[132795922]
Our pharmacy recently changed how we dispense act-bag meds. Instead of sending the via, adapter, and ivf, we now just stock the vial in pvxis; nurse grabbed the adapter and ivf from their unit stock. When iv bags are scanned, epic just verifies the type of solution, and not the volume. I heard this will be fixed with the next upgrade. We had a nurse grab a 100 ml bag instead of a 50 ml bag of ns to dilute a pantoprazole infusion. The error was discovered after the patient received the wrong dose for 6 hours. We are now planning to have pharmacy go back to dispensing the bag/adapter/vial for continuous infusions (pantoprazole, diltiazem, amiodarone). The volume of the ivf still doesn't verify when a pharmacist scans it, but at least a pharmacist check the bag before it's dispensed. Interestingly, we're also switching iv pumps. Currently nurses select "antibiotic ivpb 50 ml" or "antibiotic ivpb 100 ml", but on the new pumps they will choose exact meds (e. G. Cefazolin in 50 ml). If the med is accidentally diluted in the wrong volume, the patient may either get the dose too quickly, or may only receive half of the dose. (b)(6); access number: (b)(4).
Patient Sequence No: 1, Text Type: D, B5