What dose-timing scheme do you use for insulin glargine?

Do you use standard times such as QAM, QHS, Q12H (09,21)?
In that case, if a dose is give off standard times, subsequent doses would need to get staggerred onto stnadard times, which may not always happen corectly.

Or, Do you use a rolling schedule, basing the next dose on the last previous dose?
In that case, there's no standard time, and doses will tend to get given at various hours of the day.

Thanks for any input.
Susan

Do you limit what nurses can mix in the clinic setting?

A clinic was found that did 20 buffered lidocaine syringes each day for procedures. We have changed the process so that pharmacy provides them. But now have some providers that wonder if this will affect the nurses being able to mix other items in the clinic (for instance, steroids with local anesthetics for intrarticular injection). Are there any policies on what nurses can and cannot mix?

Hello,
Do you have the hospital owned medical office/clinics follow Joint Commission Medication Management standards? I have been doing some audits and there is room for improvement but I am not sure what standards they follow for medication management. This includes samples, refrig. meds, temp. logs and such. I would appreciated any additional advice or resources that can be offered.
Thank you
Marilyn Hargett
Medication Safety Officer

If a patient is being discharged and have a patch in place (fentanyl, clonidine, etc.) that is not due to be replaced or discontinued, do you remove the patch or let the patient go home with it in place?
If you allow them to go home with it, do you educate them on when to remove and how to dispose of? Thanks,

Cortney Swiggart
Memphis, TN

Greetings,

Has any healthcare facility addressed the issue of selling insulin syringes to patients who do not have a prescription for insulin?

We have a retail pharmacy in our hospital's main lobby and are concerned about how the needles may be used (illegal drugs) but also understand the community ramifications if dirty needles are shared.

What has your facility enacted?

Many thanks,
Carol

We have recently had an increased number of patients on U-500 insulin prior to admission with hospitalist orders to continue during admission. This has resulted in several medication safety events and near misses. Our diabetes counil would like to institute a protocol for pharmacy to automatically switch these patients to Lantus/Levemir along with a diabetic educator consult. Does anyone have a policy that would be willing to share?

Any information would be greatly appreciated.

Thanks in advance!
Amanda

Can anyone offer advice about the use of staerile talc in the canister form? Can that be used as an alternative to the vial form which is dispensed in a syringe?
Our Thoracic prople are saying the aerosol form does not have mechanism to administer the aerosol through the chest tube at the bedside.
Has anyone had experience with this form?
Thanks
Susan

I work for a 15 hospital system and we are tackling standardizing heparin concentrations used in radiology for peripheral vascular procedures (e.g. catheter directed thromboplysis). The radiologists say that they need dilute heparin so there is sufficient flow rate in addition to the MOA of heparin to prevent pericatheter thrombosis.

My premises to this project:
- Minimize available heparin drip concentrations to 1-2 at most organziation-wide
- Use premixed solutions whenever possible