What is the process your hospital uses for delivering IV medications less than 1 mL?

Here's our situation (which I think may be yours too)!
1) Priming volume of tubing is 1 mL
2) When med is, for example, 0.3 mL over 15 minutes, in 15 minutes this med is still in the tubing
3) The flush should run at the same rate as the med which will then take excessive time
4) Some nurses have been running the flush(1mL) over 5 minutes which really means the med is now going over 5 minutes

Solutions we have thought of and problems:

Hi All,

Does anyone have nomogram for dose adjusting argartoban based on aPTT for heparin induced thrombocytopenia and is willing to share?

Thanks in advance.

Agnieszka Pasternak
Akoniecka@northwell.edu
Agpasternak@yahoo.com

The Joint Commission has just visited our institution and asked about the follow best practice recommendation of eliminating 1000 ml sterile water bags outside of the pharmacy. Our Medication Safety Meeting has been addressing this issue as it relates to the Neonatal ICU use of the 1 liter bags with CPAP machines. Would appreciate any advice on how to best approach this issue as I am told there is no alternative. The notes form our Medication Safety meeting are as follows:

Dear all,

I am working on developing both a 4-week & longitudinal rotation for our PGY-1 program. Can you please share any objectives/activities you have listed for your respective programs?

dablizR@ccaduae.ae

Thank you
Rabih

For Sites with EPIC…
What sort of access do medication safety pharmacists have to test/run scenarios in EPIC? I have access to POC and TST, because I am sent content by IT to approve prior to it moving into the live/production system.

However, our IT department is reluctant to grant our safety pharmacists access to POC or TST to recreate events/test scenarios. I am just wondering what other safety pharmacists that use EPIC have access to. It may help my case!

We are curious how others are handling alcohol for PREVENTION of withdrawal in the hospital.

Do you allow this practice?
Who supplies beer, wine, spirits? ( in our institution currently beer and wine are handled by dietary, hard liquor by pharmacy.)
Do you document on the MAR and treat it like a drug, or as a food? Is it stored in the med room fridge or in the pantry?
How do you know the proper dose? Do you monitor for signs of withdrawal in these patients?

As you know, FDA-approved labeling for fat emulsion was modified last year to include a requirement for filtering infusions with a 1.2 micron filter. I'm not sure whether lipid rescue was considered though. Has anyone given that some thought or actually considered and decided one way or another? When fat emulsion is needed in an emergency such as accidental intravenously administered bupivacaine, would you require a filter as per the label?

Thanks,

Mike Cohen

How do you administer albuterol for continuous nebulization to ventilated patients? It requires administration of the product into a nebulizer via a syringe pump. Was wondering if you were using the IV pump you currently use for this product?

The syringe is a 60 mL syringe recognized by the pump however the syringe end cannot connect with IV tubing. The tubing that does come with the syringe at it’s other end can only connect with the nebulizer and not an IV line.

Is anyone willing to share their policy for use of U-500 insulin that you may have?

Hello,
Interested to know if any institutions are using pumps other than alaris. If so what pump are you using?

thanks,
Rachel