There is some discussion at ASHP about requiring nursing to use filters for IV push medications that they prepare on the unit. Is anyone requiring this? Is this an old policy or a new one implemented with the minibag shortage?

The Radiology Department is asking pharmacy to weigh in on a policy that requires patients to have a driver if they need pretreatment of Prednisone and Diphenhydramine (50 mg orally) prior to contrast studies in patients with contrast allergy.

This has posed a hardship for many patients. Can anyone comment on this? Do you have objective criteria for evaluating / screeing patients for risk related to sedative properties of diphenhydramine?

Thanks for your input,

We have been streamlining our hazardous and reproductive risk medication processes here, which included automated alerts into our ADCs and carousel for front-line staff.

I am reaching out to other facilities to see how they handle labeling hazardous and/or reproductive risk medications, especially for intact oral tablets. Do you label every tablet individually or do you label only its packaging/container (i.e. baggie)? Any other different approaches?

Thank you!

We are working to establish a single health system policy that addresses medication safety (or similar) committee roles and responsibilities. If anyone with a system policy is willing to share your policy, we would be very appreciative. Thank you in advance.

Dear all:
I need your advice in this matter.
Currently in our hospital we are in the process of initiating a medical gas committee to govern the process for handling all aspects of medical gases in the hospital.
The hospital team is proposing that the pharmacy to lead/ chair this committee
Others are proposing that this shall be under the anesthesia department.
May I know in your hospital who lead/ chair similar committees if available.
And if not available, in your opinion/ experience who shall take the custody of this process.

How are other pediatric hospitals dispensing tiny doses of SQ desmopressin < 0.04 mCg (0.01 mL)? Does anyone have stability data to further dilute the 4 mCg/mL concentration that they could share.

For those institutions following the requirement to filter fat emulsion infusions with a 1.2 micron filter, have your nurses reported issues with the filters, especially after pausing the infusion to administer intermittent medications? Our nurses are getting downstream occlusion alarms on the pumps once the fat emulsion is started again. If you've experienced this, any suggestions on how to prevent this?

Thanks!

Our institution seems to have had a recent uptick in life-threatening adverse reactions to protamine administration in the past couple of months (hypotension, pulmonary vasoconstriction, cardiovascular collapse). We have reported 4 cases to FDA MedWatch, but are interested if this increase has been noted at other institutions. We have not identified anything preventable upon review of the cases. Have any of you noticed this at your facilities?

We have recently switched to monitoring heparin assays for our weight based heparin drips and have had several situations where the heparin assays have remained subtherapeutic despite high doses of heparin (>25units/kg/hr). This has been occurring more in our critical care population. Has anyone encountered the same issue and have any guidance on how to manage ( argatroban vs giving thrombin vs alternative monitoring vs other) thanks.

Does your facility allow insulin to be pushed on med surg units besides hyperkalemia and under what conditions? thanks