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Thread: Bad Prescription

  1. #1
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    Default Bad Prescription

    I see many junior docs writing a prescription randomly..

    Prescription should b orderly and methodical:

    1. First should write some instruction for the basic nursing like how many times should the vitals b checked, I/O chart, Weight chart, Abdominal girth Chart etc

    2. Should hav instructions regarding Urinary cath., How much fluids to take, or nil oral, ryles tube feed, Nasal O2 etc

    3. Comes the drugs.. First write the most essential drugs, dont write multivitamin first and antibiotics last..

    IV drugs should b on top. Next IM, followed by Oral Capsules and Tablet, Last should b Syrup.

    Clearly mention the route, dosage and the frequency, if possible time.. For example Loop diruretics are better avoided at bed time.. so instruct the nurse to give it at 4 PM..

    How many of u follow this? Remember One look at the prescription wil tell u how good a doc u r..!!!
    "It's psychosomatic. You need a lobotomy. I'll get a saw." - Calvin in Calvin and Hobbes


  2. #2
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    grt work
    thx
    ALL that GLITTERS is NOT gOLd
    Angeles University Foundation, Philippines

  3. #3
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    thanks alot for the advice

  4. #4
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    this will certainly help us write better prescriptions.
    plz put up more such posts.
    Dr.Superior.

  5. #5
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    Excellent advice Kats!!
    F.Y.I. there is an acronym we used to use which might help some students for writing admitting orders:

    ADCA_VAN_DIML

    A: Admit to Dr. Attending Physician
    D: Admitting Dx: Pneumonia
    C: Condition: Stable/Fair/Critical...
    A: Activity: Bed Rest/Up With Assist/Ad Lib...

    V: Vitals: Routine/Per Shift/Per Protocol/Q 4 hrs.....
    A: ALLERGY: PCN/Sulfa....
    N: Nursing: Per Protocol/Foley To Gravity/NGT TO LIMS/Accu Checks QID...

    D: Diet: General/Cardiac/Renal/2Gm Na....
    I: IV: 0.9 NS @ 125ml/hr....
    M: Meds: As Per Kats (IV/IM/PO)
    L: Labs: Labs to be done next day/morning

    Hope this helps someone. I had it drilled into my head as a student and I still use it regularly.

  6. #6
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    Default

    Another thing I wanted to add is avoid polypharmacy whenever possible

  7. #7
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    The Institute for Safe Medication Practices offers a list of error-prone abbreviations. There is alot of other good information on their site.

    Code:
    http://www.ismp.org/Tools/errorproneabbreviations.pdf

  8. #8
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    thanks for sharing the site. please hide your links...and add to medical links section

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