We are embarking on a study evaluating a tool that assesses the risk of a prescribing error associated with a particular medication - your help is needed for face validation efforts. I'm happy to share the tool (it's in an Excel sheet) and any acknowledgements according to contributions.

I posted an earlier thread regarding access to EHR Test environments for medication safety pharmacists. I'm happy to report that the information shared by others helped me to successfully solicit access for our safety leads! Thank you!

NOW I have a different question...

Hello all,

I am curious how other hospitals manage therapeutic duplications between anesthesiologists and surgeons. Currently, anesthesia orders analgesics and antiemetic agents for "PACU use only" but surgeons will often order similar medications before the anesthesia orders have been discontinued. Our hospital uses Cerner for CPOE and I was wondering how others hospitals handle this issue.

Thank you,

Jim

Good morning,

We are in the process of developing USP 800 Hazardous Med Education for nursing. Has anyone developed the nursing component of education and are you willing to share? Specifically looking for how nursing will identify the hazardous med, PPE requirements and how you plan to hardwire the process.

Thank you,

Kelly Biastre, PharmD
Sr. Consultant Med Safety
Baptist Health
Jacksonville, Fl

At your organization, is entering new medications and updating the smart pump library done by a Clinical Pharmacy Manager/pharmacy manager, medication safety pharmacist or IT pharmacist? i.e. who really "owns" the library or is it shared responsibility?

Thanks!

Ivy

Hello all,
Have any institutions transitioned to U-500 pens or are in the process of transitioning to the pens? If so would you be willing to share your process for how to manage the pens?

Thanks!
Rachel

Hello,

At St. Luke's Hospital in Cedar Rapids we prepare all patient-specific doses of oral liquid medications in the pharmacy via a cartfill process within our EMR. This involves a pharmacy technician preparing all of these products at once, and have experienced some minor errors with this process. We are looking into how we can make the process of preparing oral liquid medication syringes safer. Would anyone be willing to share the written procedures they have for preparing oral syringes in this manner? We are looking at the following specifically:

Are you converting to the ENFit enteral feeding and medication products? What is your timeline for conversion? If you have converted, any tips on a smooth transition?

Thank you,
Ann

Ann Jankiewicz, PharmD, BCPS, FASHP
Medication Safety Officer
Rush University Medical Center
Chicago, IL

Focusing on severe sepsis and septic shock as defined by CMS, we are interested in administering broad-spectrum antibiotic coverage (which typically will require at least two different antibiotics) as rapidly as possible. Often times, antibiotics are Y-site compatible making it feasible to administer two antibiotics simultaneously. However, there is a theoretical concern that a patient could develop an allergic reaction, and if both antibiotics were infusing simultaneously, it would be difficult to determine which antibiotic is responsible for the reaction.

What is your institution’s policy regarding titration orders?

The Joint Commission surveyor has stated that orders must show:
• Starting dose
• Maximum dose
• Dosing increment by which to adjust
• Outcome endpoints used to determine dosage adjustment needs
• Specific time interval for reassessment/adjustment.

Can anyone share their institution’s policy on titration orders, order build specs in your EMR, or have experience with Joint Commission surveyors scoring your titration orders?

Thank you.