Re: Change of subject Mag Sulfate on L&D
From: Robert J. Carpenter, Jr. MD (zygote@icsi.net)
Tue Mar 16 18:04:01 2004
Who said practicing medicine was fun anymore!
On 15 Mar 2004 at 20:07, 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
>
--
Robert J. Carpenter, Jr. MD
6624 Fannin, #2720
St. Luke's Medical Tower
Houston,TX 77030-2339
713-795-4600
