -
Maria Cumpston
WVU Medicine

We have occasional issues where a higher concentration of a continuous infusion (e.g. dobutamine 4mg/mL instead of our standard 1 mg/mL) is intentionally dispensed but the nurse who hangs the bag and programs the pump does not notice that the concentration is different than the prior bag. This results in over/under dosing.

We are looking for ways to better incorporate Oxytocin titration into EPIC for L&D.
Currently we have a complicated procedure (with adjustments for full dose/half dose/low dose) that is linked out however we would like to better incorporate this into the EHR.

Has anyone had success building this out with discrete dosing fields at their institutions? Any details on your build would be helpful.

Thanks
Kelly Salzar

Has anyone been successful in standardizing to 1 size/drug/concentration for their OnQ pumps? We currently stock several different size pumps, and MDs order a myriad of concentrations of bupivacaine and ropivacaine. I would love to stock 1, maybe 2, sizes of pumps in just 1 concentration (0.2% ropivacaine) for anesthesiologists and surgeons to use. Any guidance is appreciated.

Has anyone been successful in standardizing to 1 size/drug/concentration for their OnQ pumps? We currently stock several different size pumps, and MDs order a myriad of concentrations of bupivacaine and ropivacaine. I would love to stock 1, maybe 2, sizes of pumps in just 1 concentration (0.2% ropivacaine) for anesthesiologists and surgeons to use. Any guidance is appreciated.

Hi everyone, wondering if there are any facilities out there who have built baclofen, intended for intrathecal administration, in there IV pump library? My health system currently has a request for it, very rare for use in baclofen weaning or due to implantable pump misadventures. My concern currently is that our pump vendor does not have the IT route as an FDA approved use of their pumps. If there are any sites that have implemented this build what additional strategies did you utilize (ie-Clinicla advisories on the pump, etc.). Thank you in advance for any responses.

I'm pretty sure I am not interpretting USP 795 correctly, and wanted to get others' input... It appears that if you are compounding a non-sterile liquid, and you do not have any stability information, it is OK to give it a BUD of up to 14 days in the fridge. (The table in the USP chapter is titled "Maximum BUD by Type of Preparation in the Absence of a USP-NF Compounded Preparation Monograph or CNSP-Specific Stability Information"). Fourteen days seems awfully generous.