Open Forum

I have found several old discussion on this topic. Looking for updated thoughts. If you are in PA that is even better. 

We currently have MA's and Pharm Techs who pend medication refills to the provider in Epic. The provider then signs and routes to the pharmacy. 

We use several protocols in Epic to help us speed up the time it takes to pend medications for chronic conditions such as HTN, high cholesterol, acid reflux, etc. 

It has been proposed that we should consider having the MA's and Pharm Techs route these medications directly to the pharmacy and have the provider co-sign after. 

We do use this process with RN's on a limited basis for urgent after hours chronic refill needs (no controls). 

Looking for thoughts from those who use a process like this and give your pros and cons. 

Thank you

Nicole

I have found several old discussion on this topic. Looking for updated thoughts. If you are in PA that is even better. 

We currently have MA's and Pharm Techs who pend medication refills to the provider in Epic. The provider then signs and routes to the pharmacy. 

We use several protocols in Epic to help us speed up the time it takes to pend medications for chronic conditions such as HTN, high cholesterol, acid reflux, etc. 

It has been proposed that we should consider having the MA's and Pharm Techs route these medications directly to the pharmacy and have the provider co-sign after. 

We do use this process with RN's on a limited basis for urgent after hours chronic refill needs (no controls). 

Looking for thoughts from those who use a process like this and give your pros and cons. 

Thank you

Nicole

I have found several old discussion on this topic. Looking for updated thoughts. If you are in PA that is even better. 

We currently have MA's and Pharm Techs who pend medication refills to the provider in Epic. The provider then signs and routes to the pharmacy. 

We use several protocols in Epic to help us speed up the time it takes to pend medications for chronic conditions such as HTN, high cholesterol, acid reflux, etc. 

It has been proposed that we should consider having the MA's and Pharm Techs route these medications directly to the pharmacy and have the provider co-sign after. 

We do use this process with RN's on a limited basis for urgent after hours chronic refill needs (no controls). 

Looking for thoughts from those who use a process like this and give your pros and cons. 

Thank you

Nicole

I have found several old discussion on this topic. Looking for updated thoughts. If you are in PA that is even better. 

We currently have MA's and Pharm Techs who pend medication refills to the provider in Epic. The provider then signs and routes to the pharmacy. 

We use several protocols in Epic to help us speed up the time it takes to pend medications for chronic conditions such as HTN, high cholesterol, acid reflux, etc. 

It has been proposed that we should consider having the MA's and Pharm Techs route these medications directly to the pharmacy and have the provider co-sign after. 

We do use this process with RN's on a limited basis for urgent after hours chronic refill needs (no controls). 

Looking for thoughts from those who use a process like this and give your pros and cons. 

Thank you

Nicole

Hi, 

In NYS, probably most stringent. MAs and techs can pend meds but must be authorized / signed by provider prior to going to the pharmacy.

Agree with other comments, that would be considered prescribing, and could not be covered by a 'protocol.' We would consider that equal to reading the provider note, as that is still not a direct order. Our allowable protocols for ambulatory around medication are only for vaccine administration, associated treatment of anaphylaxis, and some select testing. Only an RN can use those orders. In some situations, the RN can also enter a 'verbal' order that requires co-sign  after the fact, however requires actual conversation, readback, documentation and is reserved for emergent situation.

From a safety perspective, I am always concerned with non-nursing personnel even pending medication orders because they lack the professional education, responsibility and accountability to do a 'due diligence' clinical check to make sure the refill is appropriate. However, that is my personal/professional opinion and in practice, refills (but not new meds or changes) are pended by MAs.

Lastly, there are many functionalities in EPIC that allow for non-provider prescribing by choosing option for protocol without provider signature, so staff need to know that just because they have access and can do something, doesn't mean they should do it!

Regards,

Jaclyn

I have found several old discussion on this topic. Looking for updated thoughts. If you are in PA that is even better. 

We currently have MA's and Pharm Techs who pend medication refills to the provider in Epic. The provider then signs and routes to the pharmacy. 

We use several protocols in Epic to help us speed up the time it takes to pend medications for chronic conditions such as HTN, high cholesterol, acid reflux, etc. 

It has been proposed that we should consider having the MA's and Pharm Techs route these medications directly to the pharmacy and have the provider co-sign after. 

We do use this process with RN's on a limited basis for urgent after hours chronic refill needs (no controls). 

Looking for thoughts from those who use a process like this and give your pros and cons. 

Thank you

Nicole

Hi, 

In NYS, probably most stringent. MAs and techs can pend meds but must be authorized / signed by provider prior to going to the pharmacy.

