[MT-L] Medication Scale
Roach Janet
We have a three tier scale Mild Pain (1-3); Moderate Pain (4-6); Severe Pain (7-10). Then we attached these to the Scales in the drug dictionary for specific types of medications.
STEP 1: NON-NARCOTIC medications for MILD PAIN 1-3/10
Ø Acetaminophen
Ø Aspirin
Ø Ibuprofen & other NSAIDS
Ø +/- Adjuvant therapy (enhance effects of analgesics)
STEP 2: ADD OPIOID medications for MODERATE PAIN 4-6/10
Ø Acetaminophen/Hydrocodone combination therapy (Lortab, Norco, Vicodin)
Ø Acetaminophen/Oxycodone combination therapy (Percocet, Roxicet, Tylox)
Ø Acetaminophen/Codeine combination therapy ( Tylenol with Codeine #2, #3, #4)
Ø +/- Adjuvant therapy
STEP 3: ADD STRONGER OPIOID medication for SEVERE PAIN 7-10/10
Ø Morphine 5-10 mg
Ø Hydromorphone (Dilaudid) 1-4 mg
Ø Oxycodone (OxyIR, Oxycodone CR)
Ø Fentanyl
Ø +/- Adjuvant therapy
THE JOINT COMMISSION PHARMACY STANDARD “MM.04.01.01 MEDICATION ORDERS ARE CLEAR & ACCURATE”
Janet Roach, RN, BSN
Clinical Analyst
Rutherford Regional Health System
Phone 828.286.5695
______________________________________________________________________________________________________________________________________________________________________________
At several of my facilities, they have used order sets that have a pain scale reason for PRN pain medications, such as Med 1 PO Q6H PRN for mild pain (1-3); Med 2 IV Q4H PRN for moderate pain (4-7); and Med 3 IV Q2H PRN for severe pain (8-10).
Robin Ponton, BS, RN
HSM Consulting
Healthcare Services Management, Inc. (HSM) is a leading provider of operational and information technology consulting, offering our healthcare clients a full range of consulting solutions.
From: Meditech-l [meditech-...@mtusers.com]
On Behalf Of Bruce, April N. [abr...@mhhcc.org]
Sent: Tuesday, July 12, 2016 3:52 PM
To: (medit...@mtusers.com)
Subject: [MT-L] Pain Medication Scale
We had a few citations from JCAHO regarding our pain scale and the lack of tying our pain meds to the scale. The surveyor didn’t like that we had a 2-tier scale. So we are looking for feedback on what scale other Meditech hospitals are using (Mild, Mod Severe) and if they have any algorithms for specific medications standard for each tier in the scale.
Thanks
Jama Wallace, Pharm.D.
Pharmacy Clinical Manager
Memorial Hospital and Health Care Center
April Bruce, BSN, RN
Clinical Systems Analyst
Memorial Hospital and Health Care Center
800 West 9th Street
Jasper, Indiana 47546
Office: 812-996-5738
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