Greetings,

We have been having issues with our lab and nursing coordinating the appropriate time to draw medication levels (mainly vancomycin). On most occasions, the medication is infusing while the the lab is being drawn. All lab and medication orders are timed appropriately. Our hospital uses Cerner for our healthcare information system. I would like to have the ability to place a level reminder on the MAR to alert the nurse that a level has been ordered. I was wondering if any hospital has had this similar issue and how it was fixed.

Thanks,

Jim Galasso

Good Morning,

We are considering changing our practice on the way we dispense warfarin. We currently dispense it patient specific as part of our protocol for patient safety goal 3E. We are now considering loading it into our pyxis. Wondering how others are doing this and if any concerns/issues have come to light if your facility uses pyxis for dispensing.

Thank you,
Kelly Estremera, RPh, BCPS
Bangor, ME

Hello,

I am inquiring about a specific IV room practice. We have a technician who likes to use the Decapper Pliers to remove the top rubber stopper portion from the IV vial when preparing IV products in the hood. And a pharmacist who is vehemently against this practice.

The tech is effectively turning the vial into an ampule, and the vial is used for a single dose. However, it does add an extra step to the compounding process and creates an open system (even if it is being done in the hood).

If you have a Cardiac Cath Lab that uses the Impella catheter device, would you be able to share your clinical procedure for heparin infusion via the Impella catheter?
thank you!
Susan

Hi,

I'm working on a project with a pharmacy student and would greatly appreciate any articles/info/data/policies about errors associated with patients using their own supply of meds in the hospital.

I would like to find out if you require documentation of lot# and expiration date when dispensing or administering IVIG?
thank you!
Susan

Hello MSOS,
My institution currently utilizes an electronic incident reporting system, Clarity, to capture medication related errors in the facility. But as you realize self-reporting is only the tip of the iceberg. We are trying to come up with other methods to increase reporting of medication events (and/or adverse events). So my question to the group is two-fold. Are there are other methods you utilize to improve reporting and identification of medication related events? And how do you encourage staff to report events? Thanks so much for your assistance.

The Prismaflex set that we use for our CRRT therapies has a heparin syringe pump attachment, requiring heparin to be prepared in a syringe (20mL size)and sent to the nurse, which poses the obvious risk of mixup with many other products sent in 20mL syringes.
Would anyone share how they prepare/send their heparins for CRRT?
Thank you!
Susan

In your organizations, could you please describe your approach to ensuring that appropriate patient monitoring takes place to support the safe use of a medication at the point of medication administration (i.e. at baseline, during admin, following admin)? This could include monitoring related to an IV drug known to have hypersensitivity reactions at the time of infusion OR could include monitoring following an oral antihypertensive.

Protamine has a black box warning that describes serious reactions (including cardiovascular collapse) to certain patients especially those known to be of higher risk (such as use of protamine-containing drugs including NPH insulin, allergy to fish, previous vasectomy, etc.).
• In light of this warning, do you have a protocol in place to note if the patient is at a higher risk for a reaction before procedures?
• Are you giving test doses of 5 mg to patients? If so, has this helped to prevent serious reactions?