Agree with other comments, that would be considered prescribing, and could not be covered by a 'protocol.' We would consider that equal to reading the provider note, as that is still not a direct order. Our allowable protocols for ambulatory around medication are only for vaccine administration, associated treatment of anaphylaxis, and some select testing. Only an RN can use those orders. In some situations, the RN can also enter a 'verbal' order that requires co-sign  after the fact, however requires actual conversation, readback, documentation and is reserved for emergent situation.

From a safety perspective, I am always concerned with non-nursing personnel even pending medication orders because they lack the professional education, responsibility and accountability to do a 'due diligence' clinical check to make sure the refill is appropriate. However, that is my personal/professional opinion and in practice, refills (but not new meds or changes) are pended by MAs.

Lastly, there are many functionalities in EPIC that allow for non-provider prescribing by choosing option for protocol without provider signature, so staff need to know that just because they have access and can do something, doesn't mean they should do it!

Regards,

Jaclyn

I have found several old discussion on this topic. Looking for updated thoughts. If you are in PA that is even better. 

We currently have MA's and Pharm Techs who pend medication refills to the provider in Epic. The provider then signs and routes to the pharmacy. 

We use several protocols in Epic to help us speed up the time it takes to pend medications for chronic conditions such as HTN, high cholesterol, acid reflux, etc. 

It has been proposed that we should consider having the MA's and Pharm Techs route these medications directly to the pharmacy and have the provider co-sign after. 

We do use this process with RN's on a limited basis for urgent after hours chronic refill needs (no controls). 

Looking for thoughts from those who use a process like this and give your pros and cons. 

Thank you

Nicole

Hi, 

In NYS, probably most stringent. MAs and techs can pend meds but must be authorized / signed by provider prior to going to the pharmacy.

Agree with other comments, that would be considered prescribing, and could not be covered by a 'protocol.' We would consider that equal to reading the provider note, as that is still not a direct order. Our allowable protocols for ambulatory around medication are only for vaccine administration, associated treatment of anaphylaxis, and some select testing. Only an RN can use those orders. In some situations, the RN can also enter a 'verbal' order that requires co-sign  after the fact, however requires actual conversation, readback, documentation and is reserved for emergent situation.

From a safety perspective, I am always concerned with non-nursing personnel even pending medication orders because they lack the professional education, responsibility and accountability to do a 'due diligence' clinical check to make sure the refill is appropriate. However, that is my personal/professional opinion and in practice, refills (but not new meds or changes) are pended by MAs.

Lastly, there are many functionalities in EPIC that allow for non-provider prescribing by choosing option for protocol without provider signature, so staff need to know that just because they have access and can do something, doesn't mean they should do it!

Regards,

Jaclyn

I have found several old discussion on this topic. Looking for updated thoughts. If you are in PA that is even better. 

We currently have MA's and Pharm Techs who pend medication refills to the provider in Epic. The provider then signs and routes to the pharmacy. 

We use several protocols in Epic to help us speed up the time it takes to pend medications for chronic conditions such as HTN, high cholesterol, acid reflux, etc. 

It has been proposed that we should consider having the MA's and Pharm Techs route these medications directly to the pharmacy and have the provider co-sign after. 

We do use this process with RN's on a limited basis for urgent after hours chronic refill needs (no controls). 

Looking for thoughts from those who use a process like this and give your pros and cons. 

Thank you

Nicole

Hi, 

In NYS, probably most stringent. MAs and techs can pend meds but must be authorized / signed by provider prior to going to the pharmacy.

Agree with other comments, that would be considered prescribing, and could not be covered by a 'protocol.' We would consider that equal to reading the provider note, as that is still not a direct order. Our allowable protocols for ambulatory around medication are only for vaccine administration, associated treatment of anaphylaxis, and some select testing. Only an RN can use those orders. In some situations, the RN can also enter a 'verbal' order that requires co-sign  after the fact, however requires actual conversation, readback, documentation and is reserved for emergent situation.

From a safety perspective, I am always concerned with non-nursing personnel even pending medication orders because they lack the professional education, responsibility and accountability to do a 'due diligence' clinical check to make sure the refill is appropriate. However, that is my personal/professional opinion and in practice, refills (but not new meds or changes) are pended by MAs.

Lastly, there are many functionalities in EPIC that allow for non-provider prescribing by choosing option for protocol without provider signature, so staff need to know that just because they have access and can do something, doesn't mean they should do it!

