Pharmacists,

Regarding the Electrolyte Protocol changes that are going live with intravenous potassium chloride:

1. The nurse is responsible for selecting the 'correct' formulation for the patient's IV access (20 mEq/100 mL q2h x 2 doses for peripheral or 40 mEq/100 mL for central)

2. Continue to review these orders as you previously did - do not check the patient's IV access; nurses were told that pharmacy would NOT double-check their selection between these 2 options

 

Same logic applies if there is an individual order for KCl 40 mEq IVPB that is ordered outside of the protocol. The pharmacist should evaluate per routine (is the order needed, not type of IV access).  We have been giving 40 mEq in 100 mL via central and peripheral IV sites for the last 24 years.  There is no reason to spend the time changing to the 20 mEq x 2. 

 

However, if the nurse calls a pharmacist to say the 40 mEq/100 mL is burning the patient's vein, we should then offer to change to the 20 mEq x 2 or to give ORAL.