I know this comes up routinely.... Does anyone have a nurse dual sign requirement for thrombolytics? We had a Stroke Certification survey last fall and TJC was pretty insistent that this be a mandatory requirement. Our process has been to evaluate medications based on ISMP guidance so have not had these meds as a requirement. We have alteplase and tenecteplase on our formulary so both would be required. Interested if others have had this 'recommendation' from TJC and added these to their list or just have them on the list. Thank you.