Help ML/KG IV Solution set-up in order strings. | Forum

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Jul 20 '17
2017-07-20 17:17:36
We built an order set for Sepsis which includes IV fluids. We need a better way for the ER physician to order weight-based fluid bolus ml/kg.
We currently have it set-up in the Special Instructions which follows to the eMAR; but the bolus dose is not being given by the staff because they don't see it.
Currently, the functionality for weight-base dosing order strings only applies to additives.
Does anyone have any suggestions?
Thanks, Paula

Jul 21 '17
2017-07-21 14:58:39
Hi Paula,
We build these in the order sets as rounding up to the nearest liter.
So subheaders and such look like:
[FLUID 30 ML/KG (PATIENTS 66 - 99.9 KG)
NS wide open x3000 mLs.
[FLUID 30 ML/KG (Patients 100 kg to 132 kg)
NS wide open x 4000 MLS.
And so on. Doctors and nurses love it. We want a one click option, but do not like how Meditech current 5.67pp19 system handles weight based fluid orders, as we want the nurses to scan each bag, and be told how far they are in the total order.

Andrew Ventura, Pharm.D, MBA
Pharmacy Informaticist, Information Systems
Augusta Health, Fishersville VA
C/S 5.67pp19


Jul 21 '17
2017-07-21 15:29:40
Hello,
We have the Sepsis string set up in the PHA Dosing Sets as a Fluid. As Andrew mentions, it does not allow for the scan of each bag. However, our providers were more concerned about the total volume of the bolus. The nurses track the volume infused per the channel on the pump and set the total volume on the pump so it will automatically stop infusing. We have been using these strings for over a year with no issues.
Thanks, Kris
Kristopher P. Brown R.Ph.
Founder & Pharmacy Consultant
Med Preservation, Inc.
| t. 615-406-7453 |
| e. kbrown@medpreservation.com<mailto:kbrown@medpreservation.com> |
| w. /...preservation.com/>; |
Jul 21 '17
2017-07-21 17:01:58
Hi Kris,
How did your facility reconcile the loss of BMV safety checks with this workflow? That's what gets us.... What if the NS stack in the supply room had a mixup and a bag of something else slipped in?
Thanks,
Andrew Ventura, Pharm.D, MBA
Pharmacy Informaticist, Information Systems
Augusta Health, Fishersville VA
C/S 5.67pp19-->25

Jul 21 '17
2017-07-21 18:12:03
Hi Andrew,
I hear you. I don't think there is an ideal way to do this. I wish there was some way to scan every bag. The fluids in our profiled locations are now stocked in Pyxis towers. While mix-ups still can happen, Pyxis has a few extra steps that help to create a better safety net than floorstock closets. It also allows us to automatically drop a charge since we still haven't switched to charge on admin. This was the original reason we started stocking fluids in the towers in the first place. Accidental mix-ups obviously happen from time to time in Pyxis, fluids are not generally the culprit for us.
Thanks, Kris
Kristopher P. Brown R.Ph.
Founder & Pharmacy Consultant
Med Preservation, Inc.
| t. 615-406-7453 |
| e. kbrown@medpreservation.com<mailto:kbrown@medpreservation.com> |
| w. /...preservation.com/>; |
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