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Pca

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This document provides instructions for patient-controlled analgesia (PCA) medication administration and documentation. It lists common PCA medications and outlines requirements for verifying PCA syringe counts at shift changes and documenting amounts. It also describes PCA settings like the 4-hour medication limit and lockout time between doses. Procedures are provided for charting PCA medication as effective or ineffective, discontinuing orders, loading new syringes, and changing PCA medications.

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PCA Medications for PCA infusions include: Demerol, Morphine, Nubain and Dilaudid  Standard PCA orders or specific orders may be used by the physician.  The PCA Syringe Count must be verified by two licensed nurses at initiation, shift change, syringe change, dose change, and transfer of care.  At the change of shift, the on-coming and off-going licensed nurses should check the amount left in the syringe and the amount the computer says remains. Document these amounts on the end of shift PCA syringe count form. If the amounts do not match within 3 ml, complete the PCA discrepancy form.
PCA (continued) The maximum amount of medication that is delivered within a 4 hour time frame is the 4 hour limit The time period during which the patient administered dose cannot be activated by the patient is called the Limit Dose Time
PCA (continued) To chart PCA medication shift totals or 4 hour totals as EFFECTIVE: • From PCA screen, touch “Effective” • Option to change the protocol • Enter amount left in syringe, amount or amount wasted • Click on OK and OK at bottom To chart medication as INEFFECTIVE: • Touch “Ineffective “ • Select the ineffective reason • Enter amount left in syringe, amount used • Click on OK and OK at bottom * Always enter assessment data on PAGE 2 *
PCA (continued) To discontinue the PCA medication: • When the syringe volume is charted as being zero, system will prompt to discontinue the order • Touch the D/C Order Box to change to “Y” • Touch the OK Box and Update the information, and the PCA will be discontinued To load a new syringe: • Update default protocol or make necessary changes • When the syringe volume is charted as being zero, the system will prompt you to discontinue * PATIENT MAY NOT LEAVE THE UNIT WHILE ON PCA *
PCA (continued) When there is an order to change medications on a PCA, the nurse will discontinue the first medication by documenting the amount received and/or amount wasted in the PCA application of CPSI and then selecting the Y in the final box “DISCONTINUE ORDER”. Once updated, the medication is discontinued and the PCA Medication Selection menu will display. Choose the new medication, verify the protocol, and update. Have another nurse verify the medication and protocol with you before removing from the Pyxis.

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Pca

  • 1. PCA Medications for PCA infusions include: Demerol, Morphine, Nubain and Dilaudid  Standard PCA orders or specific orders may be used by the physician.  The PCA Syringe Count must be verified by two licensed nurses at initiation, shift change, syringe change, dose change, and transfer of care.  At the change of shift, the on-coming and off-going licensed nurses should check the amount left in the syringe and the amount the computer says remains. Document these amounts on the end of shift PCA syringe count form. If the amounts do not match within 3 ml, complete the PCA discrepancy form.
  • 2. PCA (continued) The maximum amount of medication that is delivered within a 4 hour time frame is the 4 hour limit The time period during which the patient administered dose cannot be activated by the patient is called the Limit Dose Time
  • 3. PCA (continued) To chart PCA medication shift totals or 4 hour totals as EFFECTIVE: • From PCA screen, touch “Effective” • Option to change the protocol • Enter amount left in syringe, amount or amount wasted • Click on OK and OK at bottom To chart medication as INEFFECTIVE: • Touch “Ineffective “ • Select the ineffective reason • Enter amount left in syringe, amount used • Click on OK and OK at bottom * Always enter assessment data on PAGE 2 *
  • 4. PCA (continued) To discontinue the PCA medication: • When the syringe volume is charted as being zero, system will prompt to discontinue the order • Touch the D/C Order Box to change to “Y” • Touch the OK Box and Update the information, and the PCA will be discontinued To load a new syringe: • Update default protocol or make necessary changes • When the syringe volume is charted as being zero, the system will prompt you to discontinue * PATIENT MAY NOT LEAVE THE UNIT WHILE ON PCA *
  • 5. PCA (continued) When there is an order to change medications on a PCA, the nurse will discontinue the first medication by documenting the amount received and/or amount wasted in the PCA application of CPSI and then selecting the Y in the final box “DISCONTINUE ORDER”. Once updated, the medication is discontinued and the PCA Medication Selection menu will display. Choose the new medication, verify the protocol, and update. Have another nurse verify the medication and protocol with you before removing from the Pyxis.