Letters to Doctors

[athomemom56]

I am a Home visit nurse, in and out usually in less than an hour. My patients medications are constantly changing or being discontinued. Its so different when you do visits.

When I get a new patient or when my current one gets med changes, I usually find out from "my patient". I don't want to just take their word for the med, dosage, etc. AND, you wouldn't believe the amount of time spent calling the clinic, trying to reach the MD's nurse and then he/she returns my call and I am with another patient and cannot talk, and this can go on for quite a while. Now imagine this happening with tons of patients.....you see where I'm going, right?

Anyway, I am trying to create a letter, something really simple, that I can fax to the clinic requesting this info. Something like this:

11/20/08

From: My Name, LPN, ABC Nursing Services

To: Dr. Doolittle

Re: Mary PatientDOB:

Medication Clarification

Dear Dr. Doolittle:

Please make corrections as needed. I have included a copy of Mary Patient's med list that we currently use. If you have any questions, please contact me at 999-888-7777.

Medication: Furosemide: You list the dosage as 20mg, our list says 40mg.

Response:

Medication: Avapro. We have this listed as discontinued. The med list you sent us does not list it as d/c'd.

Response:

What do you guys think? I am open to suggestions.

I would REALLY appreciate any help I can get. This would help eliminate some of those phone calls, and less error, because the clinic would have something visual to look at and fax back to me.

Thanks,

Barbra

[caliotter3]

I think this is a good idea. You can quickly write down the info needed while in the home and then mail this off, keeping a copy as a suspense copy. Remember to send an info copy to the office. This way you don't have to be dealing with returned or not returned phone calls. I do a version of this myself when I encounter discrepancies. I do it on an agency Doctor's Order form with the appropriate notes. I don't do phone calls because I work at night or on the weekend and phone calls are impractical for me. I would only call if there was some sense of urgency to my questions. I would like to meet you in the workplace. Most nurses in home care have an aversion to paperwork and leave updating the 485 or getting orders correct to someone else. Very frustrating at times.:wink2:

[NRSKarenRN, BSN, RN]

see these tools that may help from

home health quality improvement, provided by quality insights of pennsylvania

best intervention package:medication management

medication discrepancy tool (pdf)

sbar tool (word)

[meriposa]

Most ALFs that have HH patients use these paper tools and fax them to the physicians- but for order requests as well as clarifications. Its actually alot faster than waiting for a return phone call. Its a great idea, but you are probably going to have to get a fax machine for your house if you dont' have one already!