We have certain medications configured with a frequency of "SEE ADMIN INSTRUCTIONS" (example attached) that require administration at specific intervals before a procedure or treatment but may not generate timed medication tasks in Epic. This is by design as they may be ordered before the procedure time is determined or the procedure time may vary day by day.

Examples include contrast allergy pre-medications and medications ordered prior to hemodialysis.

RNs are supposed to review administration instructions carefully, verify the scheduled procedure/treatment time, and coordinate administration accordingly to avoid missed or delayed doses, but alas this still gets missed.

How are other organizations addressing this? Interested in Epic build solutions, order set design, clinical decision support, or workflow practices that improve reliability for time-dependent medications. How does your institution configure meds due with or before HD and pre-meds for contrast allergies? What frequency, are there due times on the MAR and how do you handle adjusting times when procedures get moved?

Thank you in advance.

Fiona Lui, PharmD BCPS Med Safety Pharmacy Program Manager
Swedish Cherry Hill, Seattle WA
fiona.lui@swedish.org