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Discussion

Orders

I have a CHF patient . Her renal function is bad too. Lives at a personal care facility who administers her meds and who's aide take daily wt and writes them on the fridge. I see her 2-3/wk. When she lost 20lbs cardio MD stopped her Zaroxolyn and lowered her Torosimide. Her wt went up. So MD restarted her Torosimide TID. weight kept going up. Order stated restart Zaroxolyn mon-wed-fri 30 min prior to torosomide.

Cardio nurse faxes all orders to facility since they administer and monitor meds.

Facility nurse read order as Zaroxolyn as TID mon-wed-fri since that is when he gets torosimide.

Now her renal function is worse and her K decreased. New order is hold zaroxolyn started amlodipine and increased K retake BMP in one week.

Is that a med error? I and she did not call cardio MD to verify the zaroxlyn order. The facilty nurse fills patients med box.

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    It sounds like the meds need to be verified. As stated, the Zaroxolyn would be TID, but don't assume without verifying the MD's intent. Verbal orders should be verified before completing (at least in NY, the verbal orders had to have a "verified by" sign off at the bottom.) If there is an error due to misinterpretation of an order, there should be an incident report and the MD notified. Mistakes should be looked at as a learning experience, not a time for punishment. Hope this helps!

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