Medication range dose

What is the safest way to document meds that are ordered in range doses?

We currently have computer generated MARs that list every possible order. Example: MSO4, 2-10mg every hour PRN....

Our current MAR will have a line with 2mg, another line with 4, another with 6...

Some will even be on different pages.

This seems much more likely to cause an error than if there was 1 line with MSO4 2-10...and we simply document when and how much was given.

We are in the process of converting to a bar code/scan system and I would like to see this changed.

How do you handle this??

Have you spoken to your manager about your concern? It would seem to me you have a very legitimate one.

What would you like to see changed??? A change towards/away the bar code system or the way that the MAR lists the dosages???

I am all for the bar code/scan system. Anything that will reduce the chance for med errors.

I am on the team that is writing policy/procedures for the new system. We have several med nurses on the team and I have surveyed most of the nurses at our facility. We are all split 50/50.

50% like the way the range doses are split.

50% think it is too easy to overlook orders or documentation of previously administered meds especially if orders are on different pages.

Like with any change, people will be upset. I just wanted to poll the "allnurses.com" group and see what the best practice was before our next meeting.

I am with the 50% that would like to see 1 line (order) and document time and amt given in the same place.

I was taught that we are not "supposed" to titrate orders except for in certain units, like in PACU we can titrate morphine or narcotic of anesthesias choice. On the floors they must order EACH drug and dose seperately even when it is the same med. For example: MS 2mg every hour for mild pain

MS 4mg .....for moderate

MS 6mg ........for severe pain

and so on. I would check with your pharmacy as to what the surveyors really require as this is the end all(as well as hospital policy of course)