Standing PRN orders and Ranged dosing at Facilities

[Kabin]

can anyone confirm medicare disallows ranged dosing at facilities? are you still able to have standing prn orders at facilities?

i spoke with a pharmacist and he says it's ok as long as the mar defines how to administer the ranged doses. our company took the other path and made drastic changes by disallowing ranged dosing and ectomied all standing prn orders.

[CoffeeRTC, BSN, RN]

We right separate orders for the meds. If it is ordered 1-2 tabs q 4-6 hrs prn, we will clarify the order with the doc and make them pic a set prn time with no range in that either.

1 tab q 4 hr prn mild to moderate pain

2 tabs q 4 hrs for mod to severe pain

[CapeCodMermaid, RN]

I might ectomy your made up words.

Regs in this state...no range is acceptable.

We do 1 tab every four hours for moderate (4-6) pain

2 tabs every four hours for severe (7-10) pain

Nothing has a range except supplemental 02...may titrate 0-4 lpm vnc to maintains sats greater than.....

[Nascar nurse, ASN, RN]

My state has never allowed standing orders of any kind since I have been a nurse (1986)

[LuvScience]

At my facility we have a list of standing orders signed by the medical director. It includes Tylenol, Phenergan, and MOM to name a few. I have also seen orders with ranges such as Percocet 1-2 tabs PRN but I think that it is probably better to write it out as 2 separate orders like the previous posters have stated.

[LuvScience]

......

[CoffeeRTC, BSN, RN]

Oh, as far as standing orders. On our admit paper work there are a few..tylenol for temp and mild pain, and then our bowel meds, mom, supository or fleets.