Regards,

Jaclyn

I have found several old discussion on this topic. Looking for updated thoughts. If you are in PA that is even better. 

We currently have MA's and Pharm Techs who pend medication refills to the provider in Epic. The provider then signs and routes to the pharmacy. 

We use several protocols in Epic to help us speed up the time it takes to pend medications for chronic conditions such as HTN, high cholesterol, acid reflux, etc. 

It has been proposed that we should consider having the MA's and Pharm Techs route these medications directly to the pharmacy and have the provider co-sign after. 

We do use this process with RN's on a limited basis for urgent after hours chronic refill needs (no controls). 

Looking for thoughts from those who use a process like this and give your pros and cons. 

Thank you

Nicole

Hi, 

In NYS, probably most stringent. MAs and techs can pend meds but must be authorized / signed by provider prior to going to the pharmacy.

Agree with other comments, that would be considered prescribing, and could not be covered by a 'protocol.' We would consider that equal to reading the provider note, as that is still not a direct order. Our allowable protocols for ambulatory around medication are only for vaccine administration, associated treatment of anaphylaxis, and some select testing. Only an RN can use those orders. In some situations, the RN can also enter a 'verbal' order that requires co-sign  after the fact, however requires actual conversation, readback, documentation and is reserved for emergent situation.

From a safety perspective, I am always concerned with non-nursing personnel even pending medication orders because they lack the professional education, responsibility and accountability to do a 'due diligence' clinical check to make sure the refill is appropriate. However, that is my personal/professional opinion and in practice, refills (but not new meds or changes) are pended by MAs.

Lastly, there are many functionalities in EPIC that allow for non-provider prescribing by choosing option for protocol without provider signature, so staff need to know that just because they have access and can do something, doesn't mean they should do it!

Regards,

Jaclyn

I have found several old discussion on this topic. Looking for updated thoughts. If you are in PA that is even better. 

We currently have MA's and Pharm Techs who pend medication refills to the provider in Epic. The provider then signs and routes to the pharmacy. 

We use several protocols in Epic to help us speed up the time it takes to pend medications for chronic conditions such as HTN, high cholesterol, acid reflux, etc. 

It has been proposed that we should consider having the MA's and Pharm Techs route these medications directly to the pharmacy and have the provider co-sign after. 

We do use this process with RN's on a limited basis for urgent after hours chronic refill needs (no controls). 

Looking for thoughts from those who use a process like this and give your pros and cons. 

Thank you

Nicole

Hi, 

In NYS, probably most stringent. MAs and techs can pend meds but must be authorized / signed by provider prior to going to the pharmacy.

Agree with other comments, that would be considered prescribing, and could not be covered by a 'protocol.' We would consider that equal to reading the provider note, as that is still not a direct order. Our allowable protocols for ambulatory around medication are only for vaccine administration, associated treatment of anaphylaxis, and some select testing. Only an RN can use those orders. In some situations, the RN can also enter a 'verbal' order that requires co-sign  after the fact, however requires actual conversation, readback, documentation and is reserved for emergent situation.

From a safety perspective, I am always concerned with non-nursing personnel even pending medication orders because they lack the professional education, responsibility and accountability to do a 'due diligence' clinical check to make sure the refill is appropriate. However, that is my personal/professional opinion and in practice, refills (but not new meds or changes) are pended by MAs.

Lastly, there are many functionalities in EPIC that allow for non-provider prescribing by choosing option for protocol without provider signature, so staff need to know that just because they have access and can do something, doesn't mean they should do it!

Regards,

Jaclyn

I have found several old discussion on this topic. Looking for updated thoughts. If you are in PA that is even better. 

We currently have MA's and Pharm Techs who pend medication refills to the provider in Epic. The provider then signs and routes to the pharmacy. 

We use several protocols in Epic to help us speed up the time it takes to pend medications for chronic conditions such as HTN, high cholesterol, acid reflux, etc. 

It has been proposed that we should consider having the MA's and Pharm Techs route these medications directly to the pharmacy and have the provider co-sign after. 

We do use this process with RN's on a limited basis for urgent after hours chronic refill needs (no controls). 

Looking for thoughts from those who use a process like this and give your pros and cons. 

Thank you

Nicole

Hi, 

In NYS, probably most stringent. MAs and techs can pend meds but must be authorized / signed by provider prior to going to the pharmacy.

Agree with other comments, that would be considered prescribing, and could not be covered by a 'protocol.' We would consider that equal to reading the provider note, as that is still not a direct order. Our allowable protocols for ambulatory around medication are only for vaccine administration, associated treatment of anaphylaxis, and some select testing. Only an RN can use those orders. In some situations, the RN can also enter a 'verbal' order that requires co-sign  after the fact, however requires actual conversation, readback, documentation and is reserved for emergent situation.

