Does anyone have a policy or SOP for your IV batching process? I'm particularly interested to know how much RPh supervision you require when batching high risk meds. We are currently having to batch heparin 1000 unit/500mL bags.

When batching 200 of these bags, which of these methods would you find acceptable?

Does anyone have a hospital policy that limits the dose of metoprolol IV (push or infusion) that may be given to a patient at one time?

The best info I can find is that doses of 2.5 to 5 mg may be given at one time, but may be repeated every 5 minutes (max dose of 15 mg).

We have seen doses of 7.5mg and 10mg ordered here. We typically restrict IV push to tele/ICU floors only, the other non-ICU/non-tele areas will get metoprolol in an IVPB.

Would appreciate your thoughts and hospital specific practice on this issue.

Our hospital has had quite a few occurrences due to known, or suspected, self-administration of patients meds at bedside. Aside from going through everyone’s belongings, we are looking for some type of procedure/policy to help prevent this from happening. What types of procedures are hospitals following to discourage and prevent patients from taking their own medications (without the RN or provider being aware of this administration) from home while they are inpatient? Thanks!

Does anyone out there still use Milk of Molasses enema? If so, does Pharmacy provide, or does another service (ex: dietary) provide the ingredients? Our nurses are concerned about the potential for patient burns if they mix it on the floor.

Thanks!

Hello All,

After a recent state regulatory survey we had a finding around the use of allergens in hospital clinics. We currently do not have a hospital policy on this practice.

Do you a have a policy on allergens you could please share?

Thank you!
Daniel

Previous posts on this topic state that some organizations are drawing up the patients dose in pharmacy. When this is done are you drawing up both the scheduled dose and the correction factor in one syringe? Does the RN call with the glucose level for the pharmacist to evaluate what is the total dose to be given?

Does anyone have a policy/workflow they would be willing to share.

Thanks,
Amanda

Hello,

Does your institution limit the number of dispenses from the Pyxis (or equivalent ADC)? If so, what is the limit for number of dispenses, and have you ran into issues in which certain exceptions must be made? How did you address it?

For example, if 10 tablets of a medication are ordered and the tablet is in the Pyxis, will it re-route to pharmacy instead of Pyxis to dispense as a safety measure? (i.e. the pharmacist would have to check 10 tablets and should question the dose since such a large amount is being dispensed).

Hi all,

Does your institution require a 2nd RN verify for induction oxytocin? For intitation and/or rate changes?

Thanks!
Jane

Hello all,

In our medication safety committee, one of the physicians asked that we look at methods to somehow communicate shortages on a daily basis to providers and nurses what is short and what alternatives we recommend.

Do any of you have tools built into your electronic health systems (ie. Epic) or automated dispensing cabinets (especially Pyxis), or other methods--- to alert providers and nursing, OR, ED etc of medications that are short and the suggested substitutes?

Thank you.

Hello! I was hoping to get some feedback regarding which dosage form of naloxone you are using at your institution.

We currently use the 2mg/ml syringe in our crash carts, but have the 0.4mg/ml vial in the Pyxis machines. The initial thought when it was set up years ago was that the bigger dose in the syringe was more appropriate for a code or respiratory arrest situation. The smaller dose in the vial was best for respiratory depression with PCAs, IV opioids, etc.