standing orders

Hi there! I am fairly new to a fairly new Hospice. I am the patient care coordinator and am intrested in initiating some standing orders. Does anyone have some suggestions on getting started and some of the things in your standing orders? Thanks:)

[momcats3]

Hi there! I am fairly new to a fairly new Hospice. I am the patient care coordinator and am intrested in initiating some standing orders. Does anyone have some suggestions on getting started and some of the things in your standing orders? Thanks:)

We have MSIR and lorazepam liquid, Lorazepam tablets, Levsin tabs, ABHR suppositories, acetaminophen suppositories, and some separate Scop patches. PM me if you want the amts of ea.

[jerseyRN]

We have MSIR and lorazepam liquid, Lorazepam tablets, Levsin tabs, ABHR suppositories, acetaminophen suppositories, and some separate Scop patches. PM me if you want the amts of ea.

On admission we send each patient a "kit" containing emergency meds. But we get orders before using any of it. We don't have standing orders that apply to everybody.

[webblarsk]

On admission we send each patient a "kit" containing emergency meds. But we get orders before using any of it. We don't have standing orders that apply to everybody.

I like the idea of emergency packs, but do you end up wasting meds or are you able to reuse the items if not used. What all is put in the emergency packs?

[webblarsk]

On admission we send each patient a "kit" containing emergency meds. But we get orders before using any of it. We don't have standing orders that apply to everybody.

Thanks for the input

[aimeee, BSN, RN]

We have standing orders for everything that commonly arises...pain, nausea, dyspnea, constipation, terminal congestion, sleeplessness, hiccups...3 pages worth of standing orders with 3 or 4 alternatives for each symptom. Most of the doctors really like the standing orders because it means they aren't being called constantly. We nurses love them because it means we aren't helpless watching a patient suffer while waiting hours for the doctor to return a call or a page.

We also use the emergency kits. Yes, most of it is wasted but they are worth their weight in gold when you have need of them in the middle of the night. No, you can't reuse the meds, but they are actually pretty cost effective.

[jerseyRN]

It has 60 mg roxanol, 3 each compazine tabs/ compazine supps, 3 tylenol supps; 3 levsin tabs and three 1-mg lorazepam tabs. We often do wind up wasting the contents, or part of the contents.. But you can't put a price on having on hand what you need to make someone comfortable right away.

[webblarsk]

We have standing orders for everything that commonly arises...pain, nausea, dyspnea, constipation, terminal congestion, sleeplessness, hiccups...3 pages worth of standing orders with 3 or 4 alternatives for each symptom. Most of the doctors really like the standing orders because it means they aren't being called constantly. We nurses love them because it means we aren't helpless watching a patient suffer while waiting hours for the doctor to return a call or a page.

We also use the emergency kits. Yes, most of it is wasted but they are worth their weight in gold when you have need of them in the middle of the night. No, you can't reuse the meds, but they are actually pretty cost effective.

Thanks for the input. I am not really as concerned with the cost but curious how it works. I will spend whatever needs to be to make my patient comfortable. I think the emergency kits are a wonderful idea, I know I don't like the idea of waiting around on a Doc. Thanks for all the great info.

[webblarsk]

It has 60 mg roxanol, 3 each compazine tabs/ compazine supps, 3 tylenol supps; 3 levsin tabs and three 1-mg lorazepam tabs. We often do wind up wasting the contents, or part of the contents.. But you can't put a price on having on hand what you need to make someone comfortable right away.

Thanks for the wonderful information, like I said in previous post, i wasn't as concerned with the cost, just curious how it worked. I think the emergency kits are a wonderful idea. Do you use the same kit for each patient or tailor it to fit your patient and diagnosis.

[aimeee, BSN, RN]

The kits are supplied by a national hospice pharmacy supplier so they are standardized. If they have allergies you can have them ship the kit without certain items but you cannot substitute anything into it. Ours have less roxanol but more of the other items mentioned. In addition they have liquid haldol and ABHR suppositories. All of the items in the kit are in the standing orders.

[webblarsk]

The kits are supplied by a national hospice pharmacy supplier so they are standardized. If they have allergies you can have them ship the kit without certain items but you cannot substitute anything into it. Ours have less roxanol but more of the other items mentioned. In addition they have liquid haldol and ABHR suppositories. All of the items in the kit are in the standing orders.

Do you have any contact information you could share with me? Thanks so much.

[Angelica]

Are the ABHR supps for nausea? We use something similar, except we use haldol, benztropine, reglan and decadron. What does the 'A' stand for?