Re-eval orders

[CapeCodMermaid, RN]

We have lots of docs and NPs who write for example: give Celexa 10 mg by mouth daily. Re-eval in two weeks. For some reason, the re-Evals keep getting missed. We've tried boxing off the re-eval date and writing a separate order with the date boxed off.

Do any of you have a suggestion? This is the first place I've worked in that this has been such an issue.

[amoLucia]

Don't really know where you're boxing the eval off - if it's a MAR, it most likely WILL be missed. I suggest recording it in a day book or desk calendar and do it day before, day of and day after.

[CapeCodMermaid, RN]

How can it be missed on the MAR? Aren't we supposed to look at EVERY box on the MAR? The staff nurses wouldn't look in the calendar book.

[amoLucia]

Just from personal experiences, I found that staff would initial the box but never get around to following through. Like they MEANT TO with all good intentions, but it ranked LOW on the priority scale when med pass was done.

I do have to ask - do electronic MARs allow for that kind of entry? I've since retired and have not used them. (Or are you still paper MARs?)

Other thing, do you have agency nurses/med techs doing the med pass? Might that be contributing to the omission? I found that those little 'odd entry' things got omitted.

Can it be addressed in psychoactive med notes? We had to do them weekly.

[CoffeeRTC, BSN, RN]

I think the MAR is appropriate place to have it noted and boxed off. I think it should probably be more specific too "Call/ notify MD with an update on recent behaviors or xyz"

I also place a note in our appointment book so that the desk nurse aka charge nurse is aware that a follow up needs done.

[amoLucia]

I think the MAR is appropriate place to have it noted and boxed off. I think it should probably be more specific too "Call/ notify MD with an update on recent behaviors or xyz"

I also place a note in our appointment book so that the desk nurse aka charge nurse is aware that a follow up needs done.

This is what I meant by 'day book' or 'desk calendar'. A unit sec'y could see it also as well as the desk nurse.

[CapeCodMermaid, RN]

lol unit secretary... Lol charge nurse... Don't have those

[amoLucia]

Wishful thinking, I know.

[budgie16]

Is the order specific as to what exactly is supposed to be re-evaluated? would advise approaching this by having these docs stop writing the vague re-eval part. Maybe involve your medical director. If not, can you put it on their list to follow up on in two weeks?

[Forever Sunshine, ASN, RN]

hahahhaha unit secretary.... lol lolol lol.

Best way we get this done is on a separate calendar like one of those big desk calendars. If you must put re-eval in the MAR is there a way to make the order only 7 or 14 days etc? and put an arrow or line through any days after that.