I understand I'm supposed to pop out two tablets becasue the dosage is not sufficient to equip 10 mg with one tablet but shouldn't the MAR say the correct number of tabs and doesn't this promote med errors? Sometime the med orders do change and the old pharm card could be wrong as well. Looking for thoughts on this. I'm orienting at a new facility and made the mistake of popping only one tablet instead of two, yesterday I took the correct dosage of this medication but did the same thing on another order that was 600 mg and the tabs were only 200 each. How can I make sure I stop making this mistake? I'm sure once I know the residents and the meds I will not make it with them but I am afraid I will keep doing it. I know I'm supposed to check the dosage ect, but just hoping someone has any good advice. Perhaps I'm not cut out to be a nurse.
At my hospital its doses only. It will never specify the number of pills if it requires more than one. However, a warning will pop up if you forget to scan multiple tablets, or if it's supposed to be half a tablet saying something along the lines of "incomplete dose".
I hate doing med rec on new admits because half the time patients have no idea of the dose... Just "half of the metoprolol" or "two of the pink one at night".
Nursing homes also seem to include the number of tablets in the MAR and some of them don't specify the actual ordered dose in a clear way. Example order reads: "Metoprolol 50mg BID- 2 tablets". So is that two 50mg tablets to = 100mg or is that two 25mg tablets to = 50mg?
What's written on the Mar should be a direct transcription from the physicians order. If the way the doctors are writing the orders promote medication errors then it should be reported so that the changes start with the physicians.
It would be two 50 mg tab. Ideally the order should be written ( metoprolol 50mg. Give two tabs po BID at 9am). An order should have medication name, dosage, quantity, route and time.
It would be two 50 mg tab. Ideally the order should be written ( metoprolol 50mg. Give two tabs po BID at 9am). An order should have medication name, dosage, quantity, route and time.
A valid medication order does not need to have quantity. Dosage is adequate.
It would be two 50 mg tab. Ideally the order should be written ( metoprolol 50mg. Give two tabs po BID at 9am). An order should have medication name, dosage, quantity, route and time.
This would still make me question if the total dose was intended to be 50mg or 100mg.
What's written on the Mar should be a direct transcription from the physicians order. If the way the doctors are writing the orders promote medication errors then it should be reported so that the changes start with the physicians.
but that is not what happens in long term care. a doc will write for 60 of lasix and the pharmacy will send either 3 20s or a 20 and a forty. usually the latter, being cheaper. though the former would be less prone to med error.
It would be two 50 mg tab. Ideally the order should be written ( metoprolol 50mg. Give two tabs po BID at 9am). An order should have medication name, dosage, quantity, route and time.
It's still not clear to me. I think it can easily be interpreted as two 25mg tablets to = 50mg, or two 50mg tablets to = 100mg.
So if they send you 1 20mg, and 1 40mg tablet they are supposed to write it that way on the MAR?
This is exactly what my post stated:
"The way we enter meds is like this:
Ok, so we have an order for hydralazine 25 mg.
When we enter it into the computer, we do NOT select "Hydralazine 25 mg," which IS an option, but that is telling pharmacy to specifically spend 25 mg pills.
We select Hydralazine tablet.
Then underneath, we enter dose: 25 unit: mg
This allows the pharmacy to fill the med how they see fit, really eliminating med errors.
Hydralazine wasn't a good example. Of course they will send 25 mg tablets.
But it helps tremendously with other medications."
I'm not understanding the confusion as to how to enter the order. If every nurse gets on the same page with entering the order, then confusion greatly decreases. I will quote myself again.
"The way we enter meds is like this:
Ok, so we have an order for hydralazine 25 mg.
When we enter it into the computer, we do NOT select "Hydralazine 25 mg," which IS an option, but that is telling pharmacy to specifically spend 25 mg pills.
We select Hydralazine tablet.
Then underneath, we enter dose: 25 unit: mg
This allows the pharmacy to fill the med how they see fit, really eliminating med errors.
Hydralazine wasn't a good example. Of course they will send 25 mg tablets.
But it helps tremendously with other medications."
Mavrick, BSN, RN
1,578 Posts
So if they send you 1 20mg, and 1 40mg tablet they are supposed to write it that way on the MAR?