LTC Admissions Nurse

[tydawg, MSN, RN]

Hello everyone I just started a job as an admissions nurse this week and have been working with the staff educator. I was wondering what your facility does when there are potential medications that are not available at your facility but ordered by the doctor.

Example happened today:

Order was for 6000 you of cholecalciferol by mouth, administer as 6, 1000unit Tablets once daily

Well my facility apparently does not offer the 1000 unit tablets and only has 2000unit CAPSULES.

Staff educator instructed me to put the order into the MAR as

6000 you cholecalciferol, administer as 3, 2000unit CAPSULES once daily. From my understanding it would be okay to change to the 2000units but only if they were tablets not capsules. However I thought about it further and the order is still PO just not tablets. The orders come to us from the hospital where I presume their Epic system automatically inputs what they have available in THEIR pharmacy. So is this something I should necessarily try to escalate to my DNS or is all on the up and up.

["nursy", RN]

Two options: check with your providing pharmacy as to equivelancies, or, call the doc and let him make the decision.

[tydawg, MSN, RN]

Update: so I had a conversation with the educator today and it turns out that medications such as those are part of the interfacility formulary. And when the doctor signs on and agrees to follow the patient here they agree for orders to be substituted with the facility formulary. They even have a separate order on each patient that has them agreeing to that.