Category Archives: News

Hypothermia Order Sets MODIFIED

The hypothermia order sets have been modified to account for new criteria. Updated for McHenry and Huntley locations.

The new naming convention is as follows for all hypothermia order sets:

Targeted Temperature Mgmt TTM Pre Induct/Induct (M or H)

Targeted Temperature Mgmt TTM Maintenance (M or H)

Targeted Temperature Mgmt TTM Maint Timed Labs (M or H)

Targeted Temperature Mgmt TTM Rewarming  (M or H)

Lorazepam Injection Shortage 12.5.18

To:            Physicians, Nursing, Pharmacy

From:     Alan Mader, Pharmacy Clinical Coordinator

Date:      12/5/2018

Re:   Lorazepam Injection Shortage

SituationLorazepam 2mg/mL 1 mL vials are on manufacturer on backorder.   The estimated re-supply date of November 2018 has already been exceeded.  Other projections for release include December 2018 to January 2019, with others extending to January 2020.
BackgroundLorazepam 2 mg/mL 10 mL vials have been on backorder since November 2017.
AssessmentThe addition of the 1 mL vials to backorder status severely limits availability of lorazepam injection.  While the pharmacy maintains some supply of lorazepam injection, the probability of depletion of stock before repletion is high.  Use of other benzodiazepines may become necessary.
RecommendationFor patients who currently require lorazepam, please consider use of the PO route whenever possible.

While there are no direct dose conversions between benzodiazepines, please consider the following information on pharmacokinetics to aid in selection of an alternative:

MedicationOnset

IV (minutes)

Onset

IM (minutes)

Duration

IV

(hours)

Duration

IM

(hours)

T ½

(Hours)

Active metabolites
Diazepam

(currently available in MDV’s only)

1 to 5Slow and erratic absorption0.3 to 0.5Slow and erratic absorption20 to120Yes
Lorazepam5 to 2015 to 306 to 86 to 88 to15No
Midazolam

5 mg/1 mL

5 mg/5 mL

2 mg/2mL

1 to 55 to 15≤22*3 to 11Yes

Pharmacologic effect of Midazolam may last up to 6 hours in some patients

Dexamethasone 10 mg/1 mL Preservative Free SHORTAGE 10.4.18

To:             Physician, Nursing, and Pharmacy Staff

From:        Alan Mader, PharmD, Pharmacy Clinical Coordinator

Date:         10/4/18

Re:             Dexamethasone 10 mg/mL 1 mL Injection PF Shortage

S

Situation

 

We have been notified that dexamethasone 10 mg/mL 1 mL PF has been placed on the shortage list.

B

Background

 

This shortage has been newly announced.

A

Assessment

The quantity of 1 mL PF vials available at NWM, NWH, NWW is 110.  The usual consumption at NWH is approximately 18 per day, with NWM and NWW being less.  Based on that number and the ability to shift product between campuses, we have about a 5 day supply available.  The shortage is expected to last from the end of October to mid-November, so that likelihood that supply will become depleted is strong.
R

Recommendation

 

Utilize dexamethasone 10 mg/mL 1mL Injection with preservatives wherever possible.

How to Invalidate Documentation in Paragon Clinician Hub?

In Paragon Clinician Hub, when a document has been entered under the wrong visit ID or for any other reason the document needs to be removed from the record, it needs to be Invalidated.

If you have received a notice stating that you need to make this change, please utilize the instructions below. For additional visual training, a screen shot and a link to a video has been added below as well.

  1. Go to Census, locate visit where the document should be entered by entering the Visit ID supplied by Medical Records into the search field.
  2. Recreate the note under the correct visit ID, noting that the date is editable.
  3. Go back to the Census Tab.
  4. Locate visit where the document is entered in error by entering the “wrong” Visit ID supplied by Medical Records into the search field.
  5. Open the note in question, and locate the icon next to red X in the upper right hand corner; click the invalidate icon and choose a reason for invalidating.

Video on how to Invalidate: https://youtu.be/3YlLdtKPqzY