Hello,

When a patch (such as clonidine) is held due to parameters, is there a process at your institution to monitor the patient and check when the patch should be given again? For example, since clonidine is given every 7 days, if it's marked as held and there's no follow up, the patient would miss an entire week of clonidine. Do nurses at your institution typically page the provider to inform, recheck again in an hour, hand off to the next shift, recheck again in a day...?

Thank you!

Does anyone have a good process for providing patient education related to Sugammadex?
An additional nonhormonal contraceptive (eg, condom, spermicide) should be used for 7 days after a dose of sugammadex in women using oral or non-oral hormonal contraception.

Who is responsible for identifying and educating patients - nursing, pharmacy, anesthesia? What does the education consist of?

our high alert policy is currently under review. RNs are not required to perform independent double check on subcutaneous administration of heparin per our current policy. We are considering if we should maintain this practice or change it to require a co-signer. What are you currently doing at your respective hospitals. Are all forms of heparin, irrespective of the route co-signed by another RN or only the IVs and the drips? Thanks for your input

What does your facility do in terms of risk mitigation for 23.4% concentrated sodium chloride? Currently pharmacy draws up and puts into an empty ViaFlex and sends up a high alert double check form with it. A new PA mentioned other facilities administered it IVP (rather than via an IVPB) and having a special 'box' in the ICU Pyxis containing the medication so I wanted to see what other facilities do. Thank you!

Due to some IV therapy errors we have had we are reviewing our practices surrounding hanging new bags. One of the topics we are debating over is whether there are recommendations regarding line labeling. Is anyone aware of guidance from any professional organizations on line labeling?

I'd also love to hear any personal opinions or experiences others have on this topic. Does it facilitate line tracing or does it cause unintended bias with line tracing?

Thanks!

We are currently reviewing our pain assessment and management policy.

Would anyone be willing to share their current policy and/or IV administration guidelines for opioids? I am interested in monitoring for continuous opioid infusions, PCAs, and IV push opioids.

I am interested in when you recommend patients be placed on continuous pulse ox, frequency of vital sign monitoring, and any additional monitoring guidelines you may have in place following IV opioid administration.

I am looking for information on interoperability logistics, caveats, etc for any institution that has Epic and uses this feature with ICU Medical Plum 360 or BD Alaris smart pumps. Thanks!

Our nursing staff is advocating for the use of locked medication carts which could be used to transport medications for multiple patients from the ADC to patient rooms for administration. Pharmacy has a number of safety concerns with the proposed process, so I am curious if anyone has been able to successfully and safely implement these types of transportation carts while remaining compliant with medication management standards.

Thank you!

Hello,

Upon reading USP 797 revised, at line 1552 the new standard describes the BUDs required on the product label. It looks to me that they are requiring both a date beyond which administration must not begin AND the date after which a preparation must be discarded.

Have others interpreted this to mean that we need to differentiate and include on our pharmacy labels both the BUD and the expiration date?

Are any of your institutions currently using continuous inhalation Epoprostenol? If so, I'm curious to learn more about your dispensing process and logistics. Is pharmacy compounding your syringes patient-specific?

Thanks!