"Medication Management Standards - Excel"
Incorporating JCAHO Medication Management Standards into MHUMC’s Standing Orders Data Collection Form Order Number: ________ Unit: _______ Physician/Serice:_________ Criteria Yes No N/A Comment Range orders Order contains criteria to determine which route to use if multiple routes are listed.1&2 Order contains specified dose (ex. 10mg vs 5-10 mg).1 Order contains specified interval (ex. q 4 hour vs q 4-6 hour).1 Order contains dose per m2 or dose per kg for all chemotherapy and pediatric orders that requires calculation for doses.3 Order contains dose written in weight (ex. 5mg) rather than number of tablets, mL, etc. unless the drug is not measure by weight (ex. Milk of magnesia).3 Order does not contain multiple ranges (ex. Demerol 25 to 50/Phenergan 25 to 50 IM or IV q 4 to 6 hrs PRN pain)1&2 Abbreviations Order does not contain prohibited abbreviations and dose designations (U, mg, IU, AU, AS, AD, OU, OD, OS, MS, MSO4, MGSO4, trailing zero, QD, QOD, TIW).1,4,5 Order does not contain trailing zero; order does contain 4&5 leading zero. Order does not contain inappropriate symbols (>, <, arrow up, arrow down).1&4 Order does not contain unapproved acronyms or phrases (ex. 1/2 PSS for 0.5% Normal Saline).1&4 Ambiguous Orders Order is clear and not ambiguous (ex. Resume med, continue home med, continue pre-op meds, or transfer med orders are prohibited; give unless allergic).3 Orders contain instructions on how to use pre-printed order sets (ex. Order contains criteria to determine which medication to use if multiple meds are listed for the same indication).1 Order does not contain coined names that may be misunderstood by people unfamiliar with them (ex. Magic mouthwash or banana bag).3 Order contains proper spelling and spacing and uses fonts and prints of professional quality (ex. propranolol20mg can be misread as propranolol 120mg).3 There are critieria for use for as needed (prn) orders containing multiple indication for use.1&2 Miscellaneous Acetaminophen use is monitored (ex. List max dose of acetaminophen use or # of tablets/day).6 Time frame is written for IV bolus/ IV push on orders.6 Generic medication name is written on orders.1&3 Medications are listed together or are easy to find. The back copies of pre-printed orders are on unlined paper because it may hide decimal points or drug number.3 Order contains drug name, dose, route, and frequency.1 Order does not contain a list of drugs to choose from because it is easy to choose the wrong item (ex. Vincristine and vinblastine).3 Pre-printed orders contain tracking number and revision date for ease of replacement and to determine need for 3 revision. There are indication for use or documented diagnosis for each drug prescribed (including PRN orders).1&2 Order contains space for physician signature and date/time.3 References 1 2004 JCAHO Medication Management Standards. www.jcaho.org. Accessed on June 17, 2003. 2 Rich DS. Ask the Joint Commission. Hospital Pharmacy 2003;38(9):878-882. 3 ISMP Medication Safety Alert! April 23, 1997. 4 ISMP Medication Safety Alert! November 27, 2003;8(24). 5 JCAHO Issues ‘Do-Not-Use’ List of Dangerous Abbreviations. www.ashp.org/news. Accessed December 16, 2003. 6 ISMP Medication Safety Alert! August 7, 2003; 8(16).