From a safety perspective, I am always concerned with non-nursing personnel even pending medication orders because they lack the professional education, responsibility and accountability to do a 'due diligence' clinical check to make sure the refill is appropriate. However, that is my personal/professional opinion and in practice, refills (but not new meds or changes) are pended by MAs.

Lastly, there are many functionalities in EPIC that allow for non-provider prescribing by choosing option for protocol without provider signature, so staff need to know that just because they have access and can do something, doesn't mean they should do it!

Regards,

Jaclyn

I have found several old discussion on this topic. Looking for updated thoughts. If you are in PA that is even better. 

We currently have MA's and Pharm Techs who pend medication refills to the provider in Epic. The provider then signs and routes to the pharmacy. 

We use several protocols in Epic to help us speed up the time it takes to pend medications for chronic conditions such as HTN, high cholesterol, acid reflux, etc. 

It has been proposed that we should consider having the MA's and Pharm Techs route these medications directly to the pharmacy and have the provider co-sign after. 

We do use this process with RN's on a limited basis for urgent after hours chronic refill needs (no controls). 

Looking for thoughts from those who use a process like this and give your pros and cons. 

Thank you

Nicole

Hi, 

In NYS, probably most stringent. MAs and techs can pend meds but must be authorized / signed by provider prior to going to the pharmacy.

Agree with other comments, that would be considered prescribing, and could not be covered by a 'protocol.' We would consider that equal to reading the provider note, as that is still not a direct order. Our allowable protocols for ambulatory around medication are only for vaccine administration, associated treatment of anaphylaxis, and some select testing. Only an RN can use those orders. In some situations, the RN can also enter a 'verbal' order that requires co-sign  after the fact, however requires actual conversation, readback, documentation and is reserved for emergent situation.

From a safety perspective, I am always concerned with non-nursing personnel even pending medication orders because they lack the professional education, responsibility and accountability to do a 'due diligence' clinical check to make sure the refill is appropriate. However, that is my personal/professional opinion and in practice, refills (but not new meds or changes) are pended by MAs.

Lastly, there are many functionalities in EPIC that allow for non-provider prescribing by choosing option for protocol without provider signature, so staff need to know that just because they have access and can do something, doesn't mean they should do it!

Regards,

Jaclyn

I have found several old discussion on this topic. Looking for updated thoughts. If you are in PA that is even better. 

We currently have MA's and Pharm Techs who pend medication refills to the provider in Epic. The provider then signs and routes to the pharmacy. 

We use several protocols in Epic to help us speed up the time it takes to pend medications for chronic conditions such as HTN, high cholesterol, acid reflux, etc. 

It has been proposed that we should consider having the MA's and Pharm Techs route these medications directly to the pharmacy and have the provider co-sign after. 

We do use this process with RN's on a limited basis for urgent after hours chronic refill needs (no controls). 

Looking for thoughts from those who use a process like this and give your pros and cons. 

Thank you

Nicole

Hi, 

In NYS, probably most stringent. MAs and techs can pend meds but must be authorized / signed by provider prior to going to the pharmacy.

Agree with other comments, that would be considered prescribing, and could not be covered by a 'protocol.' We would consider that equal to reading the provider note, as that is still not a direct order. Our allowable protocols for ambulatory around medication are only for vaccine administration, associated treatment of anaphylaxis, and some select testing. Only an RN can use those orders. In some situations, the RN can also enter a 'verbal' order that requires co-sign  after the fact, however requires actual conversation, readback, documentation and is reserved for emergent situation.

From a safety perspective, I am always concerned with non-nursing personnel even pending medication orders because they lack the professional education, responsibility and accountability to do a 'due diligence' clinical check to make sure the refill is appropriate. However, that is my personal/professional opinion and in practice, refills (but not new meds or changes) are pended by MAs.

Lastly, there are many functionalities in EPIC that allow for non-provider prescribing by choosing option for protocol without provider signature, so staff need to know that just because they have access and can do something, doesn't mean they should do it!

Regards,

Jaclyn

I have found several old discussion on this topic. Looking for updated thoughts. If you are in PA that is even better. 

We currently have MA's and Pharm Techs who pend medication refills to the provider in Epic. The provider then signs and routes to the pharmacy. 

We use several protocols in Epic to help us speed up the time it takes to pend medications for chronic conditions such as HTN, high cholesterol, acid reflux, etc. 

