Medication orders

[trlawson]

HI everyone,

Looking for some input. We are working on changing our physician orders. We are interested in seperating medication orders from non medication orders. Our VP of nursing is interested in knowing what other hospitals are doing. Could you please let me know what you do, where you work and if anyone had a copy of what their order forms look like add those. Appreciate the feedback!!

[classicdame, MSN, EdD]

I cannot publish anything. I can warn you that it needs to be worded carefullly. In Texas the nurse is not allowed to choose between a, b, c as that is an MD privilege. But something like "we ALWAYS do day one post knee replacements this way" is allowed. "Standing Orders" are generally between the MD and the NP to allow for the NP to act within certain parameters. But RN's without the NP license need to follow exact orders. Better check your nursing practice act.

[trlawson]

Ok let me clarify, I'm it sure I u f'er stand your answer. What I was meaning was that currently our physician order forms are used for ANY order the Dr may write. So it's essentially a lined piece of paper with a mix of medication and non medication orders. It makes it difficult to reconcile Mars and increases error. At another facility I used a physician order form that had the Dr write medication orders on one form and anything mon med on a completely different form. Is anyone else doing this?

[KelRN215, BSN, RN]

You're not on a computer order entry system? Your hospital should focus on rolling that out...

[VANurse2010]

You're not on a computer order entry system? Your hospital should focus on rolling that out...

Agreed. Not using an EMR in acute care in 2015 is BS.

[nurseprnRN, BSN, RN]

Agreed. Not using an EMR in acute care in 2015 is BS.

... and will make you liable for penalty or decreased reimbursement from Medicare.

And..

IT'S NOT ORDERS. We are not in the military, we are not subservient, and prescribing providers are our colleagues, not our superiors.

Physicians and other licensed providers write prescriptions, or they prescribe. Please stop using the word "orders" on your new forms, whatever they turn out to be, and start changing the culture. Words matter!

[caliotter3]

Have never seen that done from the initiation stage, but don't see any reason why your admin can't put "med" on one version of the sheet, and "non-med" on another and provide the physician with both forms.

[blondy2061h, MSN, RN]

You're not on a computer order entry system? Your hospital should focus on rolling that out...

This. Before you try and remodel your boat, you need to realize that airplanes are standard now.

This is a total non-issue is EMR's, since orders can be sorted by lab, respiratory, pharmacy, radiology, nursing, blood bank, etc.