Hi,

I wanted to share the attached letter we received from Baxter in case you utilize these affected inlet tubing products and have not yet received the letter.

Regards,
Mara Miller, PharmD BCPS
Medication Safety Coordinator
Kaweah Health Medical Center Pharmacy
400 W Mineral King
Visalia, CA 93291
T: (559) 624-5652

We are re-evaluating our bivalirudin guardrails after a medication error.

Currently we have two library files
Bivalirudin (HIT) & Bivalirudin (PCI), the soft maxes were both set at 1.76 mg/kg/hr and we were planning to lower the bivalirudin (HIT) soft max to 0.6 mg/kg/hr.

Additionally, we were going to rename the (HIT) library file because we are using bivalirudin for indications outside of HIT, like ECMO, but were not coming up with a good alternative name.

Hello!

We are interested in learning whether your sites require written informed consent for antineoplastics and biologics when used for non-oncology indications in the outpatient infusion setting (i.e. rituximab or infliximab for rheumatoid arthritis).

If yes, do you employ an electronic process for documenting informed consent?

Thank you!
Frankie

All,
Is anyone able to share the use of Smart Pump Hard Max limits with Neuromuscular Blocking agents in the Anesthesia setting for General Surgery?

Thank you,
Vic

We have an OB patient who has remote spine trauma and was told to avoid spinal/epidural procedures, so one of our anesthesiologists is wanting to do remifentanil PCA for her instead during labor. We have never used remifentanil before so it will be a new build in our EMR software, pump library, etc. The anesthesiologist provided us with a protocol from a facility in Wales as this is apparently common in the UK, but I am unfamiliar with this drug and this is the only protocol I've found so I would like something to compare it to while creating ours.

Hi everyone,
I know there is occasionally some talk about Lumason reactions, but wondering if anyone has seen a cluster of severe Definity reactions lately. We had two patients who experienced cardiac arrest almost immediately after administration. Both from Lot 1352/Exp 4/2025. We are reporting to the mfg and MedWatch but interested if this group has seen anything.
Thanks!
Erin

Hello. My facility is going to be switching to EPIC soon and one of the decisions that needs to be made is whether or not providers will be required to cosign medications given using EPIC's One Step Medication workflow. I was curious as to what other facilities require and why. Thanks!

Hello friends,
Would anyone be able to share any literature or any resources that utilizes cost savings or cost justification to support the addition of med safety positions for a healthcare system where the Med Safety Officer (me) has direct oversight of 8 hospitals, 5 free standing Eds, and 6 infusion centers? I am also expected to assist with retail pharmacies and ambulatory clinics. Any information or advice would be greatly appreciated.

Thanks,
Pratixa Patel

Hi,

Alvimopan REMS requires training for all staff involving in prescribing, describing and administering alvimopan meaning providers and the nurses need to be trained as well.
How do you keep track of provider and RN training attestation?
Did you build something in EHR to track that?

Thank you

We currently prepare patient-specific insulin detemir syringes in our sterile IV hood.

Staff have requested changing the process to prepare these subQ syringes outside the hood for convenience and to minimize traffic in and out of sterile areas. They argue that outpatients don't utilize sterile environments to prepare subQ syringes.

I am curious where other hospitals prepare insulin subQ syringes.

Would you mind sharing if your hospital requires the use of a sterile hood for subQ syringes?