Q4-6

[Tait]

Another nurse and I were just discussing this. What really is the point of putting QXhours-Xhours??

Anyone have a rationale behind this system?

Tait

[catshowlady]

Sometimes I think people measure progress and pat themselves on the back for completing something by basically just renaming it.

Tait

Well, they've got to do something to justify their continued existence.

:paw:

[Mimi2RN, ASN, RN]

Personally, it makes sense. I'm on pain meds right now, which are q 6-8 hours. It means don't stress out if your patient doesn't need it at 6 hours, it's not late at 8 hours, and maybe this way the patient is comfortable but not overmedicated. It allows you to use your nursing judgement for the benefit of your patient.

I know what works for me, and I'm using less meds. BTW, I broke my arm a few weeks ago, and had to have it rebroken in surgery. I started out with different meds and closer together. If I've been doing too much, and I'm sore, I'm more likely to take it at 6 hrs.

[suanna]

I would say they work to allow the nurse some discretion/judgment in adiministering. When range orders are written, you are supposed to start at the lowest dose and longest frequency. (I think it's a TJC thing. Some facilities don't allow them anymore.) So, you would start at the longest interval (q6h), and proceed to the shorter interval as needed. I usually see it in conjuction with a dose range, such as 1-2 Percocet q6-8h PRN. That gives the nurse some leeway in deciding how to best treat a pt's pain. Start off with 1 perc q8h and go from there.

I do see your point, though. They could just write q4h, since most range orders are for PRN's anyway. It's probably just a habit.

:paw:

It's against the rules to have two modifiers in the same order- you can either have 1 percocet every 4 to 6 hours, or 1 or 2 percocet every 4 hrs. I have never understood every 4-6 hrs orders. What changes in that from just every 4hrs PRN.