Hello colleagues,

With drugs like terbutaline, labeled for subcutaneous use only but used intravenously in practice, how do you address safe use with providers and nurses? A review of appropriate use of inactive ingredients makes sense as well as sharing literature support. Any thoughts/wisdom would be appreciated,

Megan Fragale, PharmD, MS, BCPS
Medication Safety Officer
Skagit Regional Health

Hello,
Does anyone have a process where procedural techs (cath lab, IR, etc) are authorized to remove silver nitrate from pyxis? For our organization, it is not deemed within their scope of practice and are therefore not authorized to handle silver nitrate. Does anyone have a different process at their site?

Thank you

How are sites handling compounded eye drops that have to be administered every hour? Are you keeping on ice at bedside or are they stored in the refrigerator with the expectation that the nurse should remove from Pyxis refrigerator for every administration? If at bedside how are the drops dispensed from pharmacy - label on bottom and inside a plastic bag?

Hi all,

We are pushing out some education on the risk associated with crushing extended release nifedipine. In doing so, the question was asked if this is the only medication that reaches that same level of concern.

So, I wanted to poll this group - Does anyone have any other medications they would include in this targeted education about crushing specific, high risk medications?

Thanks in advance!

Hi all,

Does anyone have any experience in determining if IC green and iodine allergies are truly a concern? We use EPIC and recently realized it doesn't fire an allergy warning in the event of IC Green order being placed on a patient with an iodine allergy documented. When I look further into it, it seems as though the jury is out on whether it is truly a concern or not. Has anyone else investigated this and come to a solid conclusion? Thanks in advance!

Question about how other hospitals are administering famotidine IV push?

The famotidine package insert recommends to dilute 2 mL of famotidine 10 mg/mL solution with NS or other compatible solution to a total volume of 5 or 10 mL prior to administering IV push.

Does anyone have any experience with the safety of administering undiluted famotidine 10 mg/mL by slow IV push into a patent IV followed by an NS flush?

I think there are benefits to reducing the amount of dilution performed by the pharmacy or bedside RNs in this case.

We are forming a BCMA work group to dig into our BCMA reports and evaluate medications that do not scan. Do you currently exclude any medications from requiring a scan? Do you have a rubric or criteria that must be met before excluding a medication from the scanning requirement?

We are experiencing a cardinal IV luer lock insulin syringe disruption. There is no equivalent substitution on the market. What is your hospital doing to give IV push insulin?
Options we are exploring include
- using a slip tip syringe with the friction fit technique
- pharmacy dispensing all IV insulin doses
- pharmacy making IV insulin "kits" with instructions for dilution and administration using a syringe in mL

I appreciate any insights into other institutions.
Thank you!
Emily

Hello - we are estimated to increase our cardiac surgery cases by a significant amount, and are in discussions with Anesthesia on how to accommodate increased workload safely and efficiently. They are proposing to pre-spike and pre-program pumps (epi and norepi) each morning for the planned cases that day. I am most interested in others' experiences and thoughts with pre-programming (vs. pre-spiking, which I have more info on). We use Alaris. Thank you!

Looking for information on how other Cerner/Oracle health systems are handling orders for holding, suspending and/or resuming medications for procedures or tests for inpatients. Specifically looking for processes around holding anti-coagulants (po or IV), antidiabetic medications, etc. Also, for medications like Vancomycin where we may need to hold due to a supratherapeutic level. Appreciate any feedback! Thank you!