Does your institution use sterile water for irrigation for reconstitution of non-sterile compounds? Labeling specifies single use only. Is there any supporting evidence for assigning a specific BUD after it has been opened for the purpose of non-sterile compounding?

Is anyone aware of CMS or JC issues with lab control reagents stored in medication refrigerators?
Thanks,

Hi all,

I know this question has been asked in various forms many times, but I couldn't find exactly the answer I was looking for.

We just recently removed the "Continue All" button in EPIC for medication reconciliation because we felt this to be a blanket order by CMS and Joint Commission. However, now that we have been live for a couple of weeks with the change we are getting medical staff push back and it is coming back to committees to reconsider whether this button should be available to them or not. We recently had a MOCK survey and the surveyor said the expectation is for the provider to go through each medication order line by line.

While I am aware the Pharmacy workflow manager systems are controversial, does anyone have experience with using these for non-sterile compounding? We currently use DoseEdge for our sterile compounding across most of our hospital system (not critical access at this time). Have there been other approaches to both increase the safety and completeness of documentation?

Thank you for your response.

Looking at USP 800, what is your hospital's procedure for handling hazardous drugs that need crushing? Do you allow crushing? Does Pharmacy do it? Do you make a solution/suspension out of it for administration?
Thank you

Andrea Gimpel-Blanchard, PharmD
Director of Pharmacy
MaineGeneral Medical Center
35 Medical Center Parkway
Augusta, ME 04330
Phone: (207) 626-4133
Fax: (207) 626-4133
Pager: (207) 580-8001

Hi Everyone,

We are evaluating our independent double check policy after our transition to Epic and want to learn what other places are doing.

At your institution, are nurses required to conduct an independent double check for high- alert medications?

If yes, is there a system prompt in the EMR for the nurse to conduct an independent double check?

If you are at an Epic institution, do you use dual sign functionality or the independent double check MAR action? Any Epic tips for implementing Nursing independent double checks would be appreciated.

Hello everyone, I am seeking your advice for proper ordering practices for mineral meds in CPOE.

Calcium Acetate (PhosLo)
Calcium CARBonate
Calcium Citrate
Calcium Glubionate
Ferrous Gluconate
Ferrous Sulfate
Ferrous Sulfate Elixir 220 mg/5 mL
Polysaccharide Iron Complex
Potassium Phosphate/Sodium Phosphate
Zinc Sulfate

The drugs listed above make a reference to elemental content and there has been confusion on the nursing side as to what to administer vs. what is labeled on the medication.

Hello,

Has anyone developed order set or preprinted order for medication use in the context of fetal transfusion? For example,

-rocuronium administered to fetus in utero

-sugammadex as "rescue" for mother ? (when mother receives some of the dose intended for fetus)

Also interested to learn how the mother vs. fetal admin is clearly differentiated in the order.

If no order sets, would also be interested in the drugs/dosing used for fetal transfusion.

Thanks

Jen Turple

IWK Health Centre

Our facility uses Truvada as post-exposure prophylaxis med. Our process was to give the patient a 5 day supply of Isentress and Truvada at the emergency encounter to last them until they could be seen and evaluated by Occupational Health. The issue is that Truvada is a moisture-sensitive medication and the manufacturer states it can only be dispensed in the original container. We contacted the manufacturer and they would not recommend ANY time out of the original container. There is no unit-dose Truvada commercially available so that is not an option.