If I am reading this post correctly, I understand that what you are looking for is not a policy for pharmacy to use, but rather a policy that applys to the nurses administration of MSO4 and other irritating medications. There are a number of good references that could help you devise a list of such irritating medications, and a few lists "floating" around. We had one once when I worked with a long term care pharmacy. It was based on the INS standards of pH and osmolarity to define "irritating". Rather than expect nurses to check this information--although they should we know they will not, we devised a list and circulated it. Then drugs on this list were strongly recommended to only be administered via central line, per INS standards. Therefore, dilution was not an issue. INS standards should guide your policy.
Perhaps if you work in a hospital or place with a proactive pharmacy, you can ask them to label drugs with thier pH or Osmolarity and/or a note such as "high osmolar drug give via central line" or "low pH drug, give via Central line", again based on INS standards. Good luck.
Chris Cavanaugh, CRNI
----- Original Message -----
From: Lynn Hadaway <[EMAIL PROTECTED]>
Date: Wednesday, July 26, 2006 12:41 pm
Subject: RE:Med dilution policy
To: "Nauman, Tanya" <[EMAIL PROTECTED]>, Sarah Kuykendall <[EMAIL PROTECTED]>, [EMAIL PROTECTED]
> In hospitals where I have worked, the pharmacy has a standard
> dilution chart that was made available to the IV team and the
> dilution was printed on the label. The IV nurses could request the
> pharmacy to alter this standard dilution based on patient
> circumstances such as fluid restriction changed from 50 ml to 10
> ml
!
> and
