MSOS Discussion Board

Menveo barcode scanning

Tracy Menninger's picture

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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!

Heparin Dosing with Smart Pump Integration

GregORY P. Burger's picture

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​​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.

Patient refusal of scheduled medications and provider notification

Jeanette Dean's picture

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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.)

Arthrectomy Solution Preparation

Zachary Allen Wallace's picture

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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.

Insulin concentration(s) for diabetic ketoacidosis management in pediatrics

Ghadeer Banasser's picture

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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.

Use of Patient Identifiers on Smart Pumps to improve safety

Forrest Shirkey's picture

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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.

Myxredlin (insulin infusion) safeguards

Donald McKaig's picture

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We are looking to implement appropriate safeguards for storage, dispensing, and administration of Myxredlin (insulin infusion). We are concerned with packaging and the risk of mix-ups with other bags which look similar--ISMP has already reported an actual error where insulin infusion run instead of cefazolin.

Can you share your practices for safeguards around following:

Capnography vs. pulse oximetry

Steve Mogridge's picture

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Can you share with me if you are using continuous pulse oximetry or capnography to monitor for opioid sedation in patients at greater risk, specifically asking for those areas outside of the critical care space.

Also, have you implemented the Michigan Opioid Safety Score (MOSS) or any other proactive screening tools to assess patients at greater risk for opioid sedation? Can you share which tool you are using?

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