Patient Safety News

January 2022

Please try to maintain social distancing during lunch, and while in common spaces.

Epic In-Basket

Providers must check their Epic in-baskets daily.

Messages left unread or unaddressed can hold up billing, or delay the fixing of errors in medical documentation.

Epic In-Basket

Disposable Scopes

We now have disposable fiberoptic scopes available for use. They are located in the equipment room.

Note: Please do not use the adult re-usable scopes. Only the pediatric re-usable scopes (no internal suction channel) may be used, until we have a disposable alternative.

Wire Baskets for O₂ Tanks

O₂ tanks should not be placed in beds during transfer.

ORAs and Anesthesia Techs can help obtain wire baskets to hold the tanks while patient is being transferred.

Blood samples for T&S and ABO/Rh

  • Samples can be drawn from the same source (ie. same PIV or a line).
  • Orders MUST be written separately.
    • They require different time stamps.
  • Consider ordering T&S → go draw your labs → then order ABO/Rh.

New Transport Monitors

We have new transport monitors! The monitors are located in the work room. Please utilize the sign out sheet to help ensure accountability.

Important: Cords need to stay with the monitors. Please physically hand them to your Tech when done. All are labeled Anesthesiology.

SAFE Report Follow Up

ID Bands

  • Please verify that every patient has an ID band on (especially ICU patients).

Patient Masks

  • Please place masks back on patient prior to transport to PACU/ICU
  • Can be placed over OR mask or NC
  • If you have a medical concern related to placing the patient’s mask, consider various options:
    • Is the patient actually ready for transport out of OR?
    • Transport with pulse ox monitor.
    • Keep mask by patient’s head and place as soon as you arrive in PACU/ICU

Drug Shortages – January 2022

Metronidazole – National severe shortage

  • National severe shortage due to manufacturing supply issues.
  • For surgical prophylaxis, please use alternatives outlined below:
    • Patients undergoing intra-abdominal surgery or gynecologic surgery with colon involvement:
      • ▪ 1st line – Cefoxitin OR Ampicillin-Sulbactam (Unasyn)
      ▪ 2nd line – Levofloxacin AND Clindamycin
      ▪ 3rd line – Clindamycin AND Gentamicin
    • Patients undergoing gynecologic surgery without colon involvement:
      • ▪ 1st line – Cefazolin OR Ampicillin-Sulbactam (Unasyn)
      ▪ 2nd line – Levofloxacin AND Clindamycin
      OR Clindamycin AND Gentamicin

Local Anesthetics with Epinephrine

  • All local anesthetics with epinephrine remain on backorder.
  • Limited centralized supply may be available from OR Pharmacy Satellite.
  • Adequate supply of all plain local anesthetic vials.

LMD (Dextran 40)

  • Next release date is not until Spring 2022.
  • Please use alternatives for volume expansion as appropriate (crystalloids, other colloids, blood products).

Belzer UW Cold Storage Solution

  • Sole manufacturer unable to accept orders.
  • Custodiol HTK Solution is being stocked as an alternative.

Midazolam preservative-free (PF) 2 mg/2 mL vials

  • Multiple providers reporting manufacturing delays.
  • May begin to see vials with preservative.
  • Preservative-free product will be conserved and stocked in all Perioperative Areas where Neonatal patients are seen.

Morphine preservative-free (PF) (Duramorph) vials

  • Shortage has resolved.

Drug Shortage information can also be found on the PSQI SharePoint site (available only when connected to the hospital’s secure network/wifi).

Questions or concerns? greg_balfanz@med.unc.edu
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UNC Department of Anesthesiology PSQI