medication administration times

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PURPOSE:Medications administered within Community Hospital are to be administered utilizing the hospital'sapproved administration time schedule.

The professional judgement of the physician, nurse, and pharmacist caring for the patient maytake precedence when clinically indicated.

DEFINITIONS:N/A

POLICY:Standard Community Hospital medication administration times will be utilized unless clinically indicatedotherwise.

The "50% rule" will be utilized when doses are to be worked into the hospital's standard administrationtimes.

PROCEDURE:

a. Standard Community Hospital medication administration times:1. Daily = 0900

(exception: for anti-infectives – time doses from the closest 9 o'clock – either 0900 or 2100)2. HS = 21003. BID = 0900 … 2100

a. Exception anticoagulants – time to be specified by physician, i.e. 0300—1500.b. If time is not specified standard times will be used.

4. Q 12 Hours = 0900 … 21005. TID = 0900 … 1400 … 21006. 15 minutes AC = 0645 … 1145 … 16457. AC or 1 Hour AC = 0600 … 1100 … 16008. PC or 2 Hours PC = 0900 … 1400 … 19009. Q 8 Hours = 0600 … 1400 … 2200

10. QID = 0900 … 1300 … 1700 … 2100

11. Q 6 Hours = 0600 … 1200 … 1800 … 235912. Q 4 Hours = 0200 … 0600 … 1000 … 1400 … 1800 … 2200

b. Respiratory Therapy Drug Administration Times1. BID = 0700 … 19002. TID = 0700 … 1300 … 19003. QID = 0700 … 1100 … 1500 … 19004. Q 6 Hours = 0700 … 1300 … 1900 … 01005. Q 4 Hours = 0700 … 1100 … 1500 … 1900 … 2300 … 0300

Policy

Medication Administration TimesInter-Departmental

13043 (Rev: 0)Official

of 3Medication Administration Times

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c. Special medication administration times1. Coumadin = 18002. HMG-CoA Reductase Inhibitors (ie; Zocor)

= 21003. Diuretics- -BID = 0600 … 12004. Thyroid Meds = 0630

d. Subsequent doses are to be worked into the hospital's standard administration times based on a 50%rule.

1. 50% rules states that:a. A missed dose of drug should be administered as soon as the patient is available even

if administered "late."b. Drugs may be administered under this guidance if the interval between the scheduled

time of administration and the time of patient availability and subsequent drugadministration is less than 50% of the scheduled dosing interval. Here are someexamples of how this works in practice:

A patient is scheduled to receive a daily dose of drug at 8 AM, but isunavailable until 1 PM. Since the dosing interval is 24 hours, the dose may begiven up to 12 hours "late". The 8 AM dose is given at 1 PM. The next dose isgiven at the originally scheduled time, 8 AM.

A patient is scheduled to receive an antibiotic every 8 hours and is due at 8AM but is unavailable until 11 AM. Since the dosing interval is 8 hours, the

dose may be given up until 12 noon. The next dose is given at the originallyscheduled time.

In both instances, had the patient unavailability extended beyond a periodexceeding 50% of the dosing interval (after 8 PM in the first example or after12 noon in the second) the guidance suggests that the dose be skipped and thenext dose be administered at the scheduled time.

The maximum effect on drug serum levels is dependent on theelimination half-life of the drug.

In general, a slight drop in the serum level would be expectedbecause of the "missed" dose being administered later than scheduled.

However, this drop in serum level is offset by a slight increase inserum level after the next scheduled dose is administered.

The impact of late administration is, as a result, negligible overall.

2. It is important to note that the "50% Rule" is only meant as a guide and not as an endorsementfor missed doses of medication. The "50% Rule" is not intended as a replacement forprofessional judgement. The professional judgement of the physician, nurse and pharmacistcaring for the patient takes precedence when clinically indicated.

RESPONSIBILITY:Physicians and Licensed Independent Practitioners, Nursing and Pharmacy staff

Referenced Documents

Reference Type Title Notes

Documents which reference this document

Referenced Documents First Choice Medication Administration

Referenced Documents Safe Medication Administration Practices

Signed by ( 04/02/2009 ) Debora Riggle( 04/06/2009 ) Kathy Olsen, Clinical Specialist( 04/09/2009 ) Beth Bricker, Chief Nursing Officer( 05/12/2009 ) James Gardner, Pharmacist


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Paper copies of this document may not be current and should not be relied on for official purposes. The currentversion is in Lucidoc at .

https://www.lucidoc.com/cgi/doc-gw.pl?ref=bch:13043

Effective 05/12/2009 Document Owner Gardner, James


9/10/2010https://www lucidoc com/cgi/doc-gw pl?ref=bch:13043/frame/DOCBODY