We have had multiple discussions at our facilities surrounding what type of naloxone to use where in the hospital. Currently, we have the 2mg/2ml prefilled syringe in all crash carts (except Neonatal) for codes and respiratory arrest. We have the 0.4mg/ml in the ADCs on all units for respiratory depression.
This difference has caused some confusion for nursing/residents as far as which one to use when and how to give it (dilute or not, push or not, etc).

Hello,
Does anyone have a process in place for when you transfer a patient out on a narcotic infusion? Are there any regulations that require documentation from the receiving hospital? Any safeguards out in place to prevent diversion.

Also if you are a hospital that takes transferred pts, how do you handle the above scenario.

Thanks,
Nancy

Med-ERRS, a subsidiary of ISMP, is looking for a few Directors of Pharmacy, or Pharmacy key decision makers for purchasing, who will be attending the ASHP Summer Meetings & Exhibition in Denver to participate in an evening advisory board. The advisory board will be focused on how certain products currently are prepared in the pharmacy, what the process is for including a new preparation on the formulary, who the key decision-makers are for this change, and how this change may impact pharmacy workflow.

Does anyone have high alert storage precautions/warnings set up for meds (e.g. NMBs) in your automated pharmacy carousels? I've heard of using red tape or auxiliary stickers in the bins, but that could be difficult to see if bins are full, and hard to keep up when meds are moved around, etc. Is there any automated messaging capability? We use Talyst.

HI all,
I was wondering what other organizations are doing with patients' gender identity and the EMR. There is "birth sex" as listed on a patient's birth certificate. There is the Self Identified Gender Identity (SIGI) which may vary from the birth sex. Patients can go get a court order to change their birth sex in their medical record in situations where there is not a separate gender identity field in the EMR.

We are discussing alteplase administration for stroke as we are looking to become a comprehensive stroke center. Does anyone know if nursing primes the line with alteplase or saline? We are having a debate on what to prime the line with and then how the smart pump would then deliver the correct dose of alteplase.
Thank you! Sarah Gallup

Our nurses have been reporting that bubbles from etoposide infusions are frequently causing the air-in-line to alarm. I read that an anti-siphon valve could be beneficial but the BD rep said that it will not help. Has anyone else experienced effervescent etoposide or have any suggestions to reduce the bubbles?

Hello,
At out institution, we are revisiting this topic and updating our policies...

Would you mind sharing a policy/guideline related to:

1) Antineoplastic agents for non-oncology indications? (eg methotrexate, IV/PO cyclophosphamide)

2) Biologic agents given for non-oncology indications? (eg rituximab, infliximab)

3) Do you require informed consent for either 1 or 2? If so, do you require re-consenting each year?

Thank you,
Tanya

Greetings!

Does anyone use insulin pens for inpatient administration? If so, what is your administration process? Storage? On unit? In patient room? How is the pen itself labeled? Labeled with patient information bar code or are you just scanning the pen itself at administration? Any information you provide would be much appreciated. Thanks in advance.

Hi, I'm curious what people think about the use of auxiliary labels on final dispensed products... i.e. when techs or RPhs place "High Alert Medication" or "Continuous Infusion" or "For RT Use only" labels on the products. This can definitely bring attention to safety concerns, but what happens when people forget? Could this actually increase risk if nurses rely on these labels to identify risks? What are some ways to make this practice more consistent? Considering if/how this should be addressed in our high alert policy. Thanks!