MSOS Discussion Board

Nitrous oxide for labor analgesia

Renu Bajwa's picture

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Does any institution currently utilize nitrous oxide for non-neuraxial labor analgesia? If so, would you be willing to share:
1. A protocol or policy and procedure used to implement the program?
2. Vendors or manufacturers utilized for the blender and scavenger systems? At this point, I think we would be more interested in a portable system as opposed to having it piped through the wall.
3. Concentration utilized for the blend: 50/50 or other? Anyone using up to a 72/25 blend?

Different Pyxis versions in same medical office

Megan Harrison's picture

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Is anyone currently converting or upgrading Pyxis models, and are operating with two different versions in the same department or medical office? If so, any safety specific concerns arise or been addressed? Any patient error reporting increases with operating on two different models?

Thank you

Insulin Pens

Diane Schultz's picture

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I know there has been some recent discussion on this lately, but one of our pharmacists has put together a survey on insulin pens so we really would appreciate any additional insight on the questions below. If easier, you email or private message back with the answers. Once collected we will summarize and post back on the site.
Thanks for your assistance! Diane diane.schultz@seattlechildrens.org

Naloxone formulations

Karin Terry's picture

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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).

Transferring Narcotic Infusion Between Hospitals

Nancy Makem's picture

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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

Looking for a few Directors of Pharmacy, or Pharmacy key decision makers for purchasing

Melinda Cozza's picture

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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.

High alert medication storage within carousels

Joanie Cook's picture

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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.

Gender Identity Medication Safety Issues

Mary E. Burkhardt's picture

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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.

Alteplase for Stroke - Administration

Sarah Gallup's picture

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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

Etoposide bubbles

Madiha Syed's picture

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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?

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