By now a lot of sites have probably moved to tenecteplase for stroke . Given that there is an urgency to the medication administration, and everything we know about the emergency department I am wondering what best practices we can share around safety ?
We have had a couple near misses even though the following is in place:
1. double checks on emar
2. order only in order set
3. stickers for dosing and cap dosing on container per pharmacy prior to ADM stocking
4. Robust clinical decision support in Epic

Looking to see if anyone else has developed any take home resources regarding hazardous medications that are dispensed in the retail setting for caregivers. Inpatient we have warnings to nurses at the ADC and many resources available. But for patients who are being discharged home with a hazardous medication they or a caregiver may be manipulating (ie: crushing or opening for g-tube administration) that level of hazard (especially reproductive hazard) may not always be communicated in the drug monograph that is dispensed (Thinking along the lines of a pregnant person as a caregiver).

We have had a couple errors in a NICU because the wrong syringe size was selected when programming syringe pumps. The 1 ml and 3 ml barrel size are similar so the pump is unable to detect the difference and it has to be a manual selection by the nurse.

We have spoken to several vendors and had our current vendor come on site, and apparently this is the case with all brands of syringe pumps.

Good afternoon,

Hi! I was wondering what other sites do for EHR downtimes when reporting out barcode medication administration (BCMA) compliance trends. Requests have been made to tease out BCMA data from known EHR downtimes. This process is manual. I was wondering if sites are speaking to compliance rates, noting trends or noting there is some cushsion in goals to allow for downtimes, etc. Thank you!

Hi all,

Our GI docs are wanting to continue to prescribe domperidone for their patients. Has any one had any luck at their institutions getting the FDA IND approved for this?

Hi everyone,

1. Does your organization have a single hydromorphone Iv infusion concentration for all infusion rates or more than one based on the ordered rate? (ex: our institution currently utilizes 0.1 mg/mL as a standard and 1 mg/mL for doses 2mg/hr and above)

2. If you only have one standard concentration, what concentration do you utilize?

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

We have seen a recent up-trend in hypoglycemic events for patients when subQ insulin was continued after tube feeds were held. Under our current practice we have note in the admin instructions for nursing to “hold subQ insulin if tube feeds are held” for these situations. We are hoping to add additional safety measure to encourage providers to hold insulin orders when tube feeds are held and/or draw nursing attention to this practice. I am looking for any other ideas or solutions that other institutions have implemented that may be helpful. Thank you in advance!

What restrictions do you have for intermittent IV labetalol administration? Do you allow it on the general acute care floor (we currently restrict it to critical care)? If so, how frequent is the monitoring? Thanks in advance! -Melody Sun, CHOC Children's

Good morning,
Anesthesia providers have reported multiple cases/lots with inefficacy of Ephedrine Syringes from Akovaz/Excela. Has anyone had any issues with efficacy/potency of Ephedrine Syringes from Akovaz/Excela?

Thank you,
Amirah A.