We have had several requests (often in response to safety incidences) to make medications be dual sign in the EHR (Epic is our platform). In evaluating these requests it has come to light that we have no guiding principles to determine if a medication should be dual sign or not. Currently all chemo, investigational, epidural/PCA's and some medications on our high alert policy require a dual sign at the time of documentation on the MAR.

In light of all the ISMP publications regarding the judicious use of dual sign (independent double check)we are hoping to develop some guiding principles for requiring dual signs/independepnt double checks. Does anyone have a policy or guidelines on what characteristics should require a medication to be dual sign on the MAR?

Thanks so much!
Lindsey Eick, PharmD, BCPS
Medication Safety Supervisor
Oregon Health and Sciences University