Hello,

At our hospital, we recently had a discussion regarding order alerts/alert fatigue and the option of turning on the 'override all' button for addressing order alerts was reviewed. I'm looking to find out what other institutions have done regarding turning on the 'override all' alerts option and if anyone used guidelines or evidence to support your decision.

Thank you,

Sadie

Hello,

We are seeing an increase in the use of BUPivacaine (Liposomal) by our surgeons. How have you provided clinical decision support to not administer other local anesthetics or other formulations of bupivacaine within 96 hours following bupivacaine (liposomal) administration? Do your pharmacists receive any kind of alert?

Thank you in advance.
Damon

Does anyone have a process in place for preparation and administration of Cyanokit for pediatrics? We have reached out to the manufacturer, and they do not have any suggestions and have only studied administration using their tubing for adults. We are trying to determine if we should prepare it in the pharmacy vs. keep in the Omnicell for nurses to prep. (If it wasn't so time-sensitive we would certainly suggest pharmacy prep). Is anyone using Alaris to administer this drug?

Dear all,

What is your current process for ensuring TJC compliance with the multiple vasopressor or sedative orders. In other words, how are ordered entered in your EMR to ensure there are instructions on when to titrate vasopressor 1 vs 2 vs 3?

Thank you,
Deepika

We recently had a question come up concerning the scope of practice of CT technicians when administering IV contrast. When a patient goes to CT with a continuous infusion is it within the scope of practice of the CT tech to determine what medications can be stopped in order to administer the IV contrast and when a second IV needs to be placed? Can the CT tech stop and restart the IV infusion? Should a RN be present making this determination and starting and stopping the pump?

We have been batching syringes of dexmedetomidine and nitroglycerin for our OR. Anesthesia has expressed concern that these look identical (they do), and have asked for color coding. Have other people implemented colors for batched syringes?

If so, can you share your workflow and implementation processes?

Thanks,
Kara
UVA Health

We're in our survey window and I wondered if anyone would be willing to share any citation trends you are aware of for 2022-2023?

Greetings,
I am reaching out with a Pyxis-centric question.

On some of our patient care units, there is no med room. In order to secure meds, we have med bins ("cassettes") loaded in the Pyxis tower for each bed - these are used for medications that are not already in Pyxis cubies on the unit (think of patient-specific pharmacy-prepared meds, short expiration dates, etc).

We have had several requests to re-evaluate our dual sign off medication list for nurses and are currently focusing on subcutaneous insulin use. We are trying to gather information about what others are doing, if anyone is willing to contribute by answering the following questions:

I am looking for feedback in regard to the use of patient specific insulin pens (Lantus, Novolog) and how to other facilities handle the charging and barcode issues when the order is changed from one dose to another. Our insulin pens are sent patient specific. When the ordered dose is changed, the barcode previously placed on the insulin pen is no longer valid as the barcode it tied to the order number. This has led to nurses overriding the scans. We utilize Cerner as our EMR. Appreciate any input. Thanks!

Heather Queen