We recently started looking at how and where our pediatric/NICU IV medications are being prepared, in the pharmacy or on the floor by nurses. Many of our IV push medications for NICU are prepared and diluted by the nurses on the floor with a 2 nurse check before administration. ISMP and Joint Commission both recommend supplying medications in the most ready to use form which would mean preparing these medications in pharmacy. Our NICU and pediatric departments are not large so this does not come up often. Preparing in the pharmacy means there could be a delay for the medication to get to the floor when needed (especially in PRN situations) and we don't have a dedicated pediatric pharmacy so techs. The nurses in NICU and pediatrics are used to preparing these medications on the floor and feel they have good safety checks in place. I would love to hear how other places supply NICU and pediatric IV push mediations especially if you don't have a dedicated pediatric pharmacy in your hospital and how you determine what level of preparation or dilution is allowed to be done by nurses on the floor. Thanks!