Changing route of admin - page 3

by Nlink 5,379 Views | 21 Comments

Recently a nurse (RN) where I work chose to admin a prn bucally instead of via g-tube. The order stated via g-tube. This client has a high risk of aspiration. I did not find out about this until after it had already happened and... Read More


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    Morphine can be given SL. If she is giving 1 ml then I assume it is liquid morphine, which is normally given SL.

    SL is not the same route as PO, it is a different route of administration. PO, SL, GT are three completely different routes of administration.

    So this was not a case of a GT med being given PO.

    It was a GT med given SL. Or rather, an SL med that was appropriately given SL to a G-tube patient. That is something that needs to be clarified.

    I have g-tube patients who receive other types of SL meds including morphine without a problem, but I always double check with the dr./pharmacy if I get an order like that to make sure it is OK.

    We have standing orders in our facility to do flushes with med pass. If you are concerned about how to handle this then I agree that the first step is to get some kind of orders for PRN meds.

    I would advise you to stay out of this. From your post it is not clear what exactly was going on. The fact of the matter is that yes, this may have been a mistake, it may have been inadvertent, it may have been deliberate. There is no way to know that.

    But I think that since morphine is very commonly given SL, then the nurse was not changing the route of administration, but rather giving a med in the manner it is typically given without stopping to double check what she was doing.

    We all of us make mistakes. You will make mistakes, you will see other people make mistakes. Pick your battles wisely.
    Last edit by mazy on Mar 18, '12
    CompleteUnknown likes this.
  2. 1
    Quote from mazy
    Morphine can be given SL. If she is giving 1 ml then I assume it is liquid morphine, which is normally given SL.

    I have g-tube patients who receive other types of SL meds including morphine without a problem, but I always double check with the dr./pharmacy if I get an order like that to make sure it is OK.

    We have standing orders in our facility to do flushes with med pass. If you are concerned about how to handle this then I agree that the first step is to get some kind of orders for PRN meds.

    I would advise you to stay out of this. From your post it is not clear what exactly was going on. The fact of the matter is that yes, this may have been a mistake, it may have been inadvertent, it may have been deliberate. There is no way to know that.

    But I think that since morphine is very commonly given SL, then the nurse was not changing the route of administration, but rather giving a med in the manner it is typically given without stopping to double check what she was doing.

    We all of us make mistakes. You will make mistakes, you will see other people make mistakes. Pick your battles wisely.
    Ummmm seriously? The order was give it in the g-tube. Giving it any other way without a modification of the order is a med error. It scares me how so many seem to not concur...now maybe shecalled the doc and got a verbal and the doc just has not entered the change yet....that is a possibility.

    Medication administration has 6 RIGHTS. Doing it any other way is a mistake and it is dangerous.
    frankie,RN likes this.


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