Newsletter

Upcoming CME Events

IU Health CME Events

To attend virtual events or add to your calendar visit https://live.iuhcpe.org/

Thurs, Sept. 28^th, 11:45am-1:00pm - SCR Recovery & Hope Project - Substance Use Treatment and Levels of Care

Annie Cheek, MSW, LCSW

Fri, Sept. 29^th, 7:30am-4:30pm - Pharmacology for Advanced Practice Providers - Virtual Conference

Fri, Sept. 29^th, 11:45am-1:00pm - Embedded Social Workers in OB Offices

Ashley Beeler, MSW

Mon, Oct. 2^nd, 12:00--pm-1:00pm - IU Health CME/CEU Virtual Learning Event - Starting Solids in Infants and Toddlers: A review of current recommendations and how to implement as a clinician

Elizabeth Prendergast Cooley, MS, RDN, LDN

Tues, Oct. 3^rd, 12:00pm-1:00pm - IU Health CME Virtual Learning Event - Hospital at Home

Peter Kamwendo

Wed, Oct 4^th, 12:00pm-1:00pm - IU Health CME Virtual Learning Event - Readmissions (TBD)

Cindy Leigh, MSN, RN and Josh Sadowski

Wed, Oct 4^th, 1:00pm-3:00pm - Riley Error Prevention Training

Kathryn Taylor, PharmD, BCPPS, Bri Logston, MSN, RN, NE-BC and Megan Isley

Wed, Oct. 4^th, 12:00pm-1:00pm, Cardiogenic Shock

Kashif Saleem, MD, FACS

Thurs, Oct. 5^th, 12:00pm-1:00pm - An Intimate Conversation on Women in Leadership with Nichole Wilson (In-person/Virtual)

Nichole Wilson, DPT, MBA, FACHE

Location: Petticrew Auditorium

Thurs, Oct 5^th, 6:00pm-8:00pm - IU Health CME/CEU Learning Event - Riley Epilepsy Symposium (In-person/Virtual)

Derryl J. Miller, MD, Taylor Parrish, Anna M. Schultheis, NP, Makram M. Obeib, MD and Saul Wilson, MD

Location: ROC Auditorium

Wed, Oct. 11^th, 12:00pm-1:00pm - Integrated Behavioral Health

Chad Schultheis, MD

Fri, Oct. 13^th, 12:00pm-1:00pm - The Role of Radiation Therapy in the Treatment of Hodgkin-Lymphomas

Naoyuki Saito, MD

Sat, Oct. 14^th, 8:00am-1:00pm - Epilepsy Symposium (In-person)

Location: Neuroscience Center Conference Room

Tues, Oct. 17^th, 12:00pm-1:00pm - IU Health Jay County CME/CEU Learning Event - Neonatal Opioid Withdrawal Syndrome: Evidence-Based Compassionate Practices

Patrick W. Clements, MD

Wed, Oct. 18^th, 12:00pm-1:00pm - Catatonia

Andrew Filipowicz, MD

Fri, Oct. 20^th, 12:00pm-1:00pm - HPV-Associated Oropharynx Cancer

Jessica Yesensky, MD

Wed, Oct. 25^th, 12:00pm-1:00pm - IU Health CME Virtual Learning Event - Blood Order Project

Megan Mathena and Jessica Kanis

Wed, Oct. 25^th, 12:00-1:00pm - Adolescent Sexual History & Physical Examination

Laura Knudson, MD

Fri, Oct. 27^th, 12:00pm-1:00pm - Identification of Child Physical Abuse

Tara Holloran, MD, MBA

Sat, Nov. 4^th, 7:00am-12:00pm - Skull Base Surgery Conference (In-person/Virtual)

Location: Neuroscience Center Conference Room

To view previously recorded presentations from the On Demand Videos and earn CME's Click here

To view the list of your completed CME's Click here

Visit The Center for Physician Education - Main Page (iuhcpe.org)

Announcements

ALERT: Practice implications for patients receiving new Alzheimer's medication Lecanemab (leqembi)

Background: Lecanemab (leqembi), a new anti-amyloid immunotherapy for patients with early-onset Alzheimer's, has been approved, and IU Health began infusing our first patients on September 22nd.

