We are looking to use Alaris Smart Pump on Epoprostenol and Treprostinil as a continuous infusion. I am requesting your success and issues using the pump with these  pulmonary hypertension agents. In addition, can you share the Drug Library setup for Epoprostenol and Treprostinil?

Thanks,

Joe

Joseph T. Moss, Jr., PharmD, MBA

System Clinical Informatics Pharmacist

UH Case Medical Center

11100 Euclid Avenue, Wearn 102

Mail Stop: WRN 5006

Cleveland, OH 44106

Office: 216-844-4248

Cell: 330-416-9715

What are your order requirements for titration orders? Do you require any of the following?:

• Starting Dose
• Maximum Dose
• Monitoring Parameter (e.g. SBP, MAP, etc.)
• Amount of Incremental Dose Adjustments
• Frequency of Incremental Dose Adjustments

If you require any of these elements, do they have to be included in the order or are you allowing nurses to reference guidelines/policy/protocol when the prescriber fails to include this level of detail in the order?

Thanks,

Ramona

Good afternoon,

Do you have an auto-stop discontinuation for opiate orders?  If so, what is the therapy length before discontinuation?  Do providers receive a prompt that the order will be expiring, or a prompt suggesting re-order if therapy still indicated?  

thank you,

Rebecca Prevost PharmD

Medication Safety Officer, Florida Hospital, Orlando, FL

Hi,

we are experiencing a shortage of Plegisol and would like to compound our own cardioplegia solution using our Baxter Compounder (Exactamix 2400) but have never done so. I am concerned about the pH. Does anyone have any recipe, including BUD they would be willing so share?

Thank you in advance for help!!

Melissa Marshall, Pharm.D., BCPS

University of Miami Hospital

mmarshall@med.miami.edu

Does anyone have first hand knowledge of preferential safety reasons for using BD Cato (newer product) over the older product DosEdge?

Thanks.

DiAnthia Patrick, PharmD

Medication Safety Coordinator

Children's National Health System

For those with pediatric patients, do you allow parents to administer PCA doses?  If you do, would you be willing to share any policy and/or procedures for how you have implemented? 

Best,

Drew

How is your med safety committee organized?  Our P&T committee is named the Medication Safety and Therapeutics (MS&T) Committee.  We are looking to carve Med Safety out of this committee and set it up as its own separate subcommittee that reports up to P&T (instead of lumping them together).  Does anyone have a Med Safety Committe charter that they would be willing to share with us as we are attempting to set up our committee structure?

We have been asked to prepare for some low volume pediatric surgery cases. I wondered if anyone had any ordersets already developed for pediatric patients they would be willing to share?

Thanks,

Kim Gaillard, PharmD

RSFH Medication Safety

We recently had a patient on suicide precautions who was on a fentanyl patch, which was disposed of incorrectly (in the trash vs. fold and flush).  The concern was raised about the availability of concentrated drug to be ingested in this manner.  As we thought more deeply, we became concerned about any topical patch used in this patient population.  Anything could be ingested causing an overdose.

Have any of you addressed this?  Do you utilize a suicide precaution checklist that might incorporate this?

Does your institution use one concentration or multiple concentrations of morphine, hydromorphone, and/or fentanyl for PCA?

For those organizations who have been able to utilize only one concentration per medication for PCA, what concentrations do you use for:

• Morphine -
• Hydromorphone -
• Fentanyl -

For those that utilize multiple concentrations, have you tried to limit to one concentration and if so, what have been barriers to implementing?