Hello all,
In light of news of the fatal medication event from Vanderbilt University Medical Center, I was wondering if any of you can share some error-reduction strategies you have in place at your institutions to prevent similar mix-ups. I have several to share but would like to hear from the group.
1) Addition of a Pyxis alert indicating High-Alert status of VECuronium
2) Possible elimination of VECuronium from formulary
3) Implementation of BMCA in procedural areas
4) Updating High-Alert policy to include language on x1 doses of NMBs
5) More real-time review of Pyxis override reports
If you have any suggestions, or have tried some of these strategies and ran into issues, I would love to hear it!
Thanks,
Phil