UNIT 9 The Medication Order

Key Terms Agent Compounding E-prescribing Pharmacist

The Medication Order Given for a specific patient Written by physician or authorized prescriber Must be legible and complete

Medication Order Guidelines Full name of patient Name of medication (generic preferred) Dose and route Frequency of administration (continues)

Medication Order Guidelines Date and time written Specific directions for administration Signature of prescriber

Legibility If illegible, unclear, or incomplete, will not be carried out Order must be rewritten or clarified in writing Prescriber, or covering provider, will be contacted

Acceptable vs. Unacceptable Abbreviations mcg or microgram units “days” or “doses” leading 0 before decimal Unacceptable abbreviations mg for microgram u or U for unit d or D trailing 0 after decimal

Prescriptions Legal document Directions for: Compounding Dispensing Administering

Two Main Types of Drugs Prescription Over-the-counter (OTC) Dangerous, powerful, or habit-forming Used under physician supervision Over-the-counter (OTC) Approved for use without medical supervision (continues)

Two Main Types of Drugs Discussion Questions: Is it acceptable for a medical assistant to write a prescription if it hasn’t been signed by the physician? If so, in which cases would it NOT be acceptable?

Electronic (E-)Prescribing Uses online, computerized software to create and sign prescriptions Two parts Two-way electronic communication between physician and pharmacy (not fax or paper) Potential for information sharing with other health care partners

Prescription Refills Write name, phone number, medication, and pharmacy Give patient approximate time you will call back Pull patient’s chart Give request to physician Notify patient

Safeguarding the Prescription Physician should not sign prescription until ready to give to patient Store prescription pads safely (lock up preprinted pads) Write amount in words and numbers Print pads in nonreproducible ink (continues)

Safeguarding the Prescription Only use one pad at a time Never leave in exam rooms Not for any other uses

Other Types of Orders Verbal order (VO) Telephone order (TO) PRN Routine Standing Single Stat Fax or E-order

Verbal Orders (VO) Become knowledgeable about current and new medications Write exactly as heard Repeat order back to physician Make sure you understand order Follow the “7 Rights” Document

Telephone Orders (TO) Type of verbal order (VO) Prescriptions called to pharmacy by physician or agent Know your legal role in your state

Facsimile or Electronic Orders Must include name and title of prescriber or agent Must include fax number of sending machine Pharmacists must verify order if in doubt about authenticity, accuracy, or appropriateness

EMR and EHR Electronic medical record (EMR) or electronic health record (EHR) Used by physicians and health care providers Many have a prescription component for easy prescription writing

The Medication Order Become knowledgeable about drugs your physician prescribes Write each verbal order exactly as heard Repeat order back to physician Understand order completely before administration If in doubt, seek assistance Be familiar with new drugs on the market

The Medication Order Discussion Questions: What three things should be checked in a patient’s chart prior to refilling a prescription? Explain the difference between a single order and a stat order. Give some examples of what you think would be standing orders.

Medication Labels Brand/generic name NDC numbers Dosage strength and frequency Administration route Warnings Expiration date Lot or batch code

Warning Labels Special instructions Placed on medication containers Patients advised to adhere to instructions

Warning Labels Discussion Questions: Which warning label(s) might be placed on a bottle of liquid amoxicillin? Which warning label(s) might be placed on a bottle of tetracycline? Which warning label(s) might be placed on a bottle of Percocet?

Abbreviations Shorthand of the medical field International language Clear and concise means for writing orders Many abbreviations, symbols, and dose designations can be misinterpreted and are reported to ISMP: create a do-not-use list