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HUC-Transcribe Medication Orders helping the nurses help patients.

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2 HUC-Transcribe Medication Orders helping the nurses help patients

3 content Objectives & criteria Review of transcription steps Standard Administration times Types of medication orders with examples Placement on Kardex Placement on MARS Mini in-class group assignment

4 Objectives Demonstrate your ability to transcribe medication orders to the appropriate locations in the chart and the Kardex with 100% accuracy

5 Review of transcription steps Identify orders to be transcribed Identify urgent orders Transcribe orders Sign off orders following protocol

6 Medication administration times You cant just give meds willy nilly Medications need to build up and maintain a therapeutic dose in the body in order to be effective If you give them too close together they might build up and become toxic but If too far apart they will all be excreted from the body and never make it to the therapeutic range Its a fine balancing act

7 Medication administration times 1. Daily = 0900 (exception: for anti-infectives – time doses from the closest 9 o'clock – either 0900 or 2100) 2. HS = BID = 0900 … 2100 a. Exception anticoagulants – time to be specified by physician, i.e b. If time is not specified standard times will be used. 4. Q 12 Hours = 0900 … TID = 0900 … 1400 … minutes AC = 0645 … 1145 … AC or 1 Hour AC = 0600 … 1100 … PC or 2 Hours PC = 0900 … 1400 … Q 8 Hours = 0600 … 1400 … QID = 0900 … 1300 … 1700 … Q 6 Hours = 0600 … 1200 … 1800 … Q 4 Hours = 0200 … 0600 … 1000 … 1400 … 1800 … 2200

8 Respiratory Therapy Drug Administration Times 1. BID = 0700 … TID = 0700 … 1300 … QID = 0700 … 1100 … 1500 … Q 6 Hours = 0700 … 1300 … 1900 … Q 4 Hours = 0700 … 1100 … 1500 … 1900 … 2300 … 0300 ** remember for brevity and learning we use abbreviations but the WRHA has banned the use of abbreviations such as bid, tid. However doctors have been slow to comply*****

9 Types of medication orders Routine PRN One dose Loading dose

10 Types of medication orders Routine medications have regularly scheduled times PRN are given as needed and you need to look for qualifying phrases such as as needed, for pain, for nausea, for constipation, for fever

11 Types of medication orders One time only means just that. For example Demerol 50 mg and droperidol 1.25mg IV one hour pre-op pre-op Loading dose – is a larger than normal dose of a medication to kick start the effect. Then you begin regular doses Amoxicillin 1000 mg now then amoxicillin 250 IV g4 h Say ahhhh

12 Placement on kardex; on this kardex ( the one you have supplied- routine drugs are on the left and prn on the right ; follow facility for one time dose

13 MARS; note routine drugs on MARS have times written in while PRN times are written by nurse

14 MARS( medication administration record sheet)-screen shot HUC

15 Practice assignments transcription of the orders: transcribe the medication to the kardex and MARS Before beginning: Refer slide 5 for the basic steps and chapter 8 of the text for help Review the difference between scheduled or routine medication orders and PRN, one-time and STAT orders and their location on the Kardex and MARS Remember to use pencil in the Kardex & pen in the chart

16 Working in pairs: Read the orders for March 23 and select the medication orders. Using the Internet or any other resources, research these drugs and write down usual doses and indications for the drugs. Brainstorm with your partner, the relationship between the drugs and the diagnosis. HUC Practical order Processing In - class Assignment one: use the paper kardex and practice sheets-. students to work in pairs. Patient demographics: remember to fill in the demographics in the appropriate spots on the kardex Mr. Alexander Murray, 77, suffered a massive anterior atrial myocardial infarction. He suffers from emphysema, diabetes, CHF, and is 5 days post-op from an AKA, right. His doctor is F. Smith. March 23/2013 Admit to ICU Portable chest and EKG - phone results 3 l per N/P ABGs today Inderal 40 mg tid; withhold if BP < 120/70 Digoxin 0.25 mg po od; withhold if pulse <60 Nitro spray for chest pain prn Morphine 10 mg IV q 4 h with 5 mg per IV prn for breakthrough pain Metformin 500 mg bid Theophylline 400mg per face mask q8h Lasix 40 mg od per IV

17 Extra learning links Preoperative medications Doctors order processing averoy/transcribing-doctors-order averoy/transcribing-doctors-order rative-medications-goals-of-preop-medication

18 References LaFleur Brooks' Health Unit Coordinating, 6e Saunders Chapters,9 ( order processing),13 ( medication orders), 14 lab orders) Workbook to accompany LaFleur Brooks' Health Unit Coordinating, 6e Administrative and Clinical Procedures for the Canadian Health Professional –chapters, 6 &16-21

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