It has been proposed that we should consider having the MA's and Pharm Techs route these medications directly to the pharmacy and have the provider co-sign after. 

We do use this process with RN's on a limited basis for urgent after hours chronic refill needs (no controls). 

Looking for thoughts from those who use a process like this and give your pros and cons. 

Thank you

Nicole

Hi, 

In NYS, probably most stringent. MAs and techs can pend meds but must be authorized / signed by provider prior to going to the pharmacy.

Agree with other comments, that would be considered prescribing, and could not be covered by a 'protocol.' We would consider that equal to reading the provider note, as that is still not a direct order. Our allowable protocols for ambulatory around medication are only for vaccine administration, associated treatment of anaphylaxis, and some select testing. Only an RN can use those orders. In some situations, the RN can also enter a 'verbal' order that requires co-sign  after the fact, however requires actual conversation, readback, documentation and is reserved for emergent situation.

From a safety perspective, I am always concerned with non-nursing personnel even pending medication orders because they lack the professional education, responsibility and accountability to do a 'due diligence' clinical check to make sure the refill is appropriate. However, that is my personal/professional opinion and in practice, refills (but not new meds or changes) are pended by MAs.

Lastly, there are many functionalities in EPIC that allow for non-provider prescribing by choosing option for protocol without provider signature, so staff need to know that just because they have access and can do something, doesn't mean they should do it!

Regards,

Jaclyn

I have found several old discussion on this topic. Looking for updated thoughts. If you are in PA that is even better. 

We currently have MA's and Pharm Techs who pend medication refills to the provider in Epic. The provider then signs and routes to the pharmacy. 

We use several protocols in Epic to help us speed up the time it takes to pend medications for chronic conditions such as HTN, high cholesterol, acid reflux, etc. 

It has been proposed that we should consider having the MA's and Pharm Techs route these medications directly to the pharmacy and have the provider co-sign after. 

We do use this process with RN's on a limited basis for urgent after hours chronic refill needs (no controls). 

Looking for thoughts from those who use a process like this and give your pros and cons. 

Thank you

Nicole

Hi, 

In NYS, probably most stringent. MAs and techs can pend meds but must be authorized / signed by provider prior to going to the pharmacy.

Agree with other comments, that would be considered prescribing, and could not be covered by a 'protocol.' We would consider that equal to reading the provider note, as that is still not a direct order. Our allowable protocols for ambulatory around medication are only for vaccine administration, associated treatment of anaphylaxis, and some select testing. Only an RN can use those orders. In some situations, the RN can also enter a 'verbal' order that requires co-sign  after the fact, however requires actual conversation, readback, documentation and is reserved for emergent situation.

From a safety perspective, I am always concerned with non-nursing personnel even pending medication orders because they lack the professional education, responsibility and accountability to do a 'due diligence' clinical check to make sure the refill is appropriate. However, that is my personal/professional opinion and in practice, refills (but not new meds or changes) are pended by MAs.

Lastly, there are many functionalities in EPIC that allow for non-provider prescribing by choosing option for protocol without provider signature, so staff need to know that just because they have access and can do something, doesn't mean they should do it!

Regards,

Jaclyn

I have found several old discussion on this topic. Looking for updated thoughts. If you are in PA that is even better. 

We currently have MA's and Pharm Techs who pend medication refills to the provider in Epic. The provider then signs and routes to the pharmacy. 

We use several protocols in Epic to help us speed up the time it takes to pend medications for chronic conditions such as HTN, high cholesterol, acid reflux, etc. 

It has been proposed that we should consider having the MA's and Pharm Techs route these medications directly to the pharmacy and have the provider co-sign after. 

We do use this process with RN's on a limited basis for urgent after hours chronic refill needs (no controls). 

Looking for thoughts from those who use a process like this and give your pros and cons. 

Thank you

Nicole

I have found several old discussion on this topic. Looking for updated thoughts. If you are in PA that is even better. 

We currently have MA's and Pharm Techs who pend medication refills to the provider in Epic. The provider then signs and routes to the pharmacy. 

We use several protocols in Epic to help us speed up the time it takes to pend medications for chronic conditions such as HTN, high cholesterol, acid reflux, etc. 

It has been proposed that we should consider having the MA's and Pharm Techs route these medications directly to the pharmacy and have the provider co-sign after. 

We do use this process with RN's on a limited basis for urgent after hours chronic refill needs (no controls). 

Looking for thoughts from those who use a process like this and give your pros and cons. 

Thank you

Nicole