Routes on Physician's Orders

  1. Good day, all...
    My question is this...
    SHOULD a Physician's Orders software package allow for multiple routes to be assigned per order?

    For example... MS Contin
    I know that an MS Contin order can be administered, either, rectally or orally...but...how would the order be written? Are there other meds out there that can be give a multitude of routes? I know that Tylenol can...but...oral Tylenol and rectal Tylenol would have distinct NDC codes...so that is not an issue...

    Ideas? Thoughts?

    Thanks,
    Abekatt
    fellow Nurse...
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  2. 3 Comments

  3. by   ClariceS
    Forgive me but I am not sure what an "NDC" code is.

    We often get written orders that offer multiple routes. E.g. Phenergan 25 mg IV/IM/PO/PR q6h prn - nausea. Or Tylenol 650 mg PO/PR q4h prn - mild pain. The doctors do this so they won't have to be called for an order for another route if the situation dictates. If we were considering physician order software, I know they would want that ability.
  4. by   P_RN
    I'd err on the side of caution here. Multiple routes automatically per order could lead to laziness on the entry persons part.

    We had WRITTEN orders with all routes specified on one order and certain doctors swore that we should have "remembered" that they didn't LIKE a certain route. (Whole 'nother topic there)

    I believe that each route probably should have a separate order, ie. Phenergan 25 CAN be given IV (ugh not my preference, it BURNS) but Phenergan 50 cannot.
  5. by   Dyno
    This is something that always erks me too. I guess it comes down to common sense & nurse initiative but I too believe it should be clearer.
    I often have metoclopromide IV/IM/O. Immediate post-op with IV access ofcourse would be given IV. Paracetamol O/PR would be better PR if pt was vommitting but who takes responsibility for adverse reaction. Where do we stand if the route is sited as having an impact on an event where the pt has a reaction to the drug.
    Yes P-RN, I too think it avoids Drs getting calls to change an order, better to cover all bases!

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Routes on Physician's Orders