Less than a year ago, pharmacy started sending inactivated Clinimix bags to the floor for nurses to activate at time of administration to extend beyond use date versus activating in pharmacy and delivering to the floor hours later (we rolled this out along with a similar process for CRRT bags). Unfortunately, we have had numerous errors where the Clinimix activation did not occur and was noticed on rounds or by another shift. We do not have Pyxis space to add to there and provide an alert / CDC. The drug line includes activation prior to administration in admin instructions and pharmacy sends up with a sticker stating Activation Needed Prior to Admin. We are working with our meds management / Epic team, but coming up short on ideas of how to potentially fix.

Two questions:
1. Are other hospitals using something within Epic to alert RNs on the MAR (action needed) or something else built into the drug line? Or another process altogether?
2. How do you interpret the BUD of 24 hours - as a hang by time or it is truly expired and requires a new bag? (Manufacturer states if bag is activated and refrigerated BUD = 9 days, but does not mention non-refrigerated temps).