Hello,

Does anyone use methadone IV in the hospital? We currently have it as non-formulary but we are thinking of adding to our "do not order" list. Does anyone do this, use restrictions or have a policy for it's use? Thanks! ---Jeff

We apologize about the recent inappropriate posting of an advertisement for naltrexone.  We have removed the ad and plan to use this case to evaluate how to better improve our filtering system to prevent such future posts.  We regret any inconvenience this may have occurred. 

Hello,
Is anyone using ofloxacin and ciprofloxacin ophthalmic drops in the ears? We use them in the ears, but I heard that the dose conversion may not be 1:1. I have not found anything specific to tell me that though.

Thank you
Marilyn Hargett MSN, RN

Hello,

I have been asked to give a medication safety presentation to our family practice medical residents. It has been left open for me to choose what will be covered. I am wondering if anyone has presented on medication safety for medical residents and what topics were covered. Were there any topics the residents were particularly interested in? I'm excited to have the opportunity to develop this lecture but just want to make sure I keep them engaged.

Thanks!
Amanda

Everyone,

I an interested in learning how your organization approaches REMS Alerts for the clinician/prescriber to acknowledge to order these agents.

We have an alerts built in our CPOE system to inform prescriber what actions they need to complete to order REMS agents.

Example: REMS Alert

FDA REMS DRUG - By ordering this medication I acknowledge that I have completed the FDA REMS certification requirements and I am an authorized prescriber.

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