Hello,

We recently had a near miss event at our institution where 2 patients with the same name (one Jr, one Sr.) almost received medications intended for the other patient.

Upon review, one of the gaps we identified was that the patient suffix does not display for nurses on Pyxis ES console. According to our BD Carefusion representative, the patient suffix information is transmitted over to Pyxis, but is information only and cannot be displayed for nursing at the console.

We are re-evaluating our guidance on Metoprolol IV. We are trying to find something that will work for all of the hospitals in our system, which have different acuity of patients. I would love to hear from you regarding what limitations, if any, you have on Metoprolol IV.

-Do you allow metoprolol IV on general units?
If yes, do you have a restriction on dose/frequency/number of doses/delivery/etc?

What standard monitoring is required?

How do you enforce your restrictions?

Any other pearls would be greatly appreciated!

We are an Epic facility using Dispense Prep and Dispense Check. We're having difficulty scanning Menveo. This product consists of 2 vials, each containing active drug component.
The solution for intramuscular injection is supplied as a lyophilized MenA conjugate vaccine component to be reconstituted with the accompanying MenCYW-135 liquid conjugate vaccine component.

Does anyone have an Epic build in place that would allow scanning both component vials at dispensing and administration?

Thanks!

​​We have had some issues that have come up with Heparin dosing since we went to Smart Pump integration in August of last year. Some patient are started in our Emergency Department on Weight Based Heparin for chest pain that are capped at a dosage of 1000 units/hour to start. Thus, the pump gets started in non-weigh based programming however, 6 hours later, once the patient is on the floor and the first Anti-Xa result is dropped the nurse has to adjust the dosage based on a weigh-based nomogram. We have had some errors and some confusion around this when this change needs to be made.

If anyone is able to share their nursing policy regarding provider notification for refused medications I would greatly appreciate it.

Discussion points surrounding this topic:
-should this be for all meds?
-should it only be for high alert meds?
-what is the ideal time frame for reporting a missed/refused dose (within 2 hour or at rounds, etc.)

Hi all,

Our system is currently preparing arthrectomy cocktails (e.g., Rotaglide/Viperslide variants) in the pharmacy. We've had request by interventionists for compounding in the Cath Lab.

Some concerns with preparation directly in the Cath Lab include USP 797 compliance and general risk associated with mixing several ingredients (e.g., verapamil, nitrates, heparin). Overall turn-around-time (TAT) from pharmacy is in the 20-30 minute range (order to delivery receipt). TAT is somewhat hindered by transportation time as the lubricants cannot be tubed.

Hello,

Is anyone aware of a protect from light bag that is clear? We've received outsourced products that are in clear bags labeled as UV/light protected, but can't have any luck finding this same type of product for our own use.

Thanks,
Pam
UPMC
Pittsburgh, PA

Hello All,

I would like to inquire about insulin intravenous infusion concentration(s) that you are using at your facilities for diabetic ketoacidosis management in pediatrics. We had a discussion at our organization about utilizing the ASHP Standardize 4 Safety Proposed Standard Concentrations for Pediatric IV Continuous infusion which calls for 0.05, 0.2, and 1 unit/mL.

Question: How have hospitals worked around possible HIPAA violation issues when using the Patient ID function on smart pumps?

Background: We recently pursued a path to require RNs to enter the MR# in the Patient ID on our smart pumps (Alaris), but were stopped due to a concern over a possible HIPAA violation should a smart pump "go missing" (leave the hospital).

Other facilities who have interoperability (bidirectional communication between eMAR and the smart pump) would theoretically have the same issue.

Hi all,