First Dose medication alert and education

by Rayrayaz13 Rayrayaz13 (New) New

I am interested in hearing how first dose of a medication alerting and education is being done in various EMR.

I found a reference on this site from a while back - and I would like to know what EMR this is and/or other options for doing similar. Thank you

The other factor is alerting staff to new medications for the patient and an ongoing tracking of the progress of education for that med. We flag the first dose of a new med for a patient, if the nurse confirms the initial education was done then the next two doses are also flagged for follow up education, evaluation of learning (teach back). If the nurse is unable to complete the the initial teaching with the first dose then the flag carries over to the next dose. If the staff have not confirmed initial teaching and follow up teaching and the patient is in the discharge process then another flag pops up saying the patient needs education to be completed prior to discharge.

~Mi Vida Loca~RN, ASN, RN

Specializes in Emergency Dept. Trauma. Pediatrics. Has 6 years experience. 5,259 Posts

I have never heard of this. It sounds like a huge pain in the rear end though. Especially if I am trying to give 4-5 different meds at once to a patient in a lot of pain or angry and what not. That's not the time patients are receptive to education.

But I am smart enough to gauge the individual situations and educate my patients accordingly.



2 Posts

Certainly understand and it is actually a JC standard to educate and assess response for first doses of new medications administered. Curious what automated alerting for new drug and med documentation processes are being used. The copy and paste above actually is what a surveyor was looking for.


Specializes in PACU, pre/postoperative, ortho. Has 11 years experience. 1,113 Posts

My facility uses meditech & has the alert pop up for the first admin of a drug. You just click the appropriate option - education given to pt, to family, etc. It doesn't pop up after the first dose. Only gripe I have is there isn't an option to type free text & no option to choose that drug is a home med (which pt has likely taken for yrs).

It can be rather annoying if you are the nurse giving the home meds for the first time during the admit & that box pops up a dozen or so times every time you scan in a med.



Specializes in CCU, SICU, CVICU. Has 3 years experience. 127 Posts

We use Cerner Powerchart and we get this stupid education alert for every new med. A box pops up with common side effects to tell the patient. A few annoying parts: in ICU (where I work), you can't educate an intubated and sedated patient and there is no box for us to specify that this isn't an appropriate time for education. Another thing is that it pops up for patient's home meds because the computer thinks it's their first dose ever, even when it's not. Lastly, it pops up for pressors which always makes me laugh. "HI HERE IS YOUR LEVO IF YOU DON'T GET IT, YOU ARE GOING TO DIE ANY QUESTIONS?"

Meriwhen, ASN, BSN, MSN, RN

Specializes in Psych ICU, addictions. 4 Articles; 7,907 Posts

Our EMR doesn't flag first doses. We're expected to stay on top of new medications and dosage changes, educate patients when said new/changed meds are given, and chart said education.

~Mi Vida Loca~RN, ASN, RN

Specializes in Emergency Dept. Trauma. Pediatrics. Has 6 years experience. 5,259 Posts

I have never seen this pop up either.

I am aware it's standard to educate patients on medication, my point was if we had to do pop up questions each time administering meds it would become a huge pain, at least in the ER setting as that's where my experience is. The way this reads I am confused if this is a pop up for first time med for that visit, or like it somehow knows if it's the first time a patient has ever had the med period.



1 Post

Our Organization uses the EPIC EMR and we get first dose medication alerts in our MAR. The system looks for medications in their Home medication history and back through any previous visits in the chart to see if the medication is a first dose or not. Then we have an icon that we click and can document in the MAR as we give the medication. It works wonderfully and keeps us in compliance with JC.

Nurse SMS, MSN, RN

Specializes in Critical Care; Cardiac; Professional Development. Has 11 years experience. 2 Articles; 6,837 Posts

We use Epic as well. It is very intuitively done and makes documentation of the education easy, economical in terms of time and seamless.