Re: Change of subject Mag Sulfate on L&D
From: Gail Waldby (gwaldby@willinet.net)
Tue Mar 16 06:39:50 2004
But, members, what about the nurse that now gives Vicodin 2 tabs q4 and
2 tabs q6?
Gail Waldby, MD
Garry E. Siegel, M.D. wrote:
>Ron, by changing those things as per the JCAHO, you'll cut down on the
>98,000 medical errors :).
>
>Garry
>
>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)
>>
>
>--
>Garry E. Siegel, M.D.
>Private Practice
>Roswell, GA
>
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