I'm looking for some guidance on how other facilities handle REMS medications from an inpatient perspective. This question was sparked by a recent ISMP newsletter (https://www.ismp.org/resources/incorporating-rems-program-requirements-s...).

For example, suboxone, do you distribute a medication guide to patients on the floor? What is your workflow? REMS guidelines seem to be written for outpatient use, however, I do not see inpatient facility exceptions.

Hello,
Do you have pentobarbital on your high alert list?
We currently do not, but are considering adding it.
Thanks,
Stacie Ethington MSN, RN
Nebraska Medicine

Please fill out this 3 question, <3 minute survey !
I will share results with this group.

It is about the details of Patient own medication use !
thank you in advance !

https://www.surveymonkey.com/r/8XKGV2M

Is anyone willing to share their Patient own medication policy ?
We are revamping ours- and I will tell you that we are actively interested in learning what others are doing.
thanks in advance !

We are evaluating our EMR alert threshold for changes in weight.
I was wondering what the threshold is in other hospitals for alerting the clinicians when a weight change is considered significant and possibly erroneous at the time of typing into the flowsheet, ordering weight based meds, and verifying.

What is the threshold based on (industry standard, evidence of normal weight changes in the hospital, etc)?

Thank you,
Eliana

Hi,

We are evaluating our med safety program to determine if we are resourced appropriately. We're hoping to benchmark ourselves against other institutions. I would appreciate any of the following information:

How many med safety FTEs do you have?

Total # beds covered?

# of hospitals?

If more than one, does each hospital have designated med safety resources?

Does hospital med safety cover ambulatory sites?

What metrics do you use to evaluate med safety resources?

Our current process for weight-based infusions is to use the current weight documented at the time the weight-based infusion is ordered. This leads to different weights for different infusions based on when the infusion is ordered during the admission. We have recently discovered that the weight is rarely updated when a new weight-based infusion is added to the pump. Leading to a discrepancy in the actual total amount of drug infusing versus what is being documented in the chart. Curious if anyone can provide insight on their current practice, specifically:

How do organizations with Epic and Omnicell handle patient-specific controlled substances (i.e. methadone)?

We currently load patient-specific syringes into a miscellaneous narcotic bin in the Omnicell, but the Omnicell does not prompt the RN to pull from this bin, causing nurses to believe that it is not available. Interested if other organizations practice similarly or if you have found a better way?

Thanks,
Sloane Hoefer
Med Safety Pharmacist
Nebraska Medicine

Have any of you moved to administering Keppra as IV push instead of the premade IV piggybacks? If so, how did you justify the vial saying "MUST DILUTE"?

Hi I'm wondering how your facilities handle flushing the medication tubing after administering an IV medication. I'm specifically asking about the medication IV tubing and not the port/line access flushing. Do you use a prefilled saline flush vs IV fluid bag vs something else?

I haven't been able to find standards of practice on this. Maybe I'm looking in the wrong place.