Here's my question.. I work in a Level 2 in which we reconstitute our own Amp and dilute our own Gent. When you reconstitute the Gent (to 2mg/ml), and you prepare the syringe and mini-infuser tubing, do you leave any add'l vol over the amt you plan to infuse, or do you fill the syringe with exactly the vol to be infused? Some of our nurses do it differently and I was curious about the "rest of the world".
Mar 2, '03
We mix our own first doses of gent and have the exact amount in the syringe with extra in the microbore tubing. Then we don't need to flush the tubing. Pharmacy sends the "exact" dose (uh well, except for that BIG air bubble...) for subsequent doses and we either flush the tubing slowly by hand or put another 0.6 - 1.0 cc of flush on the pump to finish the dose. We mix our gent 1mg/cc, by the way.
Checking all meds by 2 RNs has been standard practice everywhere I've been for at least the last 5 years - we don't double-sign where I am now, but when charting the med in the computer, we enter the initials of the "checked with" nurse.
We had a Neonatologist recently that wrote all kinds of weird orders so now all med and IV orders have to be checked and signed by 2 RNs at the time of noting, and at the time of administration, safe-dose ranges have to be checked again for each dose.
We also have sooooo many problems with pharmacy. We finally got a pharmacist that understands something about the differences between neonates and the rest of the hospital population, but she is only on during the day (would you believe NO pharmacy at all after 11pm???). Most of our pharmacists are TOTALLY CLUELESS. We have had things like a pharmacist demanding to know why we needed to keep minimum 4 vials of Survanta on hand (we keep down to 24wks). He wanted to draw up each dose when ordered - in the exact amount. Number 1, as I said, pharmacy is CLOSED 11p-6 or 7am. Number 2, until we got the inline adapters, Survanta administration was a sterile proceedure. Number 3, WHEN WE NEED IT, WE NEED IT NOW. NOT IN 1-2 HOURS!
Yeesh! Can you tell I had problems with pharmacy last night???
Last edit by nell on Mar 2, '03