Does your institution have clinical decision support or alerting to help prevent concomitant ordering of supplemental oxygen for patients on or have historically received bleomycin therapy? (increased risk of pulmonary toxicity/pulmonary fibrosis with supplemental oxygen combined with bleomycin)

Hello Everyone,

We are reviewing our current practice and orderset for the treatment of acute hyperkalemia and I am interested in what other hospitals are doing.
• Has your site/health system removed kayexalate from formulary (Y/N)?
• Has your site/health system replaced kayexalate with Lokelma or added Lokelma
as an alternative?
o If so, what is the dosing regimen used?
• What systems are in place to ensure the safety of insulin administration?

Does your institution allow a "grace" time window for early administration of PRN medications (e.g. opioids)? Our current policy is that the prescribed time interval must elapse before giving a new PRN dose, but considering a change to allow a "grace" period in light of increasing attention/audits of controlled substance administration.

A) No "grace" period for early administration of PRN medications is allowed - the prescribed frequency time interval must elapse before a new dose can be given.

B) Grace period is allowed - 15 minutes

for high alert medication our policy restricted availability of HAM TO ONLY ICU , PICU,OR and ER but sometimes we need heparin and lidocaine inj. for some ward example surgical ward for catheter maintenance(heparin fush) and as local anethetic (Lidocine) in dressing room what iwil do .iam looking for any policy or plan for this idea
thank you

Does anyone define in policy the amount of time that should lapse between controlled substance removal from the ADC and administration to the patient? If so, what is the time and where did you get it from?

Does anyone define in policy the amount of time that should lapse between controlled substance removal from the ADC and administration to the patient? If so, what is the time and where did you get it from?

I am wondering how hospitals with pediatric units manage orders for doses that are < 0.2mL (or some other small value)?

Does the pharmacy draw all of these doses and send to the unit?
What is your cut-off volume for pharmacy preparation?
What are your EHR dosing rules to accomplish this?

We have a Urogyn clinic using fluorescein with botox injections for Overactive bladder. I am wondering if others have seen these two medications used together in Urogyn clinics. I have not been able to find literature to support this use - so curious if others are using. Thanks!

Hi All,

Do you have any buprenorphine policies you are able to share? Looking for information on prescribing and dispensing restrictions in an inpatient hospital. Same for methadone.

Thank you!

Hi All,

Do you have any buprenorphine policies you are able to share? Looking for information on prescribing and dispensing restrictions in an inpatient hospital. Same for methadone.

Thank you!