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Discussion

Standing Orders for Meds RN

My supervisor at my job wants to make it a policy that a nurse can initiate a standing order for PRN medications (Tylenol, benadryl, melatonin, maalox, etc) for a patient prior to being seen by the provider. The provider may not see the patient until the next day.  He said we will have to check the current medications and the allergies and ensure there are no contraindications. Is this even in the scope of practice for an RN? This seems like it falls under "independent medical judgement" which is out of our scope. Please help

Featured Replies

  I don't see what the problem would be.  Paramedics use protocols, with a lot less information in a lot less controlled environments.   

  • Expert

Best Practice: Standing admission PRN Order protocols for RN implementation need to be developed by a facilities unit director/advanced practice nurse or chief medical officer.

North Carolina BON policy STANDING ORDERS

Quote

The purpose of a Standing Orders (SO) is to provide a means for a physician or Advanced Practice Provider (APP) to legally convey to a registered nurse (RN) or licensed practical nurse (LPN) the ability to provide routine medical interventions to a client based on subjective and objective findings, screening standards and/or age-appropriate vaccination

American Academy of Family Physicians:30 Standardized Hospital Admission Orders  covering several diagnosis.  Last year I worked Respiratory Telemetry unit, we had standing treatment orders that our Pulmonologist Unit director developed for AFIB, Asthma, CHF, COPD, Sarcoidosis, Respiratory Failure, Lung Cancer etc. so we could give Antacids/ proton pump inhibitors for client on steroids, acetaminophen for pain/muscle aches,  stool softener,  NTG, etc. based on clients admission diagnosis, subjective/objective statements + clinical parameters --especially helpful for us night shift/weekend nurses!

Providing Consistent Care With Standardized Admission Orders

This is within the scope of practice for any nurse, Lpn  or RN. It's literally what standing orders are for....And as far as checking for allergies etc., you should be doing that on any orders. Just as SOP, because doctors sometimes miss things too.

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