Hi all,
We are getting ready to launch a pilot for our RN led Hypertension Clinic and wanted to connect with the group to see if anyone has a recommended workflow for ordering medication changes following a protocol.
How are organizations handling the RN "ordering" prescription changes per protocol? Our ideal state that we developed in our protocol has the RN ordering up-titrations themselves, but any medication changes or discontinuations are pended and sent to the provider to sign. In working with our e-health team, we noticed that if the RN, following the strict protocol, signs the order, the script goes out to an external pharmacy with the Authorizing Provider as the PCP, but electronically signed by the RN. We have concerns that a pharmacy will not honor that order because it is technically signed by the RN. We are not sure if this is our own perceived issue or if it is a real barrier. How are others handling this who have nurses follow a protocol for HTN med management?
Is there an option on the backend to adjust the signature to the authorizing provider (PCP)?
Is anyone using a pharmacist or an APP to be the "go between" that signs orders?
Is the RN sending orders for titration to an internal pharmacy versus external?
Are organizations having the RN pend all orders to the PCP? Or perhaps as a cosign? If using either one of these options, has this become a barrier to the patient getting their med timely?
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Jennifer Wagner MSN RN NE-BC
Lancaster General Health Physicians
Lancaster, PA
(717) 606-9110
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