Calculate with Confidence5th edition

Gray Morris

Mosby items and derived items © 2010 by Mosby, Inc., an affiliate of Elsevier Inc.

Mosby items and derived items © 2010 by Mosby, Inc., an affiliate of Elsevier Inc.

Understanding and Interpreting Understanding and Interpreting Medication OrdersMedication Orders

Unit Three: Chapter 11Unit Three: Chapter 11

Understanding Medication Orders: Objectives

After reviewing this chapter, you should be

able to:1. Identify the components of a

medication order2. Identify meanings of standard

abbreviations used in medication administration

3. Interpret a given medication order

Objectives (cont’d)

4. Identify abbreviation, acronyms, and symbols recommended by the Joint Commission (TJC) “Do Not Use” list, and ISMP’s list of error-prone abbreviations, symbols, and dose designations

5. Read and write correct medical notations

Understanding Orders: Background PRIOR legal written order or

prescription required Physicians, dentists, nurse practitioners,

nurse midwives, physician’s assistants – under state laws

Oral (given verbally) and phone orders Error prone Emergent situations by qualified staff Write it, read back, get confirmation Prescriber’s signature within 24 hours

Understanding Orders (cont’d) “Physician’s Order Sheet” or “Order

Sheet” Noted by nurse and “unit clerk” Transcribed to Medication Administration

Record (MAR) or faxed to Pharmacy Nurse is accountable regardless of who

transcribes to MAR Some facilities utilize electronically

generated MARs

Understanding Orders (cont)

Memorization of acceptable common symbols and abbreviations is essential (Tables 11-1 & 11-2)

Some symbols have double meaning ID = intradermal, also means initial dose Reminder of TJC and ISMP guidelines

Writing Medication Orders

Seven ESSENTIAL Components1. Client’s full name2. Date and time written3. Name of medication4. Dosage5. Route6. Frequency7. Signature of prescriber or proxy

If parts are missing – order is

NOT legal and should NOT be

filled!

Writing Medication Orders (cont’d)SPECIAL CONSIDERATIONS Medication names

Trade = proprietary Generic = “proper” or chemical name Caution – look-alike or sound-alike

names Dosage

Amount and strength clear “Units” (TJC & ISMP)

Figure 11-2 Glucophage label. Notice the two names. The first, Figure 11-2 Glucophage label. Notice the two names. The first, Glucophage, Glucophage, is the trade name, identified by the registration is the trade name, identified by the registration symbol ®. The name in smaller and different print is symbol ®. The name in smaller and different print is metforminmetformin hydrochloride, hydrochloride, the generic or official name.the generic or official name.

Writing Medication Orders (cont’d)SPECIAL CONSIDERATIONS Route—very important, never assume Frequency

Standard abbreviations and meaning (q.i.d., t.i.d.)

Signatures—legibility and co-signing Special instructions—clear

Hold if… ½ hour before… For blood pressure greater than…

NEVER ASSUME – CLARIFY IF IN DOUBT!

Interpreting a Medication OrderWritten in following order:

1. Name of medication2. Dosage3. Route4. Frequency

Example: Colace 100 mg p.o. t.i.d. (name) (dose) (route)

(freq)