In our outpatient infusion center, we continue to have physicians that do not sign their chemotherapy orders until very close to the patient's scheduled appointment time. This creates stress for all involved, and it is not safe to try to rush the preparation or administration of chemotherapy. Do any facilities enforce a cut off time for receiving chemo orders? I would like to have a policy that says we must have signed chemotherapy orders in hand at least 24 hours prior to the patient's scheduled appointment.

We previously used Micromedex for compatibility information, but have switched to Lexicomp.

Hello!

Looking to get a little information regarding reporting structure and division of work / resources:

1) Do you have a separate medication safety team?
2) What department does your medication safety team or MSO report up through?
3) If willing - can you comment on pros/cons of your reporting structure?
4) How is work delineated between Medication Safety and Pharmacy? How do you determine initiatives owned and operationalized by the pharmacy department vs. medication safety? (i.e. how do these two teams typically divide and conquer?)

Hello!

Looking to get a little information regarding reporting structure and division of work / resources:

1) Do you have a separate medication safety team?
2) What department does your medication safety team or MSO report up through?
3) If willing - can you comment on pros/cons of your reporting structure?
4) How is work delineated between Medication Safety and Pharmacy? How do you determine initiatives owned and operationalized by the pharmacy department vs. medication safety? (i.e. how do these two teams typically divide and conquer?)

How early does your institution pull expiring meds out of inventory? Trying to find the sweet spot between excessive drug waste and ensuring enough time in the daily workflow to remove/replace meds before they outdate.

Does anyone have a specific Nursing policy on the time frame they have to respond to a low electrolyte lab (K, Phos, Mg)?

One of the issues we have with our electrolyte (K,Mg,Phos) protocol orders is that the RNs do not act on the lab value in a timely manner. The question has come up, what exactly is a time window in which they can still act on an "old" lab value? Do you have a policy defining when the level is too "old" to act upon, do you recommend rechecking the level or getting a Physician order to proceed per the protocol despite the "age" of the level?

Does anyone have experience using the higher concentration of 5 units/ml IV bag for managing patients with CCB or BB overdose? What processes have you put in place to prevent errors with administration via the pump?
Do you have facilities that do not have 24 hour pharmacy coverage and do you allow nursing to mix this when pharmacy is closed?
Do you allow this therapy to be initiated at stand alone EDs?

Does anyone have experience using the higher concentration of 5 units/ml IV bag for managing patients with CCB or BB overdose? What processes have you put in place to prevent errors with administration via the pump?
Do you have facilities that do not have 24 hour pharmacy coverage and do you allow nursing to mix this when pharmacy is closed?
Do you allow this therapy to be initiated at stand alone EDs?

There is lots of discussion in our Health System related to a change from Normal Saline to Lactated Ringers as the most commonly used base fluid due to literature that shows balanced fluids are superior to crystalloid ones in some outcomes.
Have other hospitals made this change and found a good process for education / tool for nurses around the incompatibilities of LR with certain medications.

Thanks

For those that listened to our Member Briefing webinar today and would like to hear more about independent double checks for subcutaneous insulin, you might want to listen to a previous brief given by Greg Burger in December of 2017:

https://register.gotowebinar.com/register/5787674558169084418

(click "register" and it will bring you to the recording)