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
It’s 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. 0300—1500. b. If time is not specified standard times will be used.
4. Q 12 Hours = 0900 … 2100
5. TID = 0900 … 1400 … 2100
6. 15 minutes AC = 0645 … 1145 … 1645
7. AC or 1 Hour AC = 0600 … 1100 … 1600
8. PC or 2 Hours PC = 0900 … 1400 … 1900
9. Q 8 Hours = 0600 … 1400 … 2200
10. QID = 0900 … 1300 … 1700 … 2100
11. Q 6 Hours = 0600 … 1200 … 1800 … 2359
12. Q 4 Hours = 0200 … 0600 … 1000 … 1400 … 1800 … 2200

8. Respiratory Therapy Drug Administration Times
1. BID = 0700 … 1900
2. TID = 0700 … 1300 … 1900
3. QID = 0700 … 1100 … 1500 … 1900
4. Q 6 Hours = 0700 … 1300 … 1900 … 0100
5. 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

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