We are considering implementing ETCO2 monitoring for patients on PCAs. Please share your experiences and lessons learned, especially for the pediatric population.

What criteria do you use for initiation of ETCO2 monitoring? Any issues with carefusion ETCO2 module? Do you utilize the pause protocol? How do you communicate the RR settings to be entered?

All feedback is greatly appreciated!

Thanks,
Jenn

How many organizations have standard labels for infusion lines? What labels are you using? Do you have a standard practice guideline or policy you are willing to share? Any negative or positive feedback is appreciated.

We are a children's hospital within an adult hospital and currently compound 0.2 units/mL and 1 unit/mL vasopressin for shock and 0.1 units/mL for DI. We give all concentrations an expiration date of 18 hours. Wondering what other children's hospitals are compounding and what BUD/stability data do you have?

Thanks,
Rachael

Gaps in intravenous line reconciliation is the active failure in safety events with inadvertent administration of titratable critical care infusions that have been paused-but remain at the bedside instead of intended IVPB, for example. A latent failure is gap in disconnection, discarding drug supply and having the order discontinued after a certain period of pause. Does anyone have robust process to prompt/support disconnection, discarding of drug supply, and order discontinuation after the infusion has been stopped (MAR documentation of STOPPED) for X period of time, such as 4 hours?

Do you monitor EKG, BR & HR when patients are being administered IV phenytoin?

Continuous cardiac monitoring (rate, rhythm, BP) and observation during IV phenytoin administration and BP and pulse monitoring every 15 minutes for 1 hour after administration is recommended. Risk of cardiovascular toxicity increases with infusion rates above the recommended infusion rate of 50mg/min, these events have also been reported at or below the recommended infusion rate.

Hi Friends, we just received approval to implement interoperability with our smart pump fleet. As we engage in the planning, I'd like to see how other folks are supporting from an org structure standpoint.

Greetings,

Our organization is updating our patient transport policy. It contains many things unrelated to medications, but it does contain a section speaking to which medications require a nurse to transport the patient.

Wondering if you have something like this do you
a. list specific medications (nursing wants this)
b. list classes of medications
c. provide non-specific guidance based on patient stability, medication titration need, or mention of high alert medications or medications that require a double check on handoff.

Wondering if any facilities are co-infusing ketamine/lidocaine infusions via the "y" site? If your facility is currently co-infusing at the "y" site would be interested in discussing with you the literature that you are using to support this practice.

Does any facility have an approval process to give biologics inpatient? Due to reimbursement issues, the thought is to try and wait for discharge. Sometimes this cannot be the case. Looking to see which ones are approved for inpatient use and the criteria.

Do you require nurses to scan each item upon removal from the Automated Dispensing Cabinet (ADC)?
In my system one hospital does require all medications to be scanned upon removal, and the other seven do not. We do have bedside barcode medication scanning.
We are discussing requiring scan on removal across the system for certain medications stored in the ADC refrigerator because of the risk of removal of incorrect product from the bins in the refrigerator.