Prescription/Medication Order 1 st step in the medication delivery process – Prescription – Medication order Components – Patient name – DOB – Date / time written – Drug name – Dose – Route – Time/frequency – Signature of AP

Prescription/Medication Order (cont.) Prescriptions are outpatient medication orders filled at a pharmacy. –May be written –May be called in to pharmacist –May be electronically written and communicated to the pharmacist

Prescription/Medication Order (cont.) Must contain 8 components of medication order Plus –Quantity –Prescriber number –Number of refills –Instructions Ellen Trent, MD 14 Southwood Blvd. Georgetown, CO Prescribed Date ___July 2, 2011____ Name Arthur Simmons DOB 9/29/49 a Address a a Rx : Doxycycline 100 mg QUANTITY: #20 SIG: cap i po BID pc Refills: 0 MD E. Trent MD aaaaaaa Prescriber ID# Signature

Prescription/Medication Order (cont.) Patient name DOB Date written Drug Dose Route Time / frequency Signature of AP Quantity Prescriber number Number of refills Instructions Arthur Simmons 9/29/49 July 2,2010 Doxycycline100 mg po BID pc cap i E. Trent MD 20 MD cap i po BID pc Ellen Trent, MD 14 Southwood Blvd. Georgetown, CO Prescribed Date ___July 2, 2011____ Name Arthur Simmons DOB 9/29/49 a Address a a Rx : Doxycycline 100 mg QUANTITY: #20 SIG: cap i po BID pc Refills: 0 MD E. Trent MD aaaaaaa Prescriber ID# Signature

Prescription/Medication Order (cont.) Medication orders are inpatient orders written in a patient’s chart. –May be in paper form or in an electronic chart –Each order entry includes: patient name; current date/time; signature of AP.

Prescription/Medication Order (cont.) For each medication order identify –DOB –Drug name –Dose –Route –Frequency/time –Instructions as needed

Prescription/Medication Order (cont.) Are these orders correct? If not, why not? Medication Order Date: 6/1/12 Correctly written Time/frequency missing Dosage strength needed Route missing Correctly written Dosage strength needed

Practice List the components of A.A prescription B.A medication order in a patient chart ANSWER: Patient name, DOB, date written, drug, dose, route, time/frequency, signature of AP, quantity, prescriber number, number of refills, and instructions ANSWER: Patient name, DOB, date written, drug, dose, route, time/frequency, and signature of AP

Practice Ellen Trent, MD 14 Southwood Blvd. Georgetown, CO Prescribed Date ___July 2, 2011____ Name Arthur Simmons DOB 9/29/49 a Address a a Rx : Ampicillin Suspension QUANTITY: 200 mL SIG: i po qid Refills: 0 MD E. Trent MD aaaaaaa Prescriber ID# Signature What is the dosage strength to be dispensed? Are the instructions adequate? ANSWER: none given ANSWER: No, the dosage form is not indicated.

Ibuprofin q8h prn aaaaaaa Inederol 10 mg q6haaaaaa 20 units subcut daily aa Valium 5 mg poaaaaaaaa Practice What is missing from these orders? ANSWER: dose ANSWER: route ANSWER: time/frequency ANSWER: medication name

Verbal Orders Used when –AP is unable to write the order –Order must be carried out quickly Can be given in person or by phone –Must be given by an authorized person –Must be received and documented in medical record

Verbal Orders (cont.) The Joint Commission (TJC) guidelines 1.Write the order as you receive it. 2.Read the order back to the physician. 3.Confirm the order with the prescriber.

Error Alert! Always be certain that you are dispensing the correct medication. –Many drugs have names that are similar. Acular  —OcularBenadryl  —Bentyl  Darvon  —Diovan  Digitoxin—Digoxin Iodine— Lodine  Nicobid—Nitrobid  Examples

Error Alert! Never guess what the prescriber meant! –If the order is not legible, always contact the prescribing physician to clarify the order.