Health care providers (HCP) are requesting to dispense silver nitrate sticks for outpatient use for Pedi patients. Per request, HCPs will be assessing parents/guardian's competence before the dispense.

Does anyone have a policy or a procedure supporting this practice and willing to share? I have not been able to locate any safe best practice recommendations and have only found one institution that currently allows it.

Thank you.

Roxie-

Good afternoon,
Our organization is looking to implement a high dose titration regimen for oxytocin during ante partum. For other organizations that do this, do you have any safety strategies in place for nursing? Dual check? Other practices? Luckily, we will stick with our standard concentration with this change.
Thank you,
Stacie Ethington MSN, RN
Nebraska Medicine

Hello,
We are looking for the best practice on how to send the IV bags to the floors if the IV bag comes in the overwrap and it requires a patient label. Does your site remove the overwrap and label with patient specific label or do not remove the overwrap and flag the label and RN adds the label to the bag once overwrap is removed?

Good morning,

We are interested in benchmarking pump utilization in perioperative settings, particularly in children's hospitals (adult information is useful and welcomed as well!). We GREATLY appreciate your reply to the below:

As part of our ongoing efforts to refine our Controlled Substances (CS) Handling Policy, we’ve encountered a particular challenge: ensuring accurate tracking and documentation of controlled substances during off-floor procedures or when given to another for future use.

We are updating our High Alert med policy and I'm wondering how other facilities differentiate between high alert meds that require an independent double check and the ones that do not. ISMP's list is extensive and states that the double check is not always optimal. But, I feel like the staff hears "high risk" and assumes double check for the most part... Also, wondering if people are still including warfarin?
I'd love to see some of your updated policies. Thanks so much!

We have developed and implemented a Relative Humidity Excursion Plan to address humidity concerns >60% in our IV rooms in response to USP 797 (2023). There currently exists no reference on how this should be addressed.

Requesting to see if other institutions have developed a plan and if so, are they willing to share their plan. Ours will be shared as well. Thanks.

Hello! Interesting, niche, question from one of our safety-minded outpatient pharmacists regarding the medication Trikafta (elexacaftor, tezacaftor, ivacaftor) for management of CF.

Curious if anyone else has come up with a solution to safely / accurately prescribe and document this medication when dose adjustments are indicated.

This med is supplied as 2 separate products packaged together in a blister card package containing 21 tablets: elexacafter/tezacaftor/ivacaftor (orange capsule-shaped tablet) in fixed-dose combination and ivacaftor (blue capsule-shaped tablets)

Hi,

I wanted to share the attached letter we received from Baxter in case you utilize these affected inlet tubing products and have not yet received the letter.

Regards,
Mara Miller, PharmD BCPS
Medication Safety Coordinator
Kaweah Health Medical Center Pharmacy
400 W Mineral King
Visalia, CA 93291
T: (559) 624-5652

We are re-evaluating our bivalirudin guardrails after a medication error.

Currently we have two library files
Bivalirudin (HIT) & Bivalirudin (PCI), the soft maxes were both set at 1.76 mg/kg/hr and we were planning to lower the bivalirudin (HIT) soft max to 0.6 mg/kg/hr.

Additionally, we were going to rename the (HIT) library file because we are using bivalirudin for indications outside of HIT, like ECMO, but were not coming up with a good alternative name.