Slightly

really ? We double check EVERY drug we give....and both nurses sign. Don`t you think it is safer that way ?

Preparation of medication in NICU We began using the unit dose system for preparation of medication about 2 years ago. Most of the drugs are prepared by the pharmacy, individually for every baby, in a syringe, in a double dose method. We connect the tubing and rinse it with half of the solution and give the rest in IV drip. We do not rinse the tubing after giving medicine through the drip. The pharmacy labels the syringes. The drugs we prepare in the department are done under laminar flow. Some drugs we inject into the rubber (in the IV set, like Caffein, Penbritine, Vit.K). Sometimes the pharmacy prepares drugs given PO, but mostly we do it in the department. The doctors write new prescriptions for unit dose every day and they are sent by fax to the pharmacy. I would like to know how is it done elsewhere. Is the unit dose system used? Are all medications prepared in the pharmacy using the unit dose system? What kind of medication is prepered in the pharmacy? Do the medications from the pharmacy arrive in a syringe ready for injection? Are the medications prepared in a double dose method or some other method? Who writes the prescription for the unit dose for the pharmacy? Are there daily prescriptions for permanent drugs? How is the prescription sent: via courier, fax or computer? Which drugs do the department make? Are the drugs from the department made in laminar flow? How do you medicate: injecting the rubber or the IV drip? Do the tubes get rinsed with saline after giving medicine through the drip? How do you write on the syringe with medication? Is there inspection of two nurses for each drug? Are you aware of research papers concerning the benefits of the unit dose method? Are you aware of research papers to show a decrease in the infections rate in the pre-mature nursery using the unit dose method? Thank you for your cooperation Lia, Israel

Where I work, we use sterile sheet and gloves, both with peripheral and central lines. We do it alone. We don`t use povidine connectors (some places do). We change the whole tubing when changing the bag, every 24 hours, lipids too. We don`t use opaque sets. Thx for your cooperation. Lia

dawngloves, I see what you mean, but, the routine here is handling it with a sterile procedure. I don`t find it rational neither, this is why I posted the question :)

hi dawngloves, What do you mean by "everything is contained" ? The pharmacy supplies the TPN transfusionbag and we connect it to the IVAC set and the extension tubing ....this is the way it is done here...

Hello all, I have a few questions about preparing TPN. 1. Do you dress sterile when changing TPN sets ? (robe, gloves, mask etc.) 2. Do you change sets alone or does it require 2 nurses ? 3. Do you use Povidone-Iodine connectors at the junctures ? 4. Do you change the whole tubing when changing the TPN sets ? 5. Do you change sets and tubing each time you change TPN transfusionbag ? 6. How often do you change the TPN transfusionbag ? 7. Do you use opaque sets and tubing ? Thanks so much Lia, Kaplan Medical Center, Israel

We are just starting to look into finding an appropriate pain assessment scale. We don`t assess pain as a routine, yet. When a nurse thinks a baby needs pain meds, she asks the doctor. We would like to use some scale and build a protocol according to the scores we get.

How often do you assess pain ? At what score do you decide about intervention ? Do you have policies or protocols for pain control ? Thank You

I work in NICU. Does anyone have a good Pain scale for premature babies and neonates ? I`ve been reading about NIPS, PIPP and CRIES, and cannot decide which one is the best to work with in NICU. Thank you