We are doing the same.  A CDS-type Admin Criteria contains the PCA Dose,
Bolus Dose and other parameters.  In the true Rx dose field, we enter
the full syringe size (or bag size for epidurals).  When the nurse scans
the med, they are attaching the full syringe, so that makes sense to us
and looks fine for documentation.  The actual patient doses are recorded
on the CDS.  This also works for IV order type type orders.

For patient dose changes, we Full Doc a non-scheduled dose as given 'N'.
The CDS pulls up and the nurse records the pump setting changes.  It
does cause the problems where it could appear that a dose was not given,
but so far that has not caused us any problems.  This example is
typically PRN use anyway.

We use the same strategy for other items that are continuous use where
we need to document rate changes.   This is how we handle all our IV
Rate changes.  We couldn't find anything standard from Meditech that
would work well.  They really left us hanging on this part of the
process.  We also see a lot of this in our NICU where syringes are
attached to pumps/buretrols for intermittent use and we want
documentation to show when drug was infusing and when not (e.g. UAC/UVC
flushes, lipids, cyclic TNA, insulin infusions).  Again, we attached
CDS's that allow the nurse to Full Doc a non-scheduled rate change and
indicate that the rate was changed to '0' when the drug was not infusing
and again Full Doc when the drug starts infusing again.

Jeff Lee
Assistant Director of Pharmacy, Support Services
DCH Regional Medical Center
809 University Blvd E.
Tuscaloosa, AL 35401
 
(205) 750-5323
[EMAIL PROTECTED]

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_____________________________________________
From: [email protected] [mailto:[EMAIL PROTECTED] On Behalf
Of Dana Pfingstler
Sent: Thursday, December 21, 2006 2:31 PM
To: Meditech L
Subject: [MEDITECH-L] PCA docmentation on eMAR

For those sites who are live with eMAR and BMV:

How are you handling PCA documentation? When you document a new PCA
syringe, what do you put in the dose field of the eMAR? Our syringes are
30mg/30ml, but the dose may be 1mg q10 min, etc. When you are hanging a
new syringe, what are using as your dose, the entire syringe, or the q10
minute dose.

Also, at our facility we are required to write on the MAR how much was
used for each shift. I created a CDS where this can be documented, and
attached it to the PCA meds, but what I don't know is how can the nurses
document on this CDS without documenting another syringe given? If the
PCA is documented as not given with the documentation done on the CDS
then the dose is blue on the eMAR and red in PCI, which could be
mistaken for a missed dose.

Thanks for your help and MERRY CHRISTMAS

Dana Pontious, RN
Nursing Analyst
Elk Regional Health Center
St Marys, PA 15857
814 788-8682
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