med error or flawed entry

[supervisorhatchet]

just wondering...

recently noticed several medications on the med cart not match what is on my eMAR...

such as

eMAR might say tylenol 650mg 1 tablet q6hrs...but what I have on hand is 325mg tablets & I must administer 2 tablets to get ordered 650mg dose.

or it might say medication XYZ 10mg, and what the pharmacy sent is 1/2 tablets of 20mg tablets..still the right dose...

I guess the question is...in preparing for survey, and as risk manager...does the eMAR have to match exactly to what I am passing or is it okay as long as the appropriate dose is being administered. If it needs to be changed, any suggestions avoid recurrence....and for wording on the order to stay in compliance.

thanks in advance

[CapeCodMermaid, RN]

You have to write the dose you have on hand and how many tablets or combination of two or more doses to equal the ordered amount.

Dose on hand 325 mg tabs.

How many to = 650 mg ?

Two tablets.

That's the way it is.

[morte, LPN, LVN]

Can't you just clarify it to say 'Tylenol 650mg po Q6h PRN pain? Why do you have to write the tabs in there.. doesn't matter HOW you get the dose as long as you get there.

because........and as I previously stated, that is not the only way to get 650 mg of APAP...on tab of SR tylenol arthritis is also 650 mg.

[catlvr]

I am curious as to the rationale for this...can nurses not be trusted to figure out how many of each strength of pill to administer to equal the prescribed dose? To me, it seems as if there is more potential for error if you have to keep checking the MAR against what strength of pills you have in the cart today. Is the state really that particular?

lol, good luck!

the pharmacy may not always send the same thing for the same order, as in my lasix example, Omnicare will send 3 1/2 tabs (cheaper, I think) but if they are short of 20 they may send a 20 and a 10 or 1/2 of a sixty....so the original posting of the med on the mar may not reflect what you get....and will have to be updated when you receive the med.

[catlvr]

Maybe I am too deep into my nightly glass of wine, but 650 mg of APAP is *not* the same as one tab of tylenol SR (sustained release), any more than one tab of 25 mg metoprolol succinate is the same as two tabs of 25 mg metoprolol tartrate. Close, but not the same and a potentially dangerous mistake. I'm willing to be educated, though.

because........and as I previously stated, that is not the only way to get 650 mg of APAP...on tab of SR tylenol arthritis is also 650 mg.

[morte, LPN, LVN]

Maybe I am too deep into my nightly glass of wine, but 650 mg of APAP is *not* the same as one tab of tylenol SR (sustained release), any more than one tab of 25 mg metoprolol succinate is the same as two tabs of 25 mg metoprolol tartrate. Close, but not the same and a potentially dangerous mistake. I'm willing to be educated, though.

ya kinda made my point....but your comparison is a little off. Yes, one tab of SR APAP is not the "same" as 650 mg of APAP. BUT, the amount of med is the same. Have seen a Doc order 1300 mg of APAP to be given instead of 2 tabs of SR APAP......shot that one done in a hurry.