For those of you who have BCMA at your facility, does your Cath Lab and/or procedural areas also use BCMA? We're getting reports that it impedes workflow and directs attention away from the patient during critical moments. Curious if others have had issues with this as well. Thanks,

Cortney Swiggart
Med Safety Officer

We have an order set for insulin that contains orders for hypoglycemia treatment and also an order for D10 for hypoglycemia prevention. If the patient receives NPH insulin and continuous tube feeds are later stopped, the nurse is to hang D10 at the same rate as the feeding rate. The D10 order may be placed days before the tube feeds are stopped for procedure or other reason. Our nurses are not hanging the D10 in all cases and we see 1-2 safety events each month for hypoglycemia due to this.

Does anyone have experience yet with IONSYS, the fentanyl iontophoretic transdermal system? Curious about how it is stacking up against IV PCA. Mike

Curious to know if anyone has a protocol for pediatric IV fluid volumes based on weight or is everyone using liter premixed bags with smart pumps on any age?

I would appreciate any guidance on policies or SOP's defining the use, ordering, dispensing of medications for education/simulation. If you have an existing policy I could view it would be helpful. Thank you.

Dear All

Recently some of the NICU Physicians raise an issue on efficacy/Potency of Vancomycin 5 mg/ml in Dextrose 5% W/V syringes that are supplied from our IV admixture unit.
They suspect the concentration of the active ingredient is less in the syringes, as they did therapeutic drug monitoring. Recently I spoke to one of the NICU specialists regarding the wrong frequency of Vancomycin (As per NICU Antibiotic guideline), he told that this baby’s TDM result shows very low trough, so he increased the frequency from Q8 Hourly to Q6 Hourly.

Could any of you share your Standards, Policies, and/or Guidelines regarding patients who come in for a procedure and has a medication patch on. Specifically, I am looking for the following:

1. Direction on situations requiring removal (ie. procedural sedation, MRI due to metallic content, when procedural site is occluded by the patch, etc.)

2. Documentation of removal or of continued therapy during procedure

3. If patch removal is indicated, destruction or storage process and its documentation

We are reviewing our potassium Chloride IV administration policy. Would anyone be willing to share the maximum concentration for peripheral bolus doses; i.e., 10 mEq/100 mL or 20 mEq/100 mL, etc?

Thanks, Vic

We are reviewing our potassium Chloride IV administration policy. Would anyone be willing to share the maximum concentration for peripheral bolus doses; i.e., 10 mEq/100 mL or 20 mEq/100 mL, etc?

Thanks, Vic

Hello Everyone,

I am writing today to ask about your institution's practice with regards to amphotericin B.

1) Does your institution carry the conventional form and any of the lipid-based formulations? If so, what is the reasoning for carrying both?

2) Did your institution carry both formulations (conventional and lipid-based) in the past and then removed one formulation? If so, what was the reasoning for the removal?

3) If your institution removed amphotericin B (either formulations) from the formulary, was there any push-back/resistance?