Pharmacy Order Clarification
May 12, 2010
In an effort to improve patient safety, the Pharmacy, in conjunction with Medical Staff leadership and Nursing has developed new guidelines to help clarify unclear medication orders. The most common unclear orders involve range, frequency and titration. To help you adhere to these new guidelines, the Pharmacy and nursing staff will be calling you to clarify your written orders.
Below are examples of unclear orders followed by the guidelines we will use to clarify these orders:
Dose Range (i.e. 1-2 tabs; 2-4 mg)
- Pharmacy and nursing will be able to automatically clarify the order per policy
- Lowest dose will be used for mildest of indication
- Highest dose will be used for most severe of indication
Frequency Range (i.e. Q3-4 hrs PRN)
- Pharmacy and nursing will be able to automatically clarify the order per policy
- Shortest frequency will be used
Duplicate Orders for same indications (i.e. Tylenol and Darvocet for mild pain)
- If a previous order exists and a new order is submitted for the same indication, the new order will override the previous order
- If duplicate orders are written at the same time, then the physician will be notified to clarify which medication will be used and for what parameters
Titration Orders
- Should have clearly defined parameters for beginning, adjustments, and dose limits
- If order says “per protocol,” there must be a protocol established
- “Double Dilaudid PCA protocol” does not exist
- “Morphine or Versed drip for sedation” does not exist