 Key takeaways:

1. Patients receiving lecanemab run the risk of developing ARIA (amyloid-related imaging abnormalities) and may present to the ED reporting headache, dizziness, upset stomach, changes in eyesight, seizures, trouble walking, or feeling confused and will need to receive an emergent MRI.

2. Patients receiving lecanemab are at an increased risk of intracerebral hemorrhage; therefore:
   1. Patients receiving lecanemab CANNOT receive any thrombolytics for STROKE (TNK, tPA).
   2. Patients receiving lecanemab CANNOT take ANY BLOOD THINNERS while on this drug.

3. Should patients present with either symptoms of ARIA or stroke, initial consultation should be with the on-call neurologist.

4. Currently, there is no way in CERNER to flag these contraindications for lecanemab patients. A CERNER build request has been submitted to IS, and work is underway. Further information will be provided once it is complete.

New Opioid Tolerance Level order sets will go live across the system on October 17, 2023.

This is an effort to support evidence-based pain management.

As you know, patients have different tolerances to opioids based on the previous usage of opioids. By using this patient care tool, our goal is to ensure that the right patient gets the right medication at the right time in their care at IU Health. We are asking that all clinicians incorporate OTL pathways when treating their patient's pain to ensure we meet their need for effective pain control that they deserve. Click here for more information.

Clinical Council Updates

Critical Care Council:

• Lifeline – Intrahospital Transfers: Dr. Thomas Lardaro shared a policy and flow diagrams aimed at standardizing levels of care and transport prioritization. The council endorsed the proposed documents for Lifeline Priority Designations and Levels of Care.

• System Quality and Safety:
  • Inpatient Sepsis- Provided updates on ongoing work with inpatient Sepsis. A dashboard for monitoring key metrics such as sepsis mortality, antibiotic administration, blood culture, lactate, and use of order sets is in progress.

The system-wide go-live of alert & screening process will be on November 14^th.

Action Item: Council members to ensure providers are aware of standalone order sets for Inpatient Sepsis and Septic Shock Order Sets.

• Opioid Education Toolkit Now Available -

What: Resource documents with definitions, current regulations, standard work examples, etc.)

Why: Offers support and education for providers on the treatment of Chronic Opioid Therapy.

Where does it live: IU Health Portal > Patient Care> Safety and Quality>  Safety and Quality (myiuhealth.org)

Go-Live: Sept 1, 2023

What is changing: Deeper education and support are being offered to providers.

Pharmacy:

• ICU Electrolyte PowerPlan: Council approved proposed updates. Summary of changes below.
  • Replaced 2g magnesium option with 4g magnesium for any Mg level <1.8 for cost savings (approx.. $95k/year).
  • Change orders for phosphate packets to phosphate tablets, as well as increasing dosages of PO phosphate replacement for lower phosphate levels.
  • Will re-add IV phosphate to powerplan once the current shortage is resolved.

• Hypertriglyceridemia-induced Pancreatitis Powerplan: Council approved the new order set for patients presenting with hypertriglyceridemia-induced acute pancreatitis without DKA/HSS. Once live, this will be viewed at all IU Health facilities.
• Fixed Dosed PCC: Council was informed that after a successful pilot at the AAHC on fixed dose 4F PCC/Kcentra for reversal of warfarin in specific patient populations (excluded ICH, massive transfusion, direct oral anticoagulants), the Anticoagulation and ED Council approved to expand use to all facilities. The 4F PCC will become viewable on the Warfarin reversal powerplan at all IUH locations. Current weight-based dosing options will remain available for the excluded patient populations listed above.

4F PCC Fixed Dosing:

• Most recent INR 1.5-7.5 or baseline INR unknown and weight less than or equal to 100 kg then 4F PCC 1500 units IVPB x 1.
• Most recent INR > 7.5 or weight > 100 kg then 4F PCC 2000 units IVPB x 1.
• Available for patients with an INR above goal or continued bleeding after receipt of fixed-dose, then 4F PCC 500 units IVPB x 1.

• Alteplase Restrictions: Council was made aware that the System Pharmacy and Therapeutics Committee approved restrictions on the use of Alteplase.

