It is my understanding that phenylephrine is becoming standard for maternal BP maintenance during C-section and the literature out there is mcg/min dosing only. Of course deciding what weight to use in this population is complicated also. We have for a while been on only mcg/kg/min dosing for all pressors and are being asked to revisit that decision in light of this. Wondering if other facilities have had this same situation arise recently and what decision you ultimately went with.

Thanks!
Jen

Hello,
Does anyone have a policy on using your negative pressure sterile hood to mix all medication in the pharmacy?

We do not have a clean room. We have a negative pressure hood vented to the outside. We mix MTX in a syringe for IM injection once a week only. We do the steps after each syringe to Deactivate, Decontaminate, Clean and Disinfect. Do we need to have a separate sterile hood to mix all other IVs since we use this hood for MTX?

Thank you in advance for any information you can provide.
Jan

Does anyone have any experience with the use of Laminaria in labor and delivery in your organization?

If you have a policy related to the use of Laminaria, would you be willing to share that policy?

Thank you very much.

Does anyone have a way built in Epic to notify the provider to discontinue a therapeutic drug level that is ordered when the provider decides to discontinue the medication? I am finding a lot of incidents where the provider has decided to discontinue Vancomycin for example and doesn't know a drug level order is pending (because pharmacy is doing the monitoring). Lab comes up and orders the level and the patient is no longer on it and the level is no longer needed. I was trying to figure out a way electronically to alert the provider that an order for the level is active.

We have recently expanded our indications for exparel (liposomal bupivacaine) and have had a few near misses with other products containing local anesthetics within the 96 hour window. In one case a compounded preparation containing ropivacaine was ordered and prepared for a patient who had received exparel pre-op. In another case, an epidural order was placed for a patient with exparel on their profile.

Arginine hydrochloride injection is not found in our market and was hoping to prepare it from basic in our pharmacy. Any suggestion and protocol would be highly appreciated

I have several questions on safety and security as it relates to injectable narcotics. I would appreciate feedback on any of the following inquiries.

Hi all,
We recently went live with Epic for our health system and are looking to see if other institutions are utilizing First Databank Alert Space to manage/optimize the alerts in Epic.
1. Do you utilize FDB Alert Space?
2. Do you find the service to be valuable?
3. Can we reach out to discuss further?

Thanks!

Lara Ellinger, PharmD, BCPS
Medication Safety and Drug Information Pharmacist
Northwestern Memorial Hospital
(312) 926-3571

If a controlled substance is still in the sealed, intact package and can be returned to the ADC, does your institution require that a second licensed staff member witness the return?

Good morning! There are numerous organizations that recommend assessing a patient's status as opioid naïve or tolerant prior to opioid administration. (ex: WAKE UP Campaign, HRET ADE Prevention Change Package, ISMP TMSBP 12, TJC SEA 49, Opioid ADE Prevention Gap Analysis Minnesota Hospital Association.) We also know that performing an assessment of opioid naïve or tolerant status is complex and prone to knowledge based error by multiple disciplines.