PRN window

Our PRN's can be given 15 min before they're due. Some of thing are q2h PRN, so giving them 1 hr before would mean you could give unlimited doses, continually.

The downside to computerized charting. I used a computer system that would only allow once daily prns to be given every 24 hours. For example, patient takes zolpidem at midnight one night and wants it the next night at 10pm…nope! We learned to put in orders with an admin note-@hs for sleep-but without putting in a daily frequency. You have to be smarter than the the computer sometimes.

Yep, our EMR has both of those nuances too- can't scan a PRN until the minute it's due, and can't give a daily med until it's been 24 hours. The other dumb warning is if you give an 0000 med at 2345- you get a wrong date warning. I just override those pop ups. It's dangerous to have so many dumb warnings because it primes people to ignore important ones.

We also had a 15 minute window to give PRNs early. The computer EMR did make giving PRNs more of a pain. Overriding the program also flags it, so putting the order in so that PRNs can be given within the designated time (ie: every 4 hours) not at an exact time helped to eliminate some of the over rides. Always document the effectiveness of the PRN.

Yep, our EMR has both of those nuances too- can't scan a PRN until the minute it's due, and can't give a daily med until it's been 24 hours. The other dumb warning is if you give an 0000 med at 2345- you get a wrong date warning. I just override those pop ups. It's dangerous to have so many dumb warnings because it primes people to ignore important ones.

That is ridiculous! I am sure some incident caused that to be added to the EMR, and it was added with good intentions, but that's just awful. Nurses will get so used to overriding those "alerts" that when they have an important alert they won't pay as much attention to it. Seems like it would create a culture where you are more likely to cause an error because you are numbed to "alert" warnings.

Best practice alerts/warnings are important safety tools when applied properly. This sounds chaotic and dangerous.

Is this more homework?