Category Archives: News

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




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




This shortage has been newly announced.



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.



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:


PERT Alert (Pulmonary Embolism Response Team)

PERT is an interdisciplinary effort to provide rapid assessment and treatment based upon the patient’s condition and best practice guidelines. Research has shown that a systematic approach to treating pulmonary embolism (PE) patients will increase time to treatment and decrease adverse events including mortality and long term heart failure.


A PERT ALERT is initiated on all patients diagnosed with a Sub-Massive or Massive PE to establish a mechanism for key personnel to rapidly evaluate and accurately risk stratify to provide evidence-based care and treatment. Patients are risk stratified in to 3 categories: Low Risk, Sub-Massive, or Massive.  Potential patients appropriate for Catheter Based Treatment (CBT) are those stratified as Sub-Massive and Massive. Most patients qualify for Catheter Based Treatment. The goal of CBT is the removal of the obstructing thrombi from the pulmonary arteries to facilitate right ventricular recovery, and to improve symptoms and survival. This includes reduction of long term heart failure. CBT uses significantly less tPA than medical treatment (or systemic treatment), thus reducing bleeding complications. Few patients receive Surgical Pulmonary Embolectomy. By providing a systematic evidence based approach, we may be able to get patients to surgery before they decompensate to a point of no return.


The initial key person to contact is the Interventional Cardiologist on call for PERT ALERT. Additional persons can include pulmonologist, surgeon, hospitalist, hematologists and pharmacist. Nursing provides support by closely monitoring the patient’s condition for deterioration, ensuring rapid completion of tests such as Stat CT Scan, Stat Echo, EKG and lab work, and administering medications.


PERT Alerts should be called by the physician receiving the report of a confirmed PE.  Once a PERT Alert has been activated a PERT Alert Algorithm will be followed as indicated in the PERT Alert Policy, #9856-261.  The PERT Alert Policy went into effect system wide effective May 1st, 2018.  The interventional cardiologist on call for PERT Alert can be found via the ED Call schedules.

PERT – PE Risk Stratification- pocket card- working document

New Citrix Receiver – Rollout Begins 6/18/18

The IT Team announced an upgrade to the Citrix Receiver 4.9 for all hospital service areas. The new Citrix Receiver is designed to eliminate desktop clutter and allow end users to manage their Citrix icons in a convenient “storefront.”  The rollout will take place June 18th through June 22nd.  The Help Desk will staff additional agents during the rollout and the Desktop Team will round on units to provide Support.  The rollout schedule is as follows:

  • Monday, June 18th              Pharmacy & Lab
  • Tuesday, Junet 19th             Inpatient Nursing Units, Physician devices, Registration
  • Wednesday, June 20th        Surgical Services
  • Thursday, June 21st             Medical Imaging
  • Friday, June 22nd                 Care Coordination

Citrix Receiver Training Guide

Paragon 14 upgrade


Paragon will be upgraded from version 13.x to version 14


Saturday 3/17/18 at 10p to Sunday 3/18/18 5p

What will be unavailable?

All Paragon applications including Clinician Hub (physician access) and Clinical care station ((nursing access)

What will be available?

PACS, MPF (medical records), T systems, OB and anesthesia Centricity, MUSE and CVIS

For instructions on accessing MPF during downtime see here.

What about labs?

Labs will be printed and placed in the paper chart.

What about notes?

Physicians will dictate notes during downtime.

What about orders?

Paper order sheets and prescriptions will be used during downtime.

What are the new features in Paragon 14?

  1. Updated Patient Card: Patient demographics are easier to see in the upper left hand corner.
  2. Patient Profile (NEW): Report containing information such as advanced directives, allergies, demographics, family history, implants, home medications etc are now available in a single report. This report can be customized by the end user for their practice
  3. New flowsheet search capabilities: Some flowsheets such as Lab can get very difficult yo navigate especially on long admissions. This new search function will allow the user to quickly scroll the needed row. In this example I searched for “chest”. I was taken to the Chest X-ray row with the specific row highlighted.
  4. Prescription writer: Now allows for secure electronic submission of controlled substances