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 When the ordered dose is changed, the barcode previously placed on the insulin pen is no longer valid as the barcode it tied to the order number.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

Wondering if others allow the use of batch bags in their compounding suites. We have a request from our technicians to use a batch bag for a specific compound to make compounding easier/safer. The bag would be made, the syringes drawn up from it, the whole process checked, and then any remaining medication would be discarded. I know there are some concerns with batch bags so I was juts curious what others are doing. Thanks!

Hello all,

We have had a significant uptick in one of our ICUs around RNs forgetting to open the roller clamp on intermittent infusions, resulting in missed doses. Their proposed solution is to run everything as a primary infusion, noting that "some facilities have stopped running intermittent infusions via secondary tubing due to med errors and delays in med therapies."
This would greatly increase their need for pump channels, and I don't know that we can support that in current state.

I am looking for information on what other hospitals are doing to tackle hold orders. Does your EMR allow providers to hold(suspend) doses for certain dates/times(i.e. am dose prior to surgery or procedure)? We have Cerner at our health system and have struggled for a long time with the multitude of ways providers are entering a hold order on a medication. In most cases we are relying on communication orders for those holds which has led to medication events and delays in care. The number of communication orders for a nurse to handle has become cumbersome.

Hello,
We have a mix of badge readers and keypads that secure our medication storage areas. For those of you that still use keypads, what is your process for updating the codes?

More specifically:
-How often do you change the codes?
-Is the code itself the same across the organization or customized per area?
-WHO changes the codes?

Thank you!
Stacie Ethington MSN, RN
Medication Safety Nurse Specialist

We recently went live with Baxter pump interoperability. We use the Rover as our BCMA device and Epic as our CPOE system. We are receiving many errors in which the nurse has scanned the pump, patient and medication. The Epic order information is sent to the pump via the Rover and the pump receives the information, because the nurse can see it on the pump, however, the transaction is not completed on the Rover. The confirmation message that should be sent from the pump to Rover doesn't complete.

We just changed over to a new Baxter syringe smart pump.
The Aerogen syringes, non-FDA approved use for respiratory medications are not recognized in the pump- which I believe it true for all pumps.
The Novum Baxter pump gives an alert that warns the nurse that this could be dangerous to use a non-approved syringe (the language is hard coded and pretty harsh).
How are you handling respiratory medications given with the use of a syringe library ?
Any help would be appreciated !

Hi all,

It's been awhile since someone asked this, and we're updating our policy. Would anyone be willing to share their Critical Med timing policy?

Thanks!
Jennifer

How are facilities addressing the ISMP recommendations for REMS? It was mentioned twice in the recent Action Agenda. In our hospital we are mostly continuing what has already been prescribed somewhere else for these specific meds... so they are not being prescribed brand new. Would the REMS still apply? The opioid one is the only one that we would be starting patients new on... but, I don't see where anything is "required" there. Would love some clarification on this if anyone knows. Thank you so much!