You could use your Variance Limit to help define the correct action to
take. Let's say you have a 1 hr variance limit on oral meds and the med
is due at 1000. If the pharmacy receives the DC order at 1030, it would
be appropriate to back-time the order dc to 0959, thus removing the
outstanding dose and the need for nursing to document. However, once you
are outside the variance limit, the dose was officially scheduled to be
given and the nurse needs to document the reason why it wasn't. 
 
This seems to be a reasonable compromise and division of responsibility
between nursing & pharmacy. It forces pharmacy to consider the real-time
dynamics of the med administration process and gives nursing a greater
incentive to get orders off the chart and to pharmacy in a timely
manner.
 
Bill Whitten
Pharmacist
Lake City Medical Center
Lake City, FL
(386)719-9343
 

________________________________

From: [email protected] [mailto:[EMAIL PROTECTED] On Behalf
Of [EMAIL PROTECTED]
Sent: Tuesday, March 27, 2007 3:43 PM
To: [email protected]
Subject: [MEDITECH-L] dc'd order with emar/bmv


What are other hospitals doing when an order is dc'd and there is an
outstanding dose to be addressed on the emar.  Currently we have the
nurse go back and document not given and the reason  code is Med DC'd.
Anyone else coming up with any solutions so the nurse would not have to
do this.  Meditech says "working as designed, blah blah blah."  Please
post to list and thanks for any help/comments.
 
Karen Hunter
[EMAIL PROTECTED]
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