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Discussion

Orders for Offsite Procedure Prep

When you have an inmate going for an offsite procedure and you have to do prep do you have an order from your facility provider for the prep, or are you following the 'order' from the offsite consultant doing the procedure? For example, lets say you have to give golytely the evening before a surgery or mag citrate before a colonoscopy. Which provider's order are you following?

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I call my provider and get the order from them. All orders come from inside.

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I call my provider and get the order from them. All orders come from inside.

This is what I've always done, and I'm being told I don't have to. It just seems right that all orders should come from the inside, but what specific legal standard can I tie this to?

I'm not sure about legal standard, but I think it's a matter of professional courtesy that the PRIMARY physician be given a chance to review what any other physician has ordered/suggested. Your example of GoLytely is a perfect example. Why would the prison doc not ok this? It's just a courtesy and probably a protocol (buried in some manual) that the prison doc be notified.

We have our off site providers send their recommendations, and our on site provider then writes the official order. Not all off site providers take into consideration the whole custody and control part of medical treatments etc.

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I've always gotten an order from our provider because it seems wrong to administer a medication without an order from your own organization's provider. And I've always been told by my supervisors that I don't need to. It's an issue now because all of our providers quit. Our on-call is overwhelmed (but I've been calling for orders anyway).

When you have an inmate going for an offsite procedure and you have to do prep do you have an order from your facility provider for the prep, or are you following the 'order' from the offsite consultant doing the procedure? For example, lets say you have to give golytely the evening before a surgery or mag citrate before a colonoscopy. Which provider's order are you following?

Our outside providers call us the day prior to ensure that orders are know. We then have documents that we have each i/m sign and we brief them about what the prep will be (golytely, npo, etc). The orders are also put into the computer and our md signs off. It's actually very smooth and we've never missed a prep. We also have one nurse is solely in charge of all the offsite providers; the consistency really helps with keeping things from falling through the cracks.

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