I am interested in information regarding the preparation and formulation of fentanyl epidurals.  Currently we are batching our epidurals in the IV room and providing them to our anesthesiologists in a locked refrigerator on the L&D floor.  The formula we use has been in practice for an undetermined amount of time, I do not know that it has ever been evaluated for best practice since I’ve been at the institution.  The bags contain fentanyl, bupivacaine, and epinephrine.  We want to make the compounding of this bag simpler, and thereby safer, by removing the epinephrine.  Do you have any

Our Medication Safety Council conducted a medication dilution survey for our inpatiet nurses similar to the survey in last summer's ISMP Alert.  After we received the results, which reflected the results found by ISMP, we determined that education needed to be provided.  Unfortunately, we aren't sure where to go from here.  Literature searches turned up very little in the way of evidence based practice for medication dilution and many of the package inserts were vague (e.g., may be diluted, dilute in 5-10mL NS or sterile water.....).  We are looking for any recommendations from others that

Our facility is reviewing the use of allergy bracelets.  Is anyone aware of best practice recommendations round the use of allergy bracelets?  Any input would be greatly appreciated.

Thanks in advance!

Amanda

Looking for policies/examples of how excipient and preservative allergies are handled? For those ingredients that electronic systems do not scan for, or alert against, what procedures are in place?

We are currently working on a policy for administration of intranasal midazolam and fentanyl for patients in ED, out patient suregery, and pediatrics without an IV site.  Doses anyone have any policies or experience with this route of administration they would like to share?

Thanks,

Melinda

Hello Everyone,

Does anyone have any protocols in place for infusing 3% saline? If so, would you be willing to share?

Thanks in advance,

Stephanie

Has anyone out there successfully implemented all 12 Targeted Best Practices? I would be interested in talking with you! Thanks!

Hello,

We are interested in knowing how other institutions enter their patient's home medications.  At our institution, we currently enter a dummy "POM" medication into the patient's profile.  However, this dummy record does not perform a drug interaction check for new or existing orders. We currently have Meditech version 5.6.6.  Our current process relies on a manual check which allows for POMs drug interactions to be missed.  Any feedback or suggestions on the following questions are appreaciated:

1- How does your institution enter patient's home medication?

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