Our EPIC Instance reports QTc using Bazett's formula.

Has anyone had success with changing their default QTc formula in EPIC to a different one: Framingham or Fredericcia?

Problem: The Bazett formula is known to overestimate the number of patients with potentially dangerous QT prolongation (overestimates QTc at high HRs, underestimates at low HRs)1. A mean difference of 24 msec between the Bazett and Fridericcia formula (overcorrecting with Bazett) was observed in patients with a heart rate ranging from 80-90 bpm.1

For those using the Alaris IV pump:
-What strategies do you use to ensure accurate PCA pump programming, especially when it comes to concentrated infusions?
-Do you have level of care restrictions for concentrated PCAs?
-Do you use capnography for concentrated PCAs?
-Anything unique or special with the independent clinician verification for concentrated PCAs?

Appreciate your insight,
Stacie Ethington MSN, RN
Nebraska Medicine

Greetings, all.

For vesicant infusions lasting longer than 30 minutes via central line, both ONS and INS recommend assessing blood return at the beginning of the infusion, per organizational policy during, and after infusion. At what frequency are your nurses assessing for blood return during the infusion?

Thanks,
Stacie Ethington MSN, RN
Nebraska Medicine

hi all,
Was wondering if anyone is doing continuous pip/tazo 9 g/13.5 g /18 g in NS for total volume of 240 mL via elastomeric pumps through midline? I'm having a hard time finding any pH / osmolality data supporting use through midline.

Have you all had any reported concerns for Y-site administration of Zosyn + LR?

Our institution is looking to participate in the Leapfrog Hospital Survey. If your institution participates, we are looking for input on FTE/time requirements specific to the Medication Reconciliation Measure.

(1) How many charts do you audit?
30 are required, but do you budget for more in the event patients don’t meet criteria for the audit?

(2) How much time is required by the technician or pharmacist for each med history audit?

Hello all,

What precautions and reminders are present at your organization to ensure that medications are appropriately adjusted by pharmacy for renal insufficiency?

Good morning!
We recently found 2 errors on the newly released Broselow Tape 2025 v3 and wanted to share it so you all are aware and can determine next steps.

#1. Flumazenil dosing on one of the dosing tables towards the beginning of the card lists the dose as 0.1 mg/kg. (the dose should be 0.01 mg/kg).

#2. Vecuronium on one of the dosing tables towards the beginning of the card, for the "Pre-RSI" indication, lists the dose as 0.1 mg/mL (should be mg/kg).
- The Vec dose under the Post-RSI is correct right below it.

I'm looking to see if anyone has had errors in which Exparel is being given pre-op and then receiving a subsequent dose during the procedure or at closure. Specifically targeting patients who may have received the max 20mL (266mg) already, and then received a duplicate 20 mL plus standard bupivacaine.

If you have, what have you done to prevent subsequent errors? Do you have CDS alerts, etc in place or physical barriers? We are utilizing Epic and looking for input on better optimization. Thanks!

Curious if/what other institutions have for clinical decision support for nurses administering chemotherapy (for example, checklists for Roadmap checks, specific policies/procedures for chemotherapy independent from other medication administration policies, etc.). I'm involved in a Lean Six Sigma project trying to improve/lean how we "check" chemotherapy prior to administration and would love to hear how other places are doing it!

Thank you!