Page 26 - APP Collaboration - Assessing the Risk (Part Two)

SVMIC Advanced Practice Provider Collaboration: Assessing the Risk

Many EHRs have alerts to caution prescribers about potential

contraindications, age and gender inconsistencies, interactions,
and so on. They also may include a pre-programmed default to

prompt discussion and print materials.

If an EHR alert/alarm is triggered due to a contraindication or
potential drug interaction with other medications, note this alert

in the record and document how it was addressed, or why it was
overridden. If the problem triggered is a dosing problem (i.e.,

high dose, wrong route) check the dose and name of drug to
verify the correct medication was selected from the dropdown

menu, and if correct, note the alert in the record and document
how it was addressed, or again, why it was overridden.

Notification that the quantity of medication prescribed or the
duration for which it has been prescribed exceeds that which is

recommended by the manufacturer should prompt a recheck of
the quantity and duration ordered to verify these were selected

accurately from the dropdown menu. If there is a good medical
justification to exceed the recommended dose or duration, the

physician should document appropriately.

Chronic or High-Risk Medication

Monitoring and follow-up appointments for patients on chronic

or high-risk medications should be outlined and adherence
emphasized and agreed upon. It is a best practice to obtain

written informed consent as appropriate for some chronic
and high-risk medications. Remember, some states require

it for opioid therapy and possibly other high-risk medication
therapies. Many patients do not understand the vital importance

of medication monitoring and will coax prescribers into
continuing medications without appropriate assurance of

safety because it is costly or inconvenient to return for testing.

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