OB-GYN-L Messages for March, 2004: Re: Change of subject Mag Sulfate on L&D

Re: Change of subject Mag Sulfate on L&D

From: Elrod Glen Maj 3 MDG/SGOB

Glen.Elrod@ELMENDORF.af.mil

Mon Mar 15 21:56:06 2004

Glen

-----Original Message----- From: islesannie@yahoo.com [mailto:islesannie@yahoo.com] Sent: Monday, March 15, 2004 4:41 PM To: Multiple recipients of list OB-GYN-L Subject: Re: Change of subject Mag Sulfate on L&D

We have those abbreviation no-no's and a few others in our hospital. One recent thing - is dietary will no longer accept "Diet As Tolerated".

The good surgical nurse is really well set for uncomplicated gyn surgical patients to make the decision at the moment - whether the patient will do best with more clear liquids or can go to something else.

You are right - we are really implying an distrust in nursing assessment skills! I would think they would object!

Joanne.

At Mon, 15 Mar 2004, ainsron wrote: >
>In preparation for our recent JCAHO inspection, which we passed we had to
>make changes in our disapproved abbreviations:
>1. We can no longer use QD, you have to write out daily, although you can
>write QPM or QAM. The pharmacist said that it could be confused with QID.
>2. We can no longer use MS or MgSO4, you have to write out magnesium
>sulfate or morphine sulfate. Apparently the nurses are not bright enough
to >interpret the doctor's orders in the context of the patient we are caring
>for. God forbid a pre-eclamptic patient be given a four gram loading dose
>MS for seizure prophylaxis by a well-meaning but efficient nurse who has no
>experience in OB.
>3. We cannot use trailing zeros, hence 0.12 mg of Synthroid, not 0.120 mg,
>and 10 mg morphine sulfate, not 10.0 mg morphine sulfate.
>4. Of course the nurses are no longer bright enough to interpret range
>orders for pain medications or sliding scales for insulin, so instead of
>writing Vicoden, 1-2 tabs PO Q4-6 hours PRN pain, you now have to write:
>Vicoden, 1 tab PO Q4h prn mild pain
>Vicoden, 1 tabs PO Q6h prn milder pain (?)
>Vicoden, 2 tabs PO Q6h prn moderate pain
>Vicoden, 2 tabs PO Q4h prn severe pain
>Although our patients and outside pharmacists are apparently still able to
>interpret range orders outside of the hospital. I don't think they could
>make labels large enough to put all the variations on the outside of the
>bottle!
>
>Ronald E. Ainsworth
>
>-----Original Message-----
>From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of Efrain
>Ramirez
>Sent: Monday, March 15, 2004 2:49 PM
>To: Multiple recipients of list OB-GYN-L
>Subject: Re: Change of subject Mag Sulfate on L&D
>
>Agree..
>
>>At Mon, 15 Mar 2004, art fougner, md wrote:
>>
>>Lack of immediate access to emergency drugs may be hazardous to women's
>>health - perhaps JACHO will be named as a co-defendant by an
>>enterprising plaintiff's attorney in a future negligence claim.
>>micromanagement does not come without a price.
>>
>>just my opinion - i could be wrong.
>>
>>art
>>
>--
>"The opposite of a correct statement is a false statement.
>But the opposite of a profound truth may well be another profound truth."
>
>Niels Bohr (1885 - 1962)
>

-- Joanne Bulley, MD Keene, NH, USA

----- "It is easier to understand a nation by listening to its music than by learning its language" -Anonymous

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