First Dose/Medication Mgmnt in the ED

[TlhRNED]

I am interested in getting feedback on the JCAHO regulations for first dose medications and medication management from the ED perspective. Our pharmacy is telling us that we need to fax every non-stat order to them prior to administration to a patient in the ED. My arguemets are delays in patient care and hellooo... all ED orders are stat! :) Any thoughts?

[HAngel]

I am interested in getting feedback on the JCAHO regulations for first dose medications and medication management from the ED perspective. Our pharmacy is telling us that we need to fax every non-stat order to them prior to administration to a patient in the ED. My arguemets are delays in patient care and hellooo... all ED orders are stat! :) Any thoughts?

My understanding is that technically pharmacists never HAVE to accept verbal information- that all info can be faxed. We recently called for a med (as we do for all), and instead of an antibiotic we received a mineral- for a neonate ER patient. I know we'd never have time to fax everything, but it could save a lot of diffficulty and also help all staff (RN, Dr, Pharm) cover theirs and each others rears to avoid medication errors.

Peace,

HAngel:rolleyes:

[needsmore$]

We now have PYXIS in our ED -that covers us for most meds. If we need something from pharmacy-we need to call the pharmacy and FAX the order to them labeled STAT (so they can tell it's from the ED). Then, 45 min later, we need to call them again to remind them that we need the med and we weren't kidding the first time we called...Anne

[rjflyn, ASN, RN]

Our hospital is just finishing prep for JCAHO next week. Along this line pharmacy has to check meds for patients that are being admitted.

rj:rolleyes:

[June55Baby]

You may be referring to the standard that says "All prescriptions or medication orders are reviewed for appropriateness" (MM.4.10). The element of performance # 1 notes that "a pharmacist reviews all prescription or medication orders unless an LIP controls the ordering... or in urgent situations..."

For our ER we consider the ER Physician the LIP who controls the ordering. Therefore nursing can remove medications from the Pyxis and administer them without the meds first being verified by a pharmacist because they (the medications) are under the control of the physician.