Does anyone have a process set up for nursing peer review? Our nursing leadership is interested in establishing this type of process and we are interested in hearing others experience if you have this process. Thanks!

Hello!

Our nurse managers want to begin a practice of having a 2nd iv access in place when a patient is on an insulin drip. Does anyone currently have this practice in your setting?

Hello colleagues,

Does your organization have time limit expectations defined in policy/procedure for pharmacist response to consults according to consult type?

Kind regards,
Megan Fragale, PharmD, MS, BCPS
Skagit Regional Health
Mount Vernon, Washington

Has anyone added Fortisite eye drops (fortified tobramycin-vancomycin available from a 503b compounder) to Formulary instead of in-house compounding?

I'm wondering for those who barcode scan enteral nutrition products, are they included on the MAR? If so, how do you organize the MAR, and have you seen any issues? If not, where is documentation and how do you incorporate barcode scanning? We are interested in exploring this in Epic, and appreciate any input from those who have already implemented. Thank you.

Recently we had an event in which haloperidol was ordered IV but administered IM because the RN saw on the vial for IM use only. Does anyone have a good process on how to alert nursing of off label use when the vial states IM only?

We have had 10+ Dilaudid (brand) 0.2mg/mL Simplist syringes that have had their plungers fall out. Most of them have been from lot # 6401540. We recently have had a box of 10 that only had 5 syringes in it, and a syringe that the RN stated had no drug in it from the same lot. Curious if anyone else has seen this or something similar.

Has anyone adopted: 1 to 6ml of Hyaluronidase for each 1ml of extravasated drug into practice (Paclitaxel and Vinca Alkaloids), per "Management of Drug Extravasations" (Lexi-Drugs)?

Would you be willing to share the dosing your institution utilizes or policy?

We are not sure when it changed but prior to this it was, "Hyalurondidase 1 mL (15 units/mL) as five separate 0.2 mL injections (using a tuberculin syringe) around the site of extravasation". May have changed around December 2023?

We are seeing an increase in ferric gluconate infusion reactions, resulting in some ED visits. I saw there was some discussion on this earlier. I wanted to see how everyone is administering and storing the ferrlecit. We use Hikma product and their manufacturer does not have refrigeration stability but based on Trissels and a published study on a different generic, we store in refrigeration for 7 days. We also have 250mg diluted in 250 mL and administered over one hour. Interestingly, we don't see the same anaphylaxis reactions in our inpatient doses, which are made on demand.