A multifaceted approach in leveraging electronic health record tools for safe inpatient use of concentrated U-500 insulin.

Purpose: The Institute for Safe Medication Practices classifies subcutaneous insulin as a high-risk medication. Concentrated U-500 insulin carries additional risks in comparison to conventional U-100 insulin, as the 5-fold more concentrated nature of this product, limitations to insulin pen dosing, and various devices for dose measurement may lead to miscommunication of patient-reported doses, resulting in downstream errors in ordering, verification, or administration. We describe a multifaceted approach to leveraging technical tools within the electronic health record (EHR) for U-500 insulin use.

Effect of Detailed Titration Instructions on Time to Hemodynamic Stability in ICU Patients Requiring Norepinephrine.

Background: This study was conducted to assess the effect of titration instructions on patients receiving norepinephrine.

Methods: In a single-center, retrospective cohort of patients who received at least 24 hours of norepinephrine as their first vasopressor (n = 1,303), patients were classified by whether they received norepinephrine before (n = 616) or after (n = 687) titration instructions were added.

Results: Patients in the two groups had significant differences at baseline.

Antimicrobial stewardship program to reduce antiretroviral medication errors in hospitalized patients with human immunodeficiency virus infection.

Objective: Evaluate antimicrobial stewardship interventions targeted to reduce highly active antiretroviral therapy (HAART)- or opportunistic infection (OI)-related medication errors and increase error resolution.

Design: Retrospective before-after study.

Setting: Academic medical center.