Imaging Clinical Council

Policy Standardization: The Council approved two proposed standards related to the Contrast Media Policy. The below documents will move forward for implementation systemwide. More information coming!

• Kate Cares Stillbirth Assessment Program: The voluntary program aims to help families answer questions about why their baby was stillborn and how to prevent it in future pregnancies. The council approved the standard views and processes for handling imaging and reports. Exams are to be interpreted by a credentialed radiologist utilizing a standardized template that contains the information needed by the Kate Cares program.

Clinical IS/ Technology:  

• New Nuclear Medicine Order Set for Prostate Therapy (Adult): The council approved a new order set for treating adults with prostate cancer. This new order set reflects all the necessary requirements for this new treatment to simplify the protocol for ordering physicians and to improve the patient’s experience. 

• Synapse Outside Exams Deletion Initiative: As Phase 2 of the initial initiative, the council approved to purge Synapse Radiology PACS Outside Exams when the “Last Modified Timestamp” exceeds 3 years. The goal of this work is to reduce patient safety risk, organizational burden, and liability associated with both storing non-IU Health images and Cybersecurity expenses.

Rhythm Disorders Council

2023 Areas of Focus: Due to time constraints, this topic was tabled. Ongoing progress will continue between council meetings. More to come….

• AF Classification Standardization- There is a power form that exists in Cerner to access a calculator to calculate the HAS-BLED and CHAD-VASC scores.

OB/GYN

2023 Areas of Focus: Due to time constraints, this topic was tabled. Ongoing progress will continue between council meetings. More to come….

• OB/GYN Metrics Update
• Opioid Stewardship
• Lifeline – Priority Designations and Levels of Care – endorsed.

Pharmacy

Ulipristal:  Heather Warhurst asked the council for endorsement of adding Ulipristal to the formulary.  Ulipristal is an oral emergency contraceptive labeled for use within 5 days of unprotected intercourse.  The council discussed Ulipristal use in both inpatient and outpatient settings and voted it be added to the formulary for both settings.

October is National Breast Cancer Awareness Month

National Blood Shortage

The Red Cross experienced a significant blood donation shortfall in August, contributing to the current blood shortage.

To ensure the blood supply recovers, the Red Cross must collect 10,000 additional blood products each week over the next month to meet hospital and patient needs.

 The Red Cross offers three ways to make a donation appointment that can help save lives:

• Download the Red Cross Blood Donor App
• Visit RedCrossBlood.org
• Call 1-800-RED CROSS (1-800-733-2767)

Fall Team Member Celebration

The Fall Team Member Celebration at the IU Health adult academic health center is just around the corner. All AAHC team members are invited to enjoy this festive event.

Stop by on the dates below to celebrate the fall season with a delicious meal, music and festivities. This page will be updated as more event details become available.

Methodist Hospital, front lawn:  

• Saturday, Sept. 30, 6 – 9 am 
• Tuesday, Oct. 3, 11 am – 2 pm; 8 – 10 pm

University Hospital, Cancer Pavilion:  

• Saturday, Sept. 30, 6 – 9 am 
• Wednesday, Oct. 4, 11 am – 2 pm; 8 – 10 pm

Breakfast menu: Scrambled eggs (GF), sliced baked ham (GF), hash brown potatoes (GF), french toast sticks, yogurt and granola, donuts, biscuits with apple butter, coffee and orange juice 

Lunch and dinner menu: Fried chicken, vegetable pasta (GF), green beans (GF), corn off the cob (GF), coleslaw (GF), spring mix salad (GF), biscuits with apple butter, pumpkin spice cake donuts from Taylor’s Bakery 

*GF = gluten free

Find a Flu Vaccine Clinic Near You

Get your shot by Thursday, Nov. 9

Vaccines received through an Employee Occupational Health Services (EOHS) flu clinic or Employee Health location are documented automatically. If you receive a flu shot elsewhere, you must submit documentation by Thursday, Nov. 9. This includes:

• IU Health Urgent Care
• IU Health Retail Pharmacy
• IU Health Primary Care provider office
• Outside IU Health

EOHS will offer free vaccines to team members. Find a flu vaccine clinic near you and mark your calendar.