Anything wrong with this order?

[smartnurse1982]

There is this order that reads:

Dose: Lactobacillus 2 packets

Frequency: daily,in divided doses throughout day

Time: 10am, 6pm

Some nurses have given two packets at one time. I also don't like the wording of the order,as at first glance it does look like it says 2 packets per dose. But other nurses think it is fine the way it is. I think if it causes confusion it should be written differently. The supervisor also said the order is ok and she won't do anything about it.

[nerdtonurse?, BSN, RN]

Divided doses? Is that q1h, q2h, q3h....?

Some of the folks I work with would set up 12 medicine cups and divide one of the packets into the twelve cups and be running in there all night, rather than call one of the docs who likes to yell at folks. Makes him feel special, I guess.

I saw that the supervisor won't call. Personally, I don't like the "charge nurse has to decide to call the doc" attitude at some places; sometimes, you disagree with the charge, or worse, you've got one that's so worried about "bothering" the doc that she doesn't look after the patient.

I'd try to bring it up again, using the angle that the patient may be getting too much or not enough (one shift gives one packet, the next gives 2, and you really don't know if the doc wanted 2 packets or 4 packets per day).

[systoly]

suggestion: write the order the way you want it to read and fax to Dr. with request for him to sign off on it.

[RN_2012, BSN, RN]

In my inexperienced opinion as a 3rd level ADN student it reads that the dosage is 2 packets a day, to be split into equal doses twice daily at the times in the order. So, you would give one packet at the first time and the 2nd packet in the 2nd time.

[cherrybreeze, ADN, RN]

In my inexperienced opinion as a 3rd level ADN student it reads that the dosage is 2 packets a day, to be split into equal doses twice daily at the times in the order. So, you would give one packet at the first time and the 2nd packet in the 2nd time.

It was a nurse that added the time; the MD didn't specify how MANY divided doses (while 2 packets would lead me to believe twice also, it isn't certain).

[Meriwhen, ASN, BSN, MSN, RN]

My translation of the order reads 1 packet BID (administered at 1000 and 1800). Which may or may not be what the prescriber intended.

Definitely a poorly-written order.

[Forever Sunshine, ASN, RN]

My translation of the order reads 1 packet BID (administered at 1000 and 1800). Which may or may not be what the prescriber intended.

Definitely a poorly-written order.

Mine too.. I would clarify that with the MD and re-translate it into our language. "Do you want this given once a day or twice a day?"

We have protocols for 1xday and 2x day unless the order states otherwise. Example (Give once daily at 2pm)