We are a pediatric hospital and frequently use empty, sterile IV bags. With the national shortage we are implementing processes to conserve our supply. We have: 1) split IV doses up to 240ml into equal volume syringes 2) Compound selected drips in pre-made IV fluid bags 3) Compound stock bags of medication in larger volumes 4) Communicated with providers for IV to PO conversion and timely discontinuing of IV fluids 5) Antibiotic Stewardship will help ensure antibiotics are ordered with the longest acceptable frequency.

I would like to network with organizations that have a low number of heparin events and/or have completed work to improve safety surrounding heparin. Our hospital is doing a comprehensive review of our heparin processes. Please contact me if you would be willing to speak concerning heparin. Thank you for your consideration.

Our organization is trying a therapeutic interchange to Levemir. We have some exception criteria to allow patients to stay on Lantus, which we are guessing will be about 30% of patients.

Currently we stock Lantus as a MDV in our ADC and send up Levemir as a patient specific medication. With the change, we are considering stocking both Levemir and Lantus as MDV in the ADC.

Do any other organizations allow this and what safety measures have you been able to implement to prevent confusion with the two brands.

Hello,
I am a Canadian pharmacist so forgive my ignorance of Joint Commission requirements.
I understand JC has requirements for policies/education around standard interpretation of orders such as HYDROmorphone 0.5-1 mg subcut q3h prn.
Would anyone be willing to share policies/educational tools or other approaches to ensure that such orders are consistently interpreted in your organization.

I am looking for some guidance on when it is ok to use a midline instead of a picc line for certain antibiotics. I have researched this topic to death and still come up with conflicting answers. I know that if the pH is <5 or >9 or >600 mOsm/L the drug should be given via picc line but some drugs in the grey area like Ampicillin (pH 8-10) or Meropenem which seems to fall in these guidelines (pH=7.3-8.3 300mOsm/L)are still listed on most "central line only" reference charts.

Nurse manager contacted me with the following question (see below). What are folks doing in their various workplace. Best regards
.....
We currently have Pitocin orders for “ 20 Units/ LR IV drip @ Wide Open (1000 ml bag x 1 bag). This poses a potential patient safety concern as there is no specific rate. This order is used in the post-partum phase (hemorrhage control/prevention). Does ISMP provide a recommended rate? Your feedback and input is appreciated.
.....

Hello all,
one of the JC standards looks for institutions to collect data on significant adverse drug reactions. We do quite a bit for med errors but could use some direction for ADR's. Can anyone share a tool they use and how you define "significant"?

Thanks!
Rachel

Does your hospital have an overarching committee that oversees smart pump technologies for multiple hospital systems.

Who are the members?
What are there responsibilities?

Could you share policies governing smart pumps?

Thank you Mark

Hello!

I am writing today to ask a question in regards to the preparation of bladder instillations (products to be administered intravesically into the bladder) in the outpatient space.

Typically these bladder instillations or bladder “cocktails” involve a combination of injectable heparin, lidocaine+sodium bicarbonate or bupivacaine, steroids and sometimes gentamicin. Typically these are administered in the office setting, however in some instances patients may be taught to administer such therapies at home as well.

Even with the lidocaine/epi shortage, our OR staff does not want to use as a MDV d/t infection risk and use in the sterile field.

Is anyone drawing up prefilled single-use syringes for OR use, and if so, what BUD are you using?

Thanks